[KimberlyOnline Facilitator August 3, 2012 at 10:17 am Post count: 4294]

#1171486

Carito71 wrote:

Kimberly wrote:

However, ironically, that same guidance document recommends that patients in Europe have a 50-60% chance of remission after 5-6 years on the ATDs.

This is very interesting. 50-60%? So 12-18 months could very likely be less. I wonder if longer than 6 years increases the %s. I’m thinking 50-60% is not much. It seems to be 10% per year on Rx … ???

Hello – Yes, the remission stats I’ve seen out of the U.S. after 12-18 months of therapy are around 20-30%. I’ve only seen one published study that showed higher rates than 50-60%, and that was a study out of Japan involving “block and replace” protocol, and to my knowledge, the success of this study has never been replicated.

[Carito71 August 10, 2012 at 9:15 am Post count: 333]

#1171487

karebear wrote:

Caro, I have been on 30mg Methimazole for a week and a half. I don’t do labs until September. My endo said that I will be on it about a year and then I will ween off of it. Hopefully go into remission as several of her patients have done. If not we will discuss the next step then. My husband was worried about the liver issue and she said to watch for a yellowing of the skin and eyes. That shows the liver is not working right. Like a newborn and jaundice.
Just wanted you to know you are not the ONLY person taking a high dose.
Karen

Hello Karen,

Welcome to the forum. I’m glad you found us. I wish you all the best with the Methimazole. I’m glad that your Dr. is wanting to try it out for a year. I would recommend making sure, if all goes well with the Methimazole, that you are in remission (I’m still trying to learn what remission entitles) before discontinuing it. I’ve read that stopping it when your TSI #s are still elevated can send you back into a hyperthyroid state again. Your Dr will be doing labs for the liver and white blood cell count I’m sure. Mine is and up to now, my liver #s have not increased. They are high but not more than 3 times the normal so my Dr keeps me on the Methimazole. I just got my labs back. Take a look at them when you get a chance. Thank you for letting me know you too are taking a high dose. It can get scary. I think they will lower mine soon though. Keep us posted and thank you for the advice

Smiles,
Caro

[Carito71 August 10, 2012 at 9:24 am Post count: 333]

#1171488

Kimberly wrote:

Hello – Yes, the remission stats I’ve seen out of the U.S. after 12-18 months of therapy are around 20-30%. I’ve only seen one published study that showed higher rates than 50-60%, and that was a study out of Japan involving “block and replace” protocol, and to my knowledge, the success of this study has never been replicated.

It is almost like we would have to be on it for 10 years to achieve a 90-100% (if there is ever a 100% probability).

What exactly is “block and replace”??

Thank you for your input.

Caro

[KimberlyOnline Facilitator August 10, 2012 at 1:00 pm Post count: 4294]

#1171489

Hello – In the studies I’ve read, the remission rates still tend to level out at 50-60%, regardless of length of time on the meds.

Traditional Block & Replace therapy involves using large doses of Anti-Thyroid Drugs to shut down thyroid production and taking replacement hormone to normalize thyroid hormone levels. However, this option is not commonly used in the U.S.. The Japan study that I mentioned showed that the results of B&R were highly successful – but these results haven’t been replicated here in the U.S. Also, there is concern that the higher doses of meds may be correlated with a higher rate of side effects, including as liver and white blood cell issues.

Another option, which was mentioned by a presenter at our 2011 Boston conference, is that it can sometimes be easier to stabilize patients on Anti-Thyroid Drugs by giving the patient a consistent dose of ATDs, and then supplementing with a small amount of thyroid hormone replacement – if needed – to make sure the patient doesn’t go hypO.

[Carito71 August 14, 2012 at 12:49 pm Post count: 333]

#1171490

Thank you for the information Kimberly.

Caro

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