[Carito71]

#1059518

Hello everyone.

Has anyone here experienced low WBCs (White blood cells) when taking Methimazole? How was it handled by your Dr.?

I’m concerned about my WBCs because they went all the way down to 3.44 (normal range = 4.8-10. at my Sept’s labs. In Nov (2 weeks ago), after lowering the dose for a month, they went back up to 5.42. My Dr. has kept me at a low dose for the next month and we are hoping that they don’t go back down but if they do, I’m afraid that my Dr. will discontinue Methimazole. I want to stay on Methimazole and try achieving remission. He is not very comfortable with Methimazole it seems like. Every time I go to my visits, he mentions RAI and TT.

I did read that about 10% of patients with untreated hyperthyroidism have leukopenia (low WBC count). When I was first diagnosed in June and before starting Methimazole, my WBC count was 4.17 (a little low).

Your experiences on this subject is greatly appreciated.

Thank you,
Caro

[Bobbi]

#1175324

The low white cell count is one of the more hazardous KNOWN side effects of the antithyroid drugs. White cells are a part of the immune system’s response to infection, and if the drug suppresses the count sufficiently, you could become very sick, even deathly ill, with an infection. Your body might not be able to fight it off. I realize you’ve placed your hopes in the single bucket of remission, but, quite frankly, the other treatments work without this risk to give us back our health. It’s one thing if the drugs work well for you. But since they don’t, you would be wise to explore one of the other choices.

[Carito71]

#1175325

Thank you Bobbi.

We are waiting to see what next labs will show. As of right now, my WBC is normal and I’m on a slow dose. When I was at 3.44 in Sept. I was feeling fine. Actually, I was feeling a lot better than I did when I was hyperthyroid. I’m hoping that after this month my WBC continue to be normal but you are right, if the Methimazole starts to lower my WBC to dangerous levels, I will definitely consider TT. I wonder though if they got to 3.44 b/c I had been hyperthyroid and being hyperthyroid can lower them. Thank you again.

Caro

[Kimberly]

#1175326

Hi Caro – I think I’ve had two cases in the last 5 years on methimazole where my WBC was slightly below normal. My own doctor’s approach in these instances was to “watch and wait”.

The really serious side effect that occurs (agranulocytosis) involves a severe reduction in WBC count, and is often accompanied by a sore throat or fever.

In fact, if you read the latest medical guidance (in the “Treatment Options” thread in the announcements section of the forum), there is actually some controversy over whether WBC should be tested routinely for patients on anti-thyroid drugs, or whether it is sufficient to do testing if worrisome symptoms occur.

Take care!

[Bobbi]

#1175327

Actually, I think it is a mistake to tie agranulocytosis with a sore throat. That is ONE of the indicators — a severe sore throat that does not go away — that doctors tell us to watch for. But the issue is that an INFECTION takes hold and there is insufficient white cell count (plus other immune thingies perhaps) to fight the infection.

[Kimberly]

#1175328

Just to clarify, the latest medical guidance recommends testing with sore throat and/or fever — so fever with or without a sore throat would be something to watch for as well.

But it’s also important not to panic over a slightly lowered WBC, but rather, to follow your doctor’s instructions for future monitoring/testing.

[Carito71]

#1175329

Hello Kimberly and Bobbi,

Thank you so much for your responses. I’m trying to stay positive.

Kimberly, hopefully mine is just one of those things like what happened to you. I’m so glad yours did not stay low and did not cause any problems.

When my WBCs were slightly low, I felt just fine. I felt happy b/c it was a big improvement from how I felt when I was hyperthyroid. Unfortunately my happiness was quickly outlived when my Dr. told me that it could be a potential problem and once again mentioned RAI and TT. I was content that he was willing to try a lower dose. My WBC came back up after that and I’m hoping that they stay up because even when they were back up he kept mentioning RAI and TT (I like my Dr but I really think he wants me to go RAI or TT … even if the Methimazole works and is not a problem ).

Bobbi, you are absolutely right. Without the WBCs our body would be in a pickle if one gets an infection. It could even transform into sepsis. Any sign or symptom of one developing an infection should be reported and in my personal opinion, labs should be ran just to make sure.

I read the other day that getting a good night sleep every night helps keep healthy WBCs … something that many times is impossible to achieve when one is hyperthyroid. I’m thinking that the low WBCs can be a combination of many things so the “watch and wait” that Kimberly’s Dr. recommended for a couple of days (and longer if there are not signs/symptoms of infection) is a good idea.

Thank you again for your responses. I feel much better knowing that it can be a temporary thing. As of right now, I’m not showing any signs/symptoms of infection

Have a great weekend,
Caro

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