[adenure]

#1059029

Hi all,

I got my liver tests back today (emailed via Kaiser), but I haven’t talked to my doctor yet. I’m on hold w/ Kaiser trying to figure out what to do. Please, any advice, knowledge, support. I’m so upset I’m in tears & so discouraged.

Labs after 7 weeks of 5 mg. of methimazole

ALT: 323 (normal 14-54)
AST: 233 (normal <31)

Alkaline phosphatase: 109 (normal: 20-125)
Bilirubin total serum: .9 (normal: .1-1.0)

I haven’t gotten my actual TSH or Free 4 results back yet.

Alexis

[snelsen]

#1171653

Hi Alexis, I am sorry it is Friday, maybe you got to talk to someone by now.
The labs which indicate liver function are high, that is why they called you. I imagine your ATD will be discontinued. After that happens, your numbers will probably go down. You will be oK. They are on top of this. Of course you know that I am not a doctor, but when you are not familiar with any of this, it is scary. I have worked in a hospital for years, and haves seen these kinds of numbers before. First thing is to stop the drug, then the labs generally go back to normal. Your docs will decide if they want to switch you to the other ATD. Both of them have this rare side effect. The important thing is you will be ok, liver-wise, and Graves’ wise. Did you talk to someone?
Shirley

[adenure]

#1171654

Hi Shirley,

I did get to talk with a doctor who advised me to stop taking the methimazole. He ordered another round of liver enzyme tests for Monday to see if they start coming down (to rule out any other causes if they were to continue to rise). I have a beta blocker (Inderal/ propranolol) prescribed in case my symptoms start to come back (heart rate/ tremors)- 10 mg. 2x’s a day. I’ve never taken it, so I’m not sure how that would go. Anyone with experience there? I’m not sure what my thyroid numbers are.

If I have to choose RAI or surgery (which it would appear I’ll have to do as I don’t think they’ll prescribe PTU based on my liver numbers on methimazole, but who’s to say I guess- I haven’t asked yet), I would prefer surgery. Is that out of the question if my numbers aren’t normal? Do I HAVE to do the RAI? Thanks for the support; this is hard.

Alexis

[adenure]

#1171655

I have Atenolol too- I’ve never tried either beta blocker? What are all of your experiences there?

Alexis

[Bobbi]

#1171656

I took propanolol. It protects the heart somewhat from arrythmias that can result from being hyper. (Too much thyroid hormone can mess up the heart’s pattern of beats — and this can be very dangerous.) It also masks some of the symptoms of hyper — it calms the tremors and it helps a bit with sleeping. Don’t be fooled, though. If it makes you feel better (and it probably will), it is not controlling the thyroid levels at all. And it is those levels that are the danger.

[catstuart7]

#1171657

I’m on propranolol too. It is invaluable, but beware of the mental side effects. It can give you a bit of brain fog and depressive thinking. Atenolol is a little better on this front because it doesn’t go as easily through the blood-brain barrier as propranolol. I react to it too much though. Again good luck to you getting it sorted all out.

[Claire95]

#1171658

I am on propranolol and I haven’t had a problem with it. The first time I took it I got very sleepy but I’ve been fine since then.

[adenure]

#1171659

catstuart,
What do you mean that you react “to much to it”? Your pulse gets too low? The dose I think I was prescribed was 1 pill- a minimum dose. 25mg. and the 25 mg. be cut in 1/2?

Alexis

[snelsen]

#1171660

Hi Alexis,
my thinking is that you are getting very good medical care, and the doc is being very vigilant and conservative with your very small dose of propanolol.
Propanolol is used for various things, generally to decrease heart rate, and sometimes to lower blood pressure. I think it is a good idea for you to follow his advice as prescribed. The things you should be aware of, are a very decreased pulse rate (below 50, as a guideline) or a very low blood pressure
(below 90/60) but with the small dose you are taking, both of these things are a non-issue most likely. I suggest you take your pulse and BP before you begin the drug, so you know your baseline at that time. Also, if you are super concerned, talk with a pharmacist this weekend. In summary, you are in good hands, good care and in this case, the experience of others is so variable, based on all of their health, plus the dosage of the beta blocker, it is not helpful to be concerned about what you hear or read. Whatever he has prescribed after your conversation, is what I would do.
Shirley

[catstuart7]

#1171661

Oh by “too much” I mean after I take atenolol and also metoprolol for a couple of weeks, I start to react even more strongly to them, even small amounts. Like a quarter of a 25mg pill can take my pulse down to the 60’s and BP to being around 100/60. Too low to be safe or feel good. I’m not sure why I start to get the exaggerated response over time – my doctors have never had a good explanation and say it is an unusual reaction. So far the propranolol doesn’t do that and I feel safer with it because it has a short half-life compard to the others. And yes you can cut the 25mg in half and take it 12 hours apart, that will help you to feel less groggy.

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