[mrondinella]

in reply to: How much Tapazole is too much? Results tomorrow… #1068952

I was diagnosed with Graves’ disease several years ago, and have been taking Tapazole for the past 3 1/2 years. I am now 53. I am slightly hypothyroid (low free T4, normal T3) right now after taking between 15 and 17.5 mg/day, in two or three doses per day, since April 2009. Here is my personal experience: in February 2006, I was started on 20 mg per day, raised to 30 mg/day after 6 weeks, dropped to 20, then down to 15, all in a six month period. My FT4 fluctuated considerably, and I felt awful. Worse of all, I had a lot of muscle pain. This is my personal observation (please discuss any changes with your own doctor). Tapazole is a very powerful medication. In Europe, many doctors recommend starting with 15 mg/day and adjusting from there based on lab results and patient symptoms. For some patients like me, TSH alone may not be a good indicator of thryoid hormone levels. I still have very low TSH but am actually a little hypo right now. Be sure to ask to have your free T4 and free T3 checked along with TSH while your dosage is being adjusted. Secondly, try taking your tapazole in two or three increments per day. If you always take it with food, try to be consistent because food can affect how it’s absorbed in your GI tract. Be very compliant and consistent. If your doctor tells you to change your dosage, don’t try and do it in one or two days. Gradually decrease or increase your dosage. When I changed my dosage abruptly, I experienced extreme muscle pain because the thyroid hormones affect our muscles. At times, I had such severe pain and cramping, I couldn’t walk. But since I’ve made dosage changes gradually, this problem has gone away. If you need to cut your pills in pieces, you can buy a very inexpensive pill splitter at any pharmacy (I call mine my pill guillotine and it cost $5 at a discount store). Be diligent about taking your medication, be sure to get your free T4 and free T3 measured with TSH, and don’t make any abrupt changes in tapazole dosage all at once. Finally, because I am close to euthyroid on a fairly low dose of tapazole, I have opted not to do RAI or surgery at this time. Also, a final note: the main reason I was put on tapazole was because of fine hand tremor and elevated pulse/heart rate. For unrelated reasons (I became a platelet donor at my local blood bank), I also gave up caffeine about two years ago, and I am sleeping much better. (I was a caffeine fiend, drinking a lot of coffee and diet cola every day!) The hand tremor is gone, and my pulse rate is about 60 beats per minute. If you don’t have any other symptoms other than tremor and restlessness, in addition to Tapazole and beta blockers, you may also want to try cutting back or giving up caffeine. Best wishes to all of you.

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