Hyperthyroid

RE: Hyperthyroid

skatealexia — Tue, 09 Feb 2016 19:35:30 GMT

The result came back as 15 (<19) - below the NWL reference range. The other biochemistry initially etc unremarkable- the current one for monitoring- mildly raised urea 12.5 (8) (not creatinine) and mild increase in liver ALP 157 (>75) which I attributed to the thyroid disease. They were giving the tablets with food. I think I'll switch to EOD dosing and then retest in two weeks. Useful to find what other people do so thank you!

RE: Hyperthyroid

Andrew Kent — Tue, 09 Feb 2016 18:38:24 GMT

Hi,

I definitely see this occasionally, the theories are either concurrent disease suppressing T4 or early disease. Either way good evidence that being hypothyroid worsens prognosis so would make a change.

You will get lots of different views on what to do from a drug/dosing point of view - do you know if the owners were giving the tablets with or without food?

The absorption of carbimazole increases by 40% if given with food so if they have been doing so then giving without food essentially reduces the dose by 40%. Alternative with carbimazole is to give every other day which I have found works well in these cases (and as sustained release doesn't seem to cause significant fluctuations in T4).

But I am sure other people would switch to methimazole and I am sure either would be fine :-)

Andy

RE: Hyperthyroid

Stuart Munro — Tue, 09 Feb 2016 18:37:45 GMT

Hi, you haven't given the most recent T4 result, but I'm assuming it is now low (<12.5 or whatever your lab's ref range is). I would now try 10mg eod and check again in 10-14 days. What's did the rest of the biochem look like? You might find you have more flexibility with Felimazole in cases like this.