What Causes Feeling Of Warm And Cold Sensations Even After Carbimazole Intake?

Posted on Wed, 27 Aug 2014

Question: hi my doctor says i have hyperthyrodism.....i was initially admitted with high palpitation of 175. They say this arterial fibrillation. The Dr to then put me on carbimoze to supress by hormone. My TSH 6was 0/pmol/l, while my T4 was 27.4 above the normal by 5.4. since taking the drug i dont see any changes.. i feel my body is warm and my feets are cold

Answered by Dr. Binu Parameswaran Pillai (4 hours later)

Brief Answer:
hello

Detailed Answer:
Hello
Good day.
Noted your points.
From the history it appears that you have atrial fibrillation. They have found that you have hyperthyroidism. Carbimazole takes up to 3 weeks for the effects. I hope your doctor also started on medicines to reduce your heart rate like inderal (propranolol). This will help to reduce your heart rate. How is your heart rate now. ? What dose of carbimazole are you on?
Regards
Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (3 hours later)

Hi Docs, thanks I wish to upload the full medical report from my Doctor later in the day. The thing is i dont thing the heart racing any more. I take carbimoze 30mg daily now. I was initially put on amiodarane 200mg daily and paradaxa 110mg for one month, but, i stopped this after first week because i was not feeling well with them. I am now on 5mg on nebilet daily. Since taking the drugs i feel more sick now. That is why I am seeking a second opinion. I am not sure whether the problem is the heart or the hormone imbalance

Answered by Dr. Binu Parameswaran Pillai (36 minutes later)

Brief Answer:
hello

Detailed Answer:
Hi
Carbimazole 30 my is a good dose. For the heart rate control you are now on 5 mg Nebilet. There are several side effects of Carbimazole. Nausea, vomiting etc to more serious side effects like altered liver enzymes atelterednd blood count. If you are not feeling well on this drug , it may be worthwhile checking a full blood count and liver function test.
Another thing to consider is a Nuclear scan of thyroid. You will have to discuss these issues with your treating doctor. I will await your blood report attachments.
Regards
Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (8 hours later)

Thanks sir. I have attached my medical report from my doctor.In one of your earlier thread you had asked if my Thyroid glands are enlarged? no they are not. Also, i think they had put me on Amiodarone initially but was withdrawn later. Kindly see the medical report attached. I dont think i am inadequate carbimazole. cos my elevated T4 was not very high and i can go the opposite if i take more doses. Nuclear scan ? no idea if they have but i will ask my doc.

My current symptoms are: feeling hot inside my body, fatigue, and having cold feet while my other body feels hot though taking the temperature is normal. I dont feel my heart racing. My BP is around 83/130.

Answered by Dr. Binu Parameswaran Pillai (5 hours later)

Brief Answer:
Hello

Detailed Answer:
Hello
Thank you for attaching the detailed medical report. I feel a nuclear scan is highly indicated in your case. The symptoms which you experience now could be due to the overactive thyroid or due to the carbimazole itself. You need another Thyroid function test, CBC and liver function tests.
In your case, the thyrotoxicosis could be due to Thyroiditis, Graves disease or a toxic thyroid nodule. Amiodarone can further make the thyroid function worse. A nuclear scan is highly recommended in your case. This will help an endocrinologist to prescribe you correct treatment.
I realize that you are under the care of a cardiologist. However, you require an endocrinology evaluation and well.
Regards XXXXXXX

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (2 days later)

Hello sir, I am still doing the test, but wanted to ask you from my result i sent you my AntiTG was abnormal low to <6.4IU/ml and Mt Anti TPO was abnormal low to <0.8IU/ml what does this indicate.. please explain in a lay mans term

Thanks,

Answered by Dr. Binu Parameswaran Pillai (3 hours later)

Brief Answer:
Hi

Detailed Answer:
Hi,
Anti TG and Anti TPO are thyroid antibodies. These tests are usually done to find out if the thyroid disease is auto immune in nature or not. Your levels indicate that, you do not have high levels of these anto antibodies and hence you do not have auto immune thyroid disease. Dont worry of low value. This is usually low in most people. These test results become high in case of auto immune thyroid disease.
you may need a TSH receptot antobody test + A nuclear scan.

Regards
Binu

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar