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What Causes Palpitations On Increasing Dosage Of Methimez?
Question: .Dear doctor, I am female age 32 yrs, am taking treatment for hyperthyroidism since 1 yr three months, now my tsh is 2.7, t3 is 67ng/dl , t4 is 6.4. Am taking methimez 10 mg , before one month my endo doctor reduced my dose to 5 mg and I got palpitations. I went to local physician he asked me to take propanolol 4o mg twice for bp and palpitations plz advise me what is my thyroid condition and how will it get completely cured. Now again she (endo) adjusted my dose to 10 mg.
Brief Answer:
Thyroid
Detailed Answer:
I understand what you are saying. Managing hyperthyroidism can sometimes pose challenges. Occasionally you could experience fluctuations which cannot be attributed to your methimez dose adjustments alone. Your endocrinologist is trying to help you by reducing the medication doses to see what is the lowest possible dose you can get by with. I do the same for my patients. The propranolol started by your physician is also a reasonable way to control palpitations. However I suggest you adhere to one doctors treatment and follow up regularly for best results.
Thyroid
Detailed Answer:
I understand what you are saying. Managing hyperthyroidism can sometimes pose challenges. Occasionally you could experience fluctuations which cannot be attributed to your methimez dose adjustments alone. Your endocrinologist is trying to help you by reducing the medication doses to see what is the lowest possible dose you can get by with. I do the same for my patients. The propranolol started by your physician is also a reasonable way to control palpitations. However I suggest you adhere to one doctors treatment and follow up regularly for best results.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear doctor thank u for the reply, how are my thyroid levels? plz tell me and can my hyperthyroid be cured completely. Plz tell me does methimez 10 mg and propanolol 40 mg have any side effects . I am getting muscle aches and palpitations now and then. Even though my thyroid levels are normal why am still having symptoms. Plz tell me sir. Can I plan for second child or will the disease flare up or come back after delivery. I have one degree goiter, no eye disease, no dermopathy.
Brief Answer:
Follow up
Detailed Answer:
1 Your thyroid levels seem fine, although if you want a precise answer then you will have to mention exact ranges for normal on your laboratory report. This is because different labs may use different methods to check T3 and T4. And so their normal ranges vary too.
2 Whether your thyroid can be cured completely depends on the cause of hyperthyroidism. For example if you are found to have Graves disease, then there is about a 30% chance it can spontaneously go away after 12 to 18 months. But f it is due to a single or multiple over-active lumps in your thyroid then they typically tend not to get better, and require more definitive treatment such as radiation with Iodine 131 or surgery
3 Methimez can have side effects like any other medication in the world and in the history of medicine. Some people tolerate it just fine while others may get itching in the skin. There is a rare side effect of it called Agranulocytosis i.e. lowering of a certain type of white blood cell. Discuss details of this with your endocrinologist as to how you need go about watching out for this.
4 Propranolol also has a number of side effects but that does not mean you will invariably experience them all. One example is lowering of the heart rate below normal i.e. below 60
5 If your thyroid levels are fine which they appear to be, the it is unlikely your muscle aches and palpitations are due to thyroid. Let your doctor examine you thoroughly and consider other possible reasons. For instance, muscle aches can occur due to vitamin D deficiency too.
6 You can plan a child but you must keep your thyroid stable and stay in touch with your endocrinologist as methimez may need to be changed to a different medication called PTU (Propyl Thio Uracil) in the first three months of pregnancy. Do not get pregnant unless you are under regular close guidance of your endocrinologist.
7 The disease can become milder in some cases during pregnancy, and may revert to its pre-pregnancy status soon after delivery
Follow up
Detailed Answer:
1 Your thyroid levels seem fine, although if you want a precise answer then you will have to mention exact ranges for normal on your laboratory report. This is because different labs may use different methods to check T3 and T4. And so their normal ranges vary too.
2 Whether your thyroid can be cured completely depends on the cause of hyperthyroidism. For example if you are found to have Graves disease, then there is about a 30% chance it can spontaneously go away after 12 to 18 months. But f it is due to a single or multiple over-active lumps in your thyroid then they typically tend not to get better, and require more definitive treatment such as radiation with Iodine 131 or surgery
3 Methimez can have side effects like any other medication in the world and in the history of medicine. Some people tolerate it just fine while others may get itching in the skin. There is a rare side effect of it called Agranulocytosis i.e. lowering of a certain type of white blood cell. Discuss details of this with your endocrinologist as to how you need go about watching out for this.
4 Propranolol also has a number of side effects but that does not mean you will invariably experience them all. One example is lowering of the heart rate below normal i.e. below 60
5 If your thyroid levels are fine which they appear to be, the it is unlikely your muscle aches and palpitations are due to thyroid. Let your doctor examine you thoroughly and consider other possible reasons. For instance, muscle aches can occur due to vitamin D deficiency too.
6 You can plan a child but you must keep your thyroid stable and stay in touch with your endocrinologist as methimez may need to be changed to a different medication called PTU (Propyl Thio Uracil) in the first three months of pregnancy. Do not get pregnant unless you are under regular close guidance of your endocrinologist.
7 The disease can become milder in some cases during pregnancy, and may revert to its pre-pregnancy status soon after delivery
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear sir
Thank u very much for ur valuable information, sir I was diagnosed hyperthyroid three yes after delivery when my tsh was 0.1. From Feb 2014 am on antithyroid drugs, in between my tsh went to 23.1 when I was using methimez 20mg. Then my doctor told me to stop the drug for two months. After two months again my value of tsh was below 0.1. Then again she put me on methimez 10 mg and Till today I am on 10 mg . my tsh is 2.7(normal range is 0.5-5.5), t3 is 67.31ng/DL(70-204), t4 is 6.4(4.8-12.6), when previously my tsh went to 23.1, one doctor done abdominal scan in XXXXXXX 2015 for other reason my liver enlarged and fatty infiltration was noted. My doctor gave me ursomax300 for two months. Now again am experiencing pain in right side of stomach. Which medication should I take and I took metal spas for pain is it OK.? Also I had thyroid scan in which there are no nodules and the two lobes and isthmus are enlarged and report impression was thyromegaly. Plz sir I have one child and I thought of having two kids in my life. I am very much afraid of my life nowadays, will I get any other complications early in my life like diabetis? Sir plz sir am crying nowadays, I did M.Pharmacy and work in clinical research but when I think about thyroid am getting frustrated. Today I went to one homeopath he told if u use allopathy they are anti thyroid and ur body will have many changes by that drugs and he said u will be unablevto move after some days. He said u will get used to them. He told as ur thyroid levels are normal reduce ur methimez dose to 5 mg and use homeo. Sir if it is graves will it go away and if endo asks me to stop will my levels be stable. Or if it is better to use homeo for graves? Sir am getting frustrated will I become more fat? Homeo doctor told. Sir plz help me
Thank u very much for ur valuable information, sir I was diagnosed hyperthyroid three yes after delivery when my tsh was 0.1. From Feb 2014 am on antithyroid drugs, in between my tsh went to 23.1 when I was using methimez 20mg. Then my doctor told me to stop the drug for two months. After two months again my value of tsh was below 0.1. Then again she put me on methimez 10 mg and Till today I am on 10 mg . my tsh is 2.7(normal range is 0.5-5.5), t3 is 67.31ng/DL(70-204), t4 is 6.4(4.8-12.6), when previously my tsh went to 23.1, one doctor done abdominal scan in XXXXXXX 2015 for other reason my liver enlarged and fatty infiltration was noted. My doctor gave me ursomax300 for two months. Now again am experiencing pain in right side of stomach. Which medication should I take and I took metal spas for pain is it OK.? Also I had thyroid scan in which there are no nodules and the two lobes and isthmus are enlarged and report impression was thyromegaly. Plz sir I have one child and I thought of having two kids in my life. I am very much afraid of my life nowadays, will I get any other complications early in my life like diabetis? Sir plz sir am crying nowadays, I did M.Pharmacy and work in clinical research but when I think about thyroid am getting frustrated. Today I went to one homeopath he told if u use allopathy they are anti thyroid and ur body will have many changes by that drugs and he said u will be unablevto move after some days. He said u will get used to them. He told as ur thyroid levels are normal reduce ur methimez dose to 5 mg and use homeo. Sir if it is graves will it go away and if endo asks me to stop will my levels be stable. Or if it is better to use homeo for graves? Sir am getting frustrated will I become more fat? Homeo doctor told. Sir plz help me
Brief Answer:
Second follow up
Detailed Answer:
The answers to many of the questions you are asking require the opportunity to examine you in-person and in detail.
What you need to understand clearly is that endocrinologists are highly qualified specialist doctors trained in managing thyroid problems.
I am not aware of any medical publication or scientific evidence of homeopathy helping the thyroid.
Just find an MD DM endocrinologist near you, whom you are comfortable with , and faithfully follow the treatment recommendations.
If you have Graves disease it can be challenging to treat at times. So you will need dedicated care and regular follow ups.
Seeking step by step treatment for a complex condition like yours is not possible on an online forum like ours.
Second follow up
Detailed Answer:
The answers to many of the questions you are asking require the opportunity to examine you in-person and in detail.
What you need to understand clearly is that endocrinologists are highly qualified specialist doctors trained in managing thyroid problems.
I am not aware of any medical publication or scientific evidence of homeopathy helping the thyroid.
Just find an MD DM endocrinologist near you, whom you are comfortable with , and faithfully follow the treatment recommendations.
If you have Graves disease it can be challenging to treat at times. So you will need dedicated care and regular follow ups.
Seeking step by step treatment for a complex condition like yours is not possible on an online forum like ours.
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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