Graves' Disease Support Group
Graves-Basedow disease is a medical disorder that may manifest several different conditions including hyperthyroidism (over activity of thyroid hormone production), infiltrative exophthalmos (protruberance of one or both eyes and associated problems) and infiltrative dermopathy (a skin condition usually of the lower extremities). This disorder is the most common cause of...
I was diagnosed with GD about 5 years ago and stayed symptom free until about 6 months ago. Started having episodes of pulse racing and not feeling well. Started on Atenolol 25 mg once a day and then about a month later started on Tapazole 5 mg. 2xday. After 4 weeks on the Tapazole started itching all over. Dr. ordered bloodwork and my thyroid levels were improving but my liver was showing inflammation. He does not recommend PTU for me and wants to do RAI. After reading all the posts I will not be jumping right into that. Anyone else have problems with the Tapazole and what was your next step?
Just wondering if your doctor ordered any baseline liver lab work prior to starting the Tap? It is a must because for so many of us with GD, our liver numbers are slightly elevated.
Please post your lab results with the liver numbers. In order to truly have a liver problem, the numbers have to be in the tens of thousands over. If only slightly elevated, it is not a cause for an alarm. Because once thyroid levels gets in range and the doses are reduced, the 'slight' liver numbers drops.
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If your Free Ts are lower than at the mid ranges, heading hypO, you are most likely ready to reduce. If that's the case, your liver numbers will be up because you are likely overmedicated. Then this means you have responded very well to the Tap.
We do not look at the TSH or dose by the TSH as it is a pituitary hormone and doesn't get dosed by any meds that one takes for their thyroid problem.
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I will say this much...if these were my Free Ts, especially the FT4, it's time to think about doing the dose reduction with the Tapazole. You have responded so well to the meds and that's wonderful.
Again, ignore the TSH, it's a Pituitary hormone, does not get dosed by any thyroid meds and it is also affected by thyroid antibodies. Thyroid antibodies will give the TSH false readings. It also lags about six weeks behind the current Free Ts readings. Only the Free Ts are the accurate and true readings at the time.
The only time you'd want to pay attention to the TSH if all of sudden it jumps up sky high as an indicator of going hypO along with the very low Free Ts.
Again, your liver number is not bad. These should go down once dose reduction with the Tap has been made. I would discuss with the doctor ASAP to reduce you. If he's dosing to get your TSH to come up, look for another doctor who looks only at the Free Ts.
Your FT3 is also getting in range so it means the Atenolol can be reduced. I used a pill cutter to start cutting and weaning down from it. Quitting cold turkey will make one go back rebounding hypER again quickly.
Your thyroid levels were not too bad to begin with in the first place which is why you responded so well.
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I do believe that if it were me, I would be telling my doctor to do his/her own research and understand that liver numbers can come up for some people when their thyroid levels drop down too quickly.
Your liver numbers are nothing to worry about. If you truly had a problem, you would be something like in the ten thousand range such as 10,000 or much higher.
Ask your doctor to work with you about restarting the Tap but instead take in lowered doses. Maybe 2.5 mg in the AM, 2.5 mg in the PM for a total of 5 mg per day?
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I was also taking Methimazole aka Tapazole for 3 weeks, was reponding well when the uncontrollable itching started. My endo switched me to PTU. I've been on PTU for 3 months and I'm responding well. My liver is fine and I get labs every 3-4 weeks to make sure. Do your own research and don't let anyone push you into a treatment that may not be the right one for you.
Pam