Would discontinue the supplemental iodine.
You have Graves' disease. Usual dose of methimazole for this situation is 10-15mg/day total. We use the beta blocker (like metoprolol -- also atenolol is used in these cases). It takes 4-6 weeks to normalize levels. In some cases of more symptoms, higher numbers, the dose of 20-30mg/day is used, but higher doses equates to higher side effects and unless the T4 is very high to begin with, the lower doses are more appropriate.
Dr. Mark Lupo, M.D.:
Thank you very much for your response. I have started slow with the methimazole and had tremors in my feet taking just 20 mg per day. I took an extra 10mg yesterday and I had severe palpitations at night and slept only half the night. I was trying to slowly go up to the 40mg a day. My symptoms were worse end of July and early August 2010. I did mention that to the endocrinologist and he based everything on the blood test and thyroid uptake that was done through my internist's office the beginning of August 2010. He saw my right hand was shaking a lot and he said my thyroid was very warm and I had some palpitations when he listend to my heart. I still have a fast heart rate with some palpitations in the morning and my right hand only shakes a lot. I always had a fast heart rate of 90-100 most of my life.
My internist said the same thing that the dosages of the medications seems a bit high especially with my sensitivities to medicines. I want to mention your response to the endocrinologist yet don't want to get him annoyed. We are very limited in the area I live in for thyroid specialists. I could just take the lower amounts and see how my blood tests come back. That is schedule for 11/11/10 which I thought blood work would have to be done sooner?
Thank you again very much for your response and any additional information would be appreciated.