Treatment on Hyperthyroidism

[VASANHF1]

Dear Doctor,
       My mother, aged 58 yrs, diagonosed for hypertyoroidism in the last week of May 2010. She had following complaints
a) dyspnea on exertion gr II
b) Palpitation
c) Lower Energy Level
d) Insomnia

Her TFT results are as follows
1) Total T3 : 282 (ng/dl) / Total T4 : 9.8 Microgram/ dl / TSH : 0.02 MicroIU/ml
2) AMA : 79.69 U/ml  / ATG : 333.33 IU/ml
3) USG Neck Report :
     Both the lobes are bulky in size and show coarse echotexture
     The Right Lobe Measures : 3.7 cm x 2.0 Cm x 1.3 Cm
     The Left Lobe Measures : 3.2 cm x 1.8 Cm x 1.5 Cm
     No focal Lesion are seen
     The isthmus is normal in size and measures 4mm in anteroposterior dimension
     Impression : Generalized goitre of thyroid
4) Report of 2-D Echo, M Mode, Doppler & Color Flow Study
     Final Impression :
      Normal LV Contractility LVEF 70%
      No LV Regional wall motion abnormality
      Normal Cardiac valves & chambers
      IAS & IVS Intact and Normal
      No clots or vegetations
      Normal Pericardium and pericardinal space
      Trivial Mitral & Tricuspid Regurgitation
      No E/o LV diastolic dysfunction

She is put on following Medicines and asked to do TFT after 40 days
1) Tab Neomercazole (5 mg) (1-0-1)
2) Tab Ciplar LA 40              ( 1/2-0-1/2)
    After starting these medicines she started feeling well after 2 days and medicines are also being administered regularly . But since last one week the symtomps are appearing again. She is feeling  pain in her legs with some difficulty to breath. Her energy level is also dropped
  I have following questions
1) Do these things are normal after starting medication.,
2) Are these the effects of medications.
3) Is the combination of above drugs is proper?
4) What should I do next?

Thanks & Regards

[Drsuresh]

i m Dr.suresh i seen ur mothers complaints,reports and medicines.it is rt for it bt for reappearing of same complaints might be poaaible due to low dose or diet to regulated and tft and haemogram with blood sugar to be check.

[Smilerdeb]

Ask your Mothers Doc to test for Graves Disease by running a TSI blood test.
Also while on anti-thyroid meds...your mother should have her levels tested every 2-3 weeks or she can ho higher in levels (hyper) or can go Hypo (low).
Hyperthyroidism is usually caused by Graves Disease.
Get this checked and also ask the Doc to test her levels again.
This time ..ask him to do FREE T4, FREE T3 and not the normal T's as those tests are outdated.
The rule of 6 week testing is no good for someone on antithyroid meds and a beta blocker and labs need to be done every 2-3 weeks or your Mother will be on a continuous rollercoaster of hyper to hypo and vice versa.

Been there, done that and it is absolute he//,

[Sherri90049]

I don't know if doctors respond on this site. I think they don't. I think you should call her doctor and let them know what's going on. Maybe they'll increase the meds a little bit. If they helped a little and then stopped, I bet she might just need a higher dose of one or both. But that is a question for her doctor only. I'm hypo (with Hashi's) and not hyper so not familiar with the meds. Good luck! That's great of you to look out for your mother like that! I hope she feels better soon. I wouldn't think hyperthyroid meds should do anything other than normalize her thyroid function (at least my hypo meds don't have side effects).