I am having hyperthyroidism which was diagnosed few days back. I am having symptoms like bulging eyes, tiredness,lack of sleep, anxiety and high heart rate. Doctor prescribed me carbimazole 10 mg which I started taking few days back. Thyroid sonography reports suggest cystic multinodular goitre. Largest cysts are of 5 mm and 3 mm respectively. The anti tpo test shows 202.6 iu/ml. T3 and t4 levels are close to upper limits and tsh is 0.003 .i was already having a nodule in thyroid which was discovered in 2019 thyroid sonography. But back then thyroid levels were normal. I don't know why suddenly this problem started. No family history of thyroid. please help.

Dr. Prabhakar Laxman JatharEndocrinologist50yrs exp

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Hello, thanks for the query. I have seen the details given. The treatment with carbamizole need to be given up to 18 to 24 months in some cases to effectively control excessive thyroid activity. So the treatment with carbamizole has to be continued. Every 3 to 4 months tsh and t4 levels need to be checked to see if normalisation has occurred. As regards the nodules if the size increases then there is a need to get fnac (fine needle aspiration cytology) to see if any untoward changes have occurred in the nodules. As regards hyperthyroidism if after 18 to 24 months of treatment tsh does not increase then rai (radio active iodine) therapy has to be used. So please continue the current treatment. If you have any questions please come back with all the details in a private conversation where I will be able to give specific guidance and recommend any medication if required. Thanks.  

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