Hello doctor, I am a 54 years old male. I was detected with hyperthyroidism for the first time when I was about 32 yrs. And was on carbimazole at min. Dose for few years before I happened to see a homeopath whose prescribed medicines effectively controlled my thyroidism. Eventually I didn't require to take any medicines for next few years without any issue before developing the symptoms again with abnormal lab test parameters and severe weight loss. That required me to start carbimazole again at moderate dose to regain my lost weight and continued with the min. Dose to maintain the condition thereafter. About three years back, I started to lose weight again and continued to lose after losing about 10 kg. So I had to increase my dose and followed a diet prescribed by my nutritionist and regained most of the lost weight within few months. Recently about a year back, I started to lose weight again and I increased the dose to offset the weight loss. But a recent lab test shows my tsh level as way too high. I don't remember of having my tsh level ever so high, in fact it was mostly very low, beyond measure. So my doctor obviously asked me to stop the carbimazole immediately for about 2 months before doing the lab test again for the results. My doctor explained that since my hyperthyroidism is a chronic condition which is an autoimmune disorder that might reverse the condition after some years. Well, I have lost more than 10 kg this time too. Please be informed that I am taking vitamin d as well and I use to take that occasionally since last few years. I have also been taking a tablet of nebivolol 5 mg daily to control my high blood pressure for almost 10 years. My cholesterol parameters have been high although the triglyceride is normal for several years but I am not advised for any medicine for that rather I try to follow the restrictions. Please suggest me the course of treatment as well as diet plan and do's and don'ts to regain my weight quickly. Thanks.
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Hello, Thanks for the query. I have seen the details given. However, there is no mention of actual TSH and T4 levels and even the dosage of Carbimazole. Based on whatever stated in the details, the reason for high TSH is excessive dosage of Carbimazole . Normal TSH expected to be maintained around 3 to 4 mU/L at which level most of the symptoms related to thyroid conditions are absent. Another aspect which is very important point is in case of hyperthyroidism in quite a few patients after 18 to 24 months of treatment with carbimazole become normal. Hyperthyroidism invariably subsides. The disease may not come back at all. However, in many cases after a few months to a year hyperthyroidism may come back. Then taking Carbimazole may not be beneficial. Then other measures like treating radio active iodine(RAI) which stops functioning of thyroid gland and then patient becomes hypothyroid (TSH goes up). Another method is to remove thyroid gland. Then continue to take Levothyroxine (T4 ) as a regular treatment for rest of life time. Since you have not given other details which are needed, no further comments can be made. So please do come back with all the necessary information. Thanks.
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