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Grave's disease

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Thyroid Gland is diffusely enlarged and shows hypoechoic parenchyma and increased internal vascularity.

Having a lump in the throat feeling, difficulty while swallowing (Already intaking carbimazole for hyper thyroidism for almost a year now).

Thyroid Profile on 24/08/2013

Serum T3 : 125 ng/dL
Serum T4 : 8.8 ug/dL
Serum TSH : 0.10 uIU/mL

Thyroid Profile On 10/12/2013

Serum T3 : 209 ng/dL
Serum T4 : 12.4 ug/dL
Serum TSH : 0.03 uIU/mL

Category: Endocrinologist

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Category: Diabetologist
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The profile is suggestive of Graves' disease! You have taken Carbimazole for over a year! The profile of Dec 2013 shows uncontrolled thyrotoxicosis, which means, if you have been on regular carbimazole in good dose, you will require radioablation! You may try carbimazole at the dose of 30 mg daily for 3-6months, and see if it remits, and then consider radio Iodine treatment, if not willing at present.

Hope this helps
Feel free to ask followups
Thank you

Col (Dr) J Muthukrishnan, SM
Senior Adviser (Med & Endocrinology)

Patient replied :

I guess the medical readings taken in december 10th was wrong. I did another check today from another lab. The readings are as follows
Serum T3 : 2.05 nmol/L
Serum T4 : 15.74 ug/dl
Serum TSH : 0.05 uIU/ml

I have been taken two tablets of carbimazole(5 mg) for almost an year now. So what do you suggest that I do at present?

I suggest that you take two tablets of Carbimazole 10mg every dayand repeat TSH and T4 test after every 2 mths for next six months. You can reduce the dose by 5mg /day once the TSH becomes normal or higher than 5 mIU/l. If the profile continues to show low TSH even after 6mths, you can consult for RadioIodine ablation treatment.

Dr. J Muthukrishnan
Category: Diabetologist
1. 10th Asia-Pacific Pediatric Endocrine Society  Fellows meeting, Seoul, Korea, Oct 2008
2. Eighth ICMR Course on Genetics and Genetic Counseling – Jul 2008 – SGPGI, Lucknow
3. Annual Certificate Course on Endocrinological Laboratory Techniques at National Institute of Nutrition (ICMR) Hyderabad,India, ( Aug-Sep 2006) 
Fellowship: Endocrinology, Diplomate of National Board, National Academy of Medical Sciences, New Delhi, 2008, Medwin Hospital, Hyderabad
Senior Residency: Diplomate of National Board (General Medicine), National Academy of Medical Sciences, New Delhi, 2002
Residency: MD, General Medicine, 1997-2000, Armed Forces Medical College, 2nd position in University
Medical School: MBBS, Armed Forces Medical College, 1992
Dr. J Muthukrishnan and 4 other Medical Specialists are ready to help you

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