Thyroid

[middleeast]

Dear Dr. Lupo,
In a 'nutshell', I live in the Middle East, so it is sometimes hard to get straight answers.  I was hyper and said to have all indications of Graves and was started on Carbimazole 30mg daily and Propranolol in 2007, now I am hypo for the last 1-3 months and on only 5mg daily of Carbimazole.  I do blood work every two months.  

Why am I still on Carbimazole if I am hypo?
I read somewhere you said something to the fact that you may not have Graves if you are now hypo.  What did you mean?
I am having weight gain.  Tell me what I can do to combat this and I will do it without question? I was taking B6/B12 daily as part of a diet which was working, can I continue to do this?
I am having hair loss which is driving me to tears most of the time.  The male pattern baldness seems to be it.  What can I do to combat this, injections, hair replacement therapy???
Also, I desperately want to get pregnant, how does this work with a thyroid problem/medication etc.?

Thank you so much in advance!
Sincerely, Michele

[Mark Lupo, M.D.]

nothing in life is 100% -- even a "normal" pregnancy is not 100% safe in terms of miscarriage, malformations, etc.  The safest (according to many) from a thyroid standpoint would be to have the thyroid removed surgically or ablated with radioactive I-131 then stabilize the Hypothyroidism with levothyroxine, then try to become pregnant (waiting at least 6 months after radioactive iodine).  Levothyroxine is considered safer in pregnancy than PTU (which is the preferred antithyroid medication over carbimazole/methimazole).  But PTU is very safe.

[middleeast]

Thank you so very much,

One other question about thyroid and pregnancy.  

Is there a 100% safe medication to be on while pregnant?  

My doctor said yes, but I don't know what medication he is taking about and I am very skeptical.

Although I desperately want to get pregnant, I will NOT do it, unless it is 100% safe for the baby, even if it is 99.9% safe and a slim chance of something happening to the baby, I don't think it is worth the risk.

Thanks again,
Michele

[Mark Lupo, M.D.]

If you are hypo on anti-thyroid drugs, then the dose of carbimazole is usually decreased (which it appears it has been) - you still likely have Graves, but are hypo due to the anti-thyroid medication.  Occassionally patients will swing to hypo from Graves -- this becomes a pattern more like Hashimoto's.

The weight gain comes with any type of treatment of hyperthyroidism -- exercise and calorie control are the keys.  B6/B12 is fine.

The hair loss is likely transient - unless it is true male-pattern baldness which may be due to excess testosterone and not related to thyroid.

Thyroid problems can cause infertility and increased miscarriage, so control of thyroid levels before and during pregnancy are key.

[middleeast]

Thank you once again, Michele

[ChitChatNine]

I'm so glad you got on to post to Dr. Lupo .. let us know what he says on the other thyroid board ok?  Cheryl