Topic of the Week
Anti-Thyroid Med Facts
Topic of the Week!
Anti-Thyroid Med Facts
There are only two meds that lower thyroid hormone.
Tapazole (TPZ), Methimazole (MMI), Carbimazole (CBZ), Thiamazole and Neomarcazole are all the same medication. They have different names in different countries and the dosing is slightly different but they all have the same active ingredient. With proper use it is excellent at reducing and maintaining optimal thyroid levels and has mild antibody reducing properties. For expediency I’ll use the term MMI in this teaching session but I’m referring to all of the above variations.
Propylthiouracil (PTU) is the inferior med that is less effective and has more side effects but is a good alternative during the first trimester of pregnancy or in cases of a true allergic reaction.
Note: allergic reactions like rashes with MMI that occurred after taking several doses are not true allergic reactions, they’re just an indicator that your dose is too high. A true allergic reaction will occur with the first dose or two. Unless you have a true allergy to MMI do not switch to PTU. I will talk about MMI going forward in this lesson but most is also true for PTU, just keep in mind it is the inferior med so it’s benefits will be the same but with less efficacy and more potential side effects
MMI is safe long term in low doses. Emphasis on low doses. See the 10 year study posted in my Files Section that proves this. Or just believe the thousands of us here in this group who successfully achieved full antibody remission with long term low dose MMI. If you’re needing a dose higher than 5mg for more than 3 to 6 months, there’s a problem that can be resolved with proper limiting of iodine in your diet. I cannot teach about this in the group setting as it’s entirely individual so if this describes your situation, please get with me for a 1 Hour Consultation and subsequent Lab Interpretations so I may teach you based on your individual needs.
MMI has a short half-life of only 5-6 hours. In order to get the antibody reducing properties we must split our daily dose and take it a minimum of twice a day. The manufacturer actually recommends three times a day but with proper management I’ve found twice a day is sufficient to get the antibody reducing properties.
MMI will lower both thyroid levels and Graves antibodies. However, it is fabulous for lowering thyroid levels quickly but lowering antibodies takes a long time and must be combined with long term proper management. Average time to antibody remission is 2 to 4 years. So, commit to the long haul. Slow and steady wins this race.
Doctors are not taught how to properly use MMI in med school. They’re taught to only use it to lower thyroid levels out of thyroid storm range then remove or ablate the thyroid ignoring the actual cause of your hyperthyroidism which is the autoimmune disease of Graves. They use doses that are too high then use dose adjustments that are also too high causing a yo-yo effect of thyroid levels being too high then too low, then too high, then too low, and on and on. This only leads to miserable symptoms and hair loss. It will NOT achieve antibody remission.
We must continue MMI until full antibody remission is achieved. Read that again! Stopping meds when only your thyroid is under control will not lead to antibody remission. In order to get the mild antibody reducing properties we must continue low dose, long term MMI until full antibody remission is achieved and maintained for at least 6 to 12 months. Remission is term only used for antibodies NOT thyroid levels. You doc may use the term remission when talking about thyroid levels but he/she is WRONG. This is the big red flag that indicates your doc is not Graves savvy.
If you’d rather use an herbal protocol than anti thyroid meds just know that full antibody remission is unlikely to occur. Bugleweed (none of the other herbs you read about) will lower thyroid levels in milder cases but it does not have the antibody reducing properties that meds do. In the rare cases where antibody remission is achieved using bugleweed, it takes an average of 7 to 10 years of maintaining optimal thyroid levels and that in itself is difficult to achieve since the herb’s efficacy can be different from batch to batch. If that’s your choice, I will help you but I don’t teach it in the group setting and I don’t recommend it as the best way to manage your thyroid or get into full antibody remission.
MMI does not cause liver damage, per se! When your dose is too high it can raise liver enzymes but this is easily resolved by lowering your dose and adjusting your diet. If your doc ignores these elevated liver enzymes and continues to use too high of a dose for a year or more then eventually mild damage can occur. But who would do that? As bad as our doctors are at managing this disease with the thyroid intact, few if any are that bad.
Agranulocytosis (low white blood cell count) is another potential side effect of MMI but again, it’s only with higher doses and is easily resolved with lowering the dose and adjusting iodine intake in the diet.
If you’re on more than 10-15mg of MMI for more than 6 months your doc is likely not Graves savvy and is over medicating you. Docs mistakingly believe that by making you hyPO they’re helping you. This is false!! They’re not helping you, they’re making you miserable. Some will do this intentionally in the hope that you’ll choose to remove or ablate your thyroid. And most just simply don’t know any better. Don’t let them use a sledgehammer on your thyroid levels, a chisel is the preferred tool! Slow and steady wins this race!
Reminder: This is a teaching group. Please limit comments to valid questions. Inaccurate advice will be removed without notice.
