General Medicine

» gemmagirl - is pregnancy safe on neomercazole?

hi there
I was diagnosed with Graves about a week ago and ever since have been madly reading! Am yet to see a specialist but i'm a bit alarmed by something my dr told me when i was initially diagnosed and wanted to ask our opinion to see what you thought ... she's put me on neomercazole (carbimazole) and has told me that a) i can only be on this for a maximum of two years because it's quite a 'nasty' medication and will therefore practically definitely have to have either surgery or radiotherapy in the near future (remission is out of the question according to her) and b) i can never, never, never consider getting pregnant whilst i'm on neomercazole... this was quite sad for me and my partner and i decided about 4 months ago to start trying to conceive.. I realise that every situation/person is different etc, but i just wondered what your initial thoughts are re what my Dr has told me? is she on the money, or being a bit 'knee jerk'?
thanks so much!
gemmagirl

-- posted by gemmagirl

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» Elaine Moore - is pregnancy safe on neomercazole?

In response to is pregnancy safe on neomercazole? posted by gemmagirl:
Hi,
Carbimazole is widely used during pregnancy in European countries. Because it can cross the placental barrier, it's important to have your levels in control before becoming pregnant, and then using the lowest dose needed to keep your levels in control.
Carbimazole works by blocking iodine absorption, reducing the amount of thyroid hormone you can make. At the onset, when you first start on meds, you need a higher dose because the hormone stored in your gland is being released and you want to dramatically reduce the amount of hormone you can make.
After the first 6 weeks, the stored hormone is used up and you only need a minimal dose of Carbimazole, just enough to keep your FT4 level in range. Your TSH level will continue to be low for some time and this doesn't mean that you're still hyperthyroid. Most people can get by on a dose of 2.5-10 mg Carbimazole daily after the first 6 weeks. And over time, the dose usually needs to be reduced.
During pregnancy, thyroid hormone levels eventually fall and most people on anti-thyroid meds are able to stop meds completely or dramatically lower their dose. Best, Elaine

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» sunshine4818 - is pregnancy safe on neomercazole?

In response to is pregnancy safe on neomercazole? posted by gemmagirl:
Hey! i'm really glad i saw your post! I was diagnosed with Graves disease about 3 years ago. My TSH was less than .001...sorry i never remember what T3 and T4 were. But anyway, I went on 30mg a day of MMI. After 6 months of gradually decreasing the dosage...I was down to 5 mg a day maintenance dosage and my levels were all within normal range. My doc said i was in remission and recommended maintenace dose of 5mg of MMI a day. I decided to take my chances without meds.
3 years later my hubby and i start trying to get preggers. After 3 monts of no luck...i figure that maybe my thyroid is hyper again. I got back to the endo and i am out of remission. TSH is less than .001 again and T4 and T3 are way high. Doctor says no MMI this time since PTU is safer during pregnance.
After 6 weeks on 50 mg of PTU a day, my TSH is up to .006 and my T3 and T4 are now within nomal range!
I had a day 21 progesterone test done this cycle and it was positive for ovulation!! Both the endo and OB say that i should be able to conceive!
Hope that info helps!!
Good luck! keep me posted if you get preggers and on your levels and i'll do the same!
xoxo
Sunshine
***OH AND after reasearching what neomercazole is it is MMI (methimazole)! same thing as i was taking the first time i was hyper. If pregnancy is a priority, I would ask your doctor to switch you to PTU. MMI is more effective, and i knew it would work for me...but really what's the point if you can't get pregnant on it anyway!? ;)
OH AND ONE MORE THING haha...my first doc told me that my levels were so bad that it wasn't likely i would ever go into remission and tried to push iodine ablation! But i did go into remission, and i believe i will again! Also, i really don't like the odds of becoming hypOthyroid for the rest of my life that the iodine ablation brings!

-- posted by sunshine4818

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» gemmagirl - is pregnancy safe on neomercazole?

In response to is pregnancy safe on neomercazole? posted by sunshine4818:

hi Sunshine and Elaine
thanks so much for your posts - sorry i haven't responded earlier... been waylaid by a few things.
Anyway, all great info... Elaine - really interested to hear that neomercazole is used in pregnancy in other countries... isn't it interesting how you get so many different stories/opinions depending on who you speak to? Anyway, still super early days for me... i've got my next blood test at the end of august - and that'll be my first on the meds, so we'll see if it's made any difference.

Thanks also sunshine - huge congrats to you on ovulating - that's a real struggle for me at the minute, but i'm hoping that once my thyroid is more under control, it might happen more regularly!

Having only been on this ride for a wee bit, i'm already getting the feeling that a lot of medical people will be pushing for me to go the radioiodine route further down the track. It seems that it's the common opinion that it's the best option.... i'm reluctant to just swap one problem (ie hyper) for another (ie hypo), but understand that for some people it IS the right decision? I'm reading your book Elaine (Graves Disease: A practical guide) and it's brilliant... makes me feel like i can have some kind of input into the treatment route i decide to take.. mind you, i'm not sure every dr/specialist i see will appreciate that - i already get the feeling some don't appreciate it too much when you're assertive/well-read about these things - perhaps makes them feel like you're telling them their job?

anyway, guess it's a matter of seeing what happens.
thanks again
gemmagirl

-- posted by gemmagirl

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