Medication For High Thyriod (Hyperthyroidism)

[Felt 35]

My wife got diagnosed with Hyperthyroidism some 10 months ago and here blood levels have now finally stabilized but following here latest check she will still have to take medication for a year or two! She is allergic to some medication and the doctor and hospital she initially used when she got diagnosed had some trouble finding a medicine she tolerated. The tablets she have used and tolerate is Tapazole 0,5mg produced by Olic Thailand Ltd. These tablets she has easily bought from different pharmacies, but have lately got the message that Tapazole produced by Olic Thailand Ltd not are available any more.

Is there anyone who knows if Olic Thailand Ltd have cut production of this medications permanent or are they still to get in Bangkok and other cities upcountry? We are in Phuket and my wife has checked most pharmacies and the reply is empty all the way.

My wife have changed doctor and hospital a few times in the last 10 months and on here last check with new doctor at a new hospital they want here to have an ultrasound done outside of her neck. Is this the same as thyroid scan?

Thanks & Regards

[chiang mai]

Yes, the ultrasound scan of the neck/throat is used to view/measure the thyroid, it's a short painless procedure although thyroid activity is useually assessed via blood tests and measurement of free T3 and free T4.

I can't help with the medication you require although your wifes endocrinologist should know where she can obtain the medication she needs.

[lopburi3]

That appears to be the recommended medication but geriatric name seems to be Methimazole so you might see if other brands are available - I suspect they are. My wife uses an alternate medication, Propyl Thiouracil, and had no issue getting normal 3 month supply a week ago.

[Sheryl]

Actually, my sources (MIMS) indicate that tapazole is both made and distruibuted by DKSH, you can contact them directly to ask about whether it is still being sold and if so where in tyour area there is a supplier.

DKSH (Thailand)

280 New Rd Bangkok 10100

Tel: 0 2220 9000, 1364 (Call Center)

Fax: 0 2220 9090

Email: [email protected]

Website: http://www.dksh.com

In addition, the exact same drug (methimazole) is sold in Thailand under 2 other brand names as follows:

Timazol

Methimiazole Yung Shin

You might try asking by those brand names.

[Felt 35]

Yes, the ultrasound scan of the neck/throat is used to view/measure the thyroid, it's a short painless procedure although thyroid activity is useually assessed via blood tests and measurement of free T3 and free T4.

I can't help with the medication you require although your wifes endocrinologist should know where she can obtain the medication she needs.

Thanks for the reply. It was my thoughts that they only used the ultrasound scan if the illness escalated but I can absolute be wrong there. But a bit surprised that this hospital suggesting this procedure now when the earlier (hospitals)doctors she have seen not even have mentioned any scan.

[Felt 35]

That appears to be the recommended medication but geriatric name seems to be Methimazole so you might see if other brands are available - I suspect they are. My wife uses an alternate medication, Propyl Thiouracil, and had no issue getting normal 3 month supply a week ago.

The propyl thiouracil is one of the meds my wife gets an allergic reaction from. She got really ill from it, Had to stay in hospital a few days last year and that’s most likely why she now are very vary about any new meds

[Felt 35]

Actually, my sources (MIMS) indicate that tapazole is both made and distruibuted by DKSH, you can contact them directly to ask about whether it is still being sold and if so where in tyour area there is a supplier.

DKSH (Thailand)

280 New Rd Bangkok 10100

Tel: 0 2220 9000, 1364 (Call Center)

Fax: 0 2220 9090

Email: [email protected]

Website: http://www.dksh.com

In addition, the exact same drug (methimazole) is sold in Thailand under 2 other brand names as follows:

Timazol

Methimiazole Yung Shin

You might try asking by those brand names.

Thanks Sheryl!

I think Olic Thailand Ltd is a member of the Dksh group. I will send them an e-mail and ask.

[lopburi3]

As said that is a different medication - suspect you can find what she needs under another name. Ultrasound is a good non invasive way to get details of gland without x-ray radiation and is easy. Had done twice before operation to remove.

[chiang mai]

Yes, the ultrasound scan of the neck/throat is used to view/measure the thyroid, it's a short painless procedure although thyroid activity is useually assessed via blood tests and measurement of free T3 and free T4.

I can't help with the medication you require although your wifes endocrinologist should know where she can obtain the medication she needs.

Thanks for the reply. It was my thoughts that they only used the ultrasound scan if the illness escalated but I can absolute be wrong there. But a bit surprised that this hospital suggesting this procedure now when the earlier (hospitals)doctors she have seen not even have mentioned any scan.

I believe the main purpose of the ultrasound exam is to assess whether there are any tumours present and if so to measure them, the follow on to a positive finding is to undergoe an FNA biopsy test which is also short and painless. It's worth noting here that tumours on the thyroid are very common, over 50% of people age 50 have them, 60% of people aged 60 and so, only a very small percentage turn out to be cancerous so the finding in itself is not a major concern. I think all of that is slight distraction from the blood tests which seem to be the main method for determining hyper and/or hyporthyroidism.

[lopburi3]

Actually FNA is invasive but not very painful (but is uncomfortable for a minute - you do feel it). Needle in the throat is not my idea of a fun visit. But this would be later and may not even be required.

[dingdang]

the usual method to find tumors is to get a contrasting liquid injected (arm), and then the thyroid is scanned... its not painful...

Edited July 5, 2012 by dingdang

[chiang mai]

the usual method to find tumors is to get a contrasting liquid injected (arm), and then the thyroid is scanned... its not painful...

I've never heard of that being done on the thyroid and I've undergone two FNA's. Perhaps that's the approach used if the nodule is hot?

Loppburi: I agree it's invasive as any biopsy must be, all I said was that it is short and painless, slightly uncomfortable at worst although much of that discomfort is thought of what's going on rather than the goings on themselves, I think.

Edited July 5, 2012 by chiang mai

[lopburi3]

Suspect he is talking about this scan - which would not likely be a first check.

Thyroid scan. In some cases, your doctor may recommend a thyroid scan to help evaluate thyroid nodules. During this test, an isotope of radioactive iodine is injected into a vein in your arm. You then lie on a table while a special camera produces an image of your thyroid on a computer screen.

Nodules that produce excess thyroid hormone — called hot nodules — show up on the scan because they take up more of the isotope than normal thyroid tissue does. Cold nodules are nonfunctioning and appear as defects or holes in the scan. Hot nodules are almost always noncancerous, but a few cold nodules are cancerous. The disadvantage of a thyroid scan is that it can't distinguish between benign and malignant cold nodules.

The length of a thyroid scan varies, depending on how long it takes the isotope to reach your thyroid gland. You may have some neck discomfort because your neck is stretched back during the scan, and you'll be exposed to a small amount of radiation.

[dingdang]

its what the mod described above...

sorry, with "tumors" i mean, everything that spreads from the thyroid...

to determine if it is cancer, possibly a biopsy is needed - to decide, whether to cut the thyroid out or not, what leaves a long slash on the neck...

but in europe first of all the contrast-scan is done, and biopsy afterwards is not always done...

faik:

1) blood tests, trying to get the thyroid under control with medication...

2) if this doesnt help - thyroid scan

3) maybe a biopsy

4) other treatment - iodine therapy (taking a "radioactive" pill in a hospital) or cutting the thyroid out...

to have any 4) done, the thyroid scan is mandatory at least in parts of europe...

Edited July 5, 2012 by dingdang

[lopburi3]

Actually the long slash is only a couple of inches and once stitches are removed is not evident and after a year am hard pressed to even see mine. But that is not OP issue now and may never be. But the ultra sound would seem to be good/safe check at this point to my non medical mind.

[dingdang]

after i had read (a little) up on the topic, i find it outright shocking, to remove someones thyroid...

as i understand, the reason why a thyroid runs crazy is not (at all!) necessarily the thyroid - it (for my understanding) usually has an underlying reason, which should rather be found...

(bearing this in mind, i was puzzled by the OP who said, his wife was "allergic" against some medication...)

if you dont mind asking - are you feeling better without it, lopburi?

because many people seem to suffer heavy side effects without their thyroid!

Edited July 5, 2012 by dingdang

[lopburi3]

It was not working well and had large (suspect) nodals that did not respond to medication to reduce there size so yes I am happy to have it mostly removed. Immigrate change was able to swallow easily again. No other change except being unable to tilt head back as far as before. Take daily pill to supplement.

[chiang mai]

If someone has cancerous tumours in the lobes of their thyroid there is little choice but to eventually remove them, ditto if non-cancerous tumours exist but there growth is such that the airway is impacted. But if the problem is other than those things and is "merely" the over/under production of hormones, removal does seem extreme and unecessary, I've heard that once removed, getting the hormonal balance right is often a nightmare as no doubt Lopuri may tell us.

[dingdang]

i dont have much medical knowledge, but it appeared to me as there are NOT any proper standards followed here, because

- a "thyroid check" includes T, T3 and T4 - and thats it...

- the medication advise seemed a bit odd - to me...

imo...

* no conclusion can be made on the thyroid if not at least the renal values are taken?

* i didnt ask for it, even though was told that my cortisone-level had to be below 10!, in order to get a cortisone-prescription - im almost 50 and 10 is rock bottom (too )...

i found, this is not the way to go...

it appears to me as if you have a bullet in the head, and the endocrinologists are putting plasters on the wound, with a lot of hot air...

Edited July 5, 2012 by dingdang

[lopburi3]

Actually have not had any issues since removal other than feeling better physically and mentally. As said the hope that no medication would be required did not come to pass but one 50mg euthyrox seems to be the answer for me. And much relieved that pathology showed growths to be non malignant. The OP has had testing and treatment with what are the normal medications and a non invasive ultrasound is now proposed to rule out physical change and serve as baseline for future it seems and expect a good idea if financial conditions do not rule it out.