# Methimazole reaction?? Debating if I need to go to ER



## bosox10

Was recently diagnosed with Graves after going to the the ER with heart palps and have not been to an Endo yet (appt is July 5th)

Begged my PCP to put me on something and he put me on 30mg of "Meth"...was taking as ordered till yesterday even though it was making me break out with little pimples on the top of my chest area. I backed it off to two a day yesterday (20mg) since I was feeling crappy and the rash seemed to get a bit better but....

Today my right hand fingers suddenly swelled up as did my right second toe..I feel my left fingers getting swollen too. I have been itchy all day in the webs of my fingers, my elbows and the tops of my feet by my toes. I can understand the itching but the swelling?? I literally cannot close my right hand and it feels slightly warm going down my arm now 

I think I'm freaking myself out as well so I'm trying to remain calm. Do you think it's the meds and is it strange that this would happen after 3 weeks of taking them if I was going to have a reaction? Do you think if I just stop taking the pills and wait for the Endo appt it might make things better? It seems to be worse on my index fingers for some reason, very strange.

Thanks.


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## april

Your liver is not tolerating the meth. Get off of it. My hands and fingers itched and swelled and I told my Endo. She said it was my liver and did liver enzyme testing and sure enough three of the enzymes were elevated. She said this was one of the side effects from anti-thyroid meds. My liver is returning to normal after not taking it for 12 weeks. I had the RAI therapy done. If meds don't work RAI or surgery is all that is left.


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## april

Also I took the meth for about 2 months before I had any symptoms. And the strange thing it wasn't constant. It would start out of the blue every once in a while. I had it especially in the palms of my hands.


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## bosox10

Thank you. That makes me feel a bit "normal" although I'm not happy that meds don't seem to be an option for me. The swelling slowed thankfully so while annoying, I don't think I'll need to go anywhere tonight. This is so frustrating!


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## desrtbloom

It sounds like the medication. You should call your doctor and let him/her know you are having an allergic reaction (that's what it sounds like) and have him/her put you on another anti-thyroid medication. Have you tried a Benadryl for the rash and swelling? If you feel like you need to go to the ER, you should. Better safe than sorry. It does sound though like you are having an allergic reaction. It takes time for the Methazimole to build up in your system and that is probably why your symptoms are slowly coming on and getting worse.

Good luck hun. :hugs:


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## bosox10

I'm pretty sure it's the meds. I had my GP put me on something while I waited for the Endo appt so since I'm just a week away, I'm just going to wait and stop taking the "Meth". I took Benadryl last night so the swelling didn't get worse but it's not better this morning either. My hands look and feel like I've been boxing LOL. Hopefully they'll go down soon. Hopefully it doesn't take the same amount of time to go away as it did to start showing symtoms


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## Andros

bosox10 said:


> Was recently diagnosed with Graves after going to the the ER with heart palps and have not been to an Endo yet (appt is July 5th)
> 
> Begged my PCP to put me on something and he put me on 30mg of "Meth"...was taking as ordered till yesterday even though it was making me break out with little pimples on the top of my chest area. I backed it off to two a day yesterday (20mg) since I was feeling crappy and the rash seemed to get a bit better but....
> 
> Today my right hand fingers suddenly swelled up as did my right second toe..I feel my left fingers getting swollen too. I have been itchy all day in the webs of my fingers, my elbows and the tops of my feet by my toes. I can understand the itching but the swelling?? I literally cannot close my right hand and it feels slightly warm going down my arm now
> 
> I think I'm freaking myself out as well so I'm trying to remain calm. Do you think it's the meds and is it strange that this would happen after 3 weeks of taking them if I was going to have a reaction? Do you think if I just stop taking the pills and wait for the Endo appt it might make things better? It seems to be worse on my index fingers for some reason, very strange.
> 
> Thanks.


I think you should stop the med "and" go to the ER. This does not sound good.

Side Effects of Methimazole - for the Consumer
Methimazole
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Methimazole:

Change in taste; dizziness; drowsiness; headache; joint pain; lightheadedness; muscle pain; nausea; numbness and tingling; stomach upset; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur when using Methimazole:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); changes in appetite; dark urine; fainting; fast or irregular heartbeat; fever, chills, or persistent sore throat; severe or persistent headache, nausea, or vomiting; stomach pain; tremor; unusual bruising or bleeding; unusual hair loss; unusual tiredness or weakness; vision changes; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

http://www.drugs.com/sfx/methimazole-side-effects.html

Worried here...............................check in when and if you can.

It sounds like you could be thyrotoxic in spite of taking the Methimazole. I had that experience. I wanted to rip my skin off, I itched so bad.


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## AZgirl

I had the reaction too... endo mismanaged my meds i believe! 40 mgs! went to another endo, she said 10 would of been just fine! I backed half of my meds along with a benedryl for about 2 weeks. had no problems after that! 9 months later, 2.5 mgs, and feeling great!!!! FYI, I TALKed to my GP, and 2 pharmisists regarding benedryl and methi together, said it was ok to do it that way. but not forever. personally i think it was because it was to much mgs IMO


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## bosox10

Hi Andros- I thought I would be able to ride it out but went to my GP this morning after the itching continued. While I was sitting in the room waiting for him to come in I LITERALLY started breaking out in hives on the backs of my arms and on my legs. Which led me to a small panic attack thinking I was going to die in this little room all by myself LOL, so I ran out to find my husband and get some air...I calmed down enough to go back in and wait. Funny thing how worked up I can get now . Doc was pretty sure it was the med's and gave me a steroid shot, and an RX for prednisone. I gotta tell ya, that was at 10am and it took till 3pm for the dumb hives to go away and my hands to "un" swell. 
My last "meth" pill was yesterday at 10am. I can't say for sure yet, cause I think I'm just exhausted, but I almost feel my "shakiness" coming back slightly. That was the reason I had the GP put me on something to begin with, while I waited for the Endo appt on 7/5...So I guess my question is....
If I can't tolerate med's to control the Thyroid, and the shakiness comes back very soon after NOT being on med's for the Thryoid, is my only reasonable option going to be Surgery to get it out completely? 
I'm trying hard to make it till the 5th but I will def. go to the ER if the shakiness gets bad again. At least my BP/Heart rate are under control.
And yes, if I could have taken a knive to the tops of my feet, elbows, webs of my fingers and the backs of my arms I would have! It was horrible..even though it took about 2 1/2 weeks to get that way. Grrrrr


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## Andros

bosox10 said:


> Hi Andros- I thought I would be able to ride it out but went to my GP this morning after the itching continued. While I was sitting in the room waiting for him to come in I LITERALLY started breaking out in hives on the backs of my arms and on my legs. Which led me to a small panic attack thinking I was going to die in this little room all by myself LOL, so I ran out to find my husband and get some air...I calmed down enough to go back in and wait. Funny thing how worked up I can get now . Doc was pretty sure it was the med's and gave me a steroid shot, and an RX for prednisone. I gotta tell ya, that was at 10am and it took till 3pm for the dumb hives to go away and my hands to "un" swell.
> My last "meth" pill was yesterday at 10am. I can't say for sure yet, cause I think I'm just exhausted, but I almost feel my "shakiness" coming back slightly. That was the reason I had the GP put me on something to begin with, while I waited for the Endo appt on 7/5...So I guess my question is....
> If I can't tolerate med's to control the Thyroid, and the shakiness comes back very soon after NOT being on med's for the Thryoid, is my only reasonable option going to be Surgery to get it out completely?
> I'm trying hard to make it till the 5th but I will def. go to the ER if the shakiness gets bad again. At least my BP/Heart rate are under control.
> And yes, if I could have taken a knive to the tops of my feet, elbows, webs of my fingers and the backs of my arms I would have! It was horrible..even though it took about 2 1/2 weeks to get that way. Grrrrr


I cannot tell you how worried I was about you. I try to be careful over the internet so as to not cause more problems like freaking people out unnecessarily BUT..................there are times when I have to lay it out.

Thank God you went to the doctor and that you are coming out of it. You will be quite ill for a few days. This is a very nasty and possibly life-threatening experience.

That said, "You just take it easy and pamper yourself!" Get the water flowing and get those kidneys to do what they do and that is get the toxins out of your system.

Options are removal surgically (ablation)or RAI (frying that bugger!)

I actually don't think any other (PTUwould work for you as you are in advanced stages. But you will discuss this with your doctor on the 5th..

And please let us know how you are doing over the holiday weekend.


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## bosox10

Thanks Andros! You're probably gonna think I'm nuts but I really felt cruddy NOT taking the "Meth" so at my doc's suggestion, I am taking 5mg 2x a day for just 10mg instead of 30mg a day. My hives and swelling went away completely now and I'm on Prednisone for a few days so I figured I would monitor things closely. I don't know if it was just a mental thing that I was feeling bad and starting with shakes or what but I think was just taking way to much. I can't wait till my Endo appt next week. And I can't wait till I can sleep again! I was afraid to take anything last night in case I wasn't done having an allergic reaction so I was up all night. Can't figure out if it's the meds or the thyroid. Hmmm.


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## Andros

bosox10 said:


> Thanks Andros! You're probably gonna think I'm nuts but I really felt cruddy NOT taking the "Meth" so at my doc's suggestion, I am taking 5mg 2x a day for just 10mg instead of 30mg a day. My hives and swelling went away completely now and I'm on Prednisone for a few days so I figured I would monitor things closely. I don't know if it was just a mental thing that I was feeling bad and starting with shakes or what but I think was just taking way to much. I can't wait till my Endo appt next week. And I can't wait till I can sleep again! I was afraid to take anything last night in case I wasn't done having an allergic reaction so I was up all night. Can't figure out if it's the meds or the thyroid. Hmmm.


That sounds like a more sensible dose for right now to me and you are right to not go off it completely as you are hyper and you need to slow all that down.

Are you on a beta-blocker as well? If not, talk to the endo about that also. It protects your heart.

It actually could be both. Sigh! You just never know!

Glad to hear from you and trust your instincts at all times.


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## AZgirl

bosox, just telling you my experiance....same thing happened. exactly, i took my shirt off at work in the bathroom and just took millions of towels to wet them and lay all over me! my face looked a red hot swollen wreck! but im very stubborn and did not want to go to my next 2 choices of treatment. I saw my 2nd endo, she too agreed that my meds from endo 1 was way to high!!! she put me on 10 plus i took a benedryl for 2 weeks, (after i cleared up, like 3 days later) and i havent had a problem since. im now down to 2.5 mgs no benedryl, and close to remission. that was last october (my endo wants me off meds soon, but i dont want to just yet, iwanna be on them for another 2 years to make sure) according to my other graves message board, which happens to be a board with many remission people in it... not saying that is the answer for y ou, but i swear same thing happend to me. there is no need for you to be on that high of a dose, when less then half of that would control your symptoms. many links to prove that


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## bosox10

Andros- yes I'm on Propranolol ER 120 mg. My cardiologist put me on them so I just had to take 1 a day instead of 3. They are keeping my heart rate and BP down so I'm very happy. 
AZgirl- so you've managed on JUST meds? You haven't had the radiation or the surgery? I've wondered if it was possible to do that but worried about it just freaking out again one day. I'll do more research on remission. Thanks!

I actually slept last night (with a pill LOL) and I went to the mall tonight! I haven't been able to walk around or feel "right" since I was in the hosp over Memorial day weekend when I was first diagnosed. I def think the lower dose is helping.


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## AZgirl

bosox, yes, i have managed on meds alone! i had a very tough time though. because even 10 mgs is pretty high, but for starters its ok. I found my self getting very hypo...about 1 month later..and i went down fast! Your FT3 and Ft4 are high, but with meds should go down quite fast. its best to watch them meet in the middle of the range. assuming your still good with the meds when you see your endo, hopefully your endo will not try to jump so fast to your other options. Mine sure did, and i stuck to my guns. When was those results for your labs? are you going to go again for labs b4 your appointment? post new ones as soon as you get, an keep an eye out so you can lower dosage. I didnt know any better when i was first dx. but now i know i never needed that much med. At 10 mgs, i was sooo hypo,,,TSH should be arounda 2, well, mine jumped to 45. i believe i was dead for a few months. honestly! This is where i couldnt get up, or hardly eat cus i was sleeping. Here is where my endo encourgaged RAI once again! Not understanding things, i still said NO. we dropped to 7.5 then one month later 5.0 one month again, 2.5 and i have been there since early march. all my levels are great.. last thing she told me at last appointment, was that she was going to take me off meds in NOV. However, i will not do that and worried about trying to encourage that situation! Suggestions from remission patients all told me to stay on, even with good numbers for at least 2 years. Making sure my Trabs are very very low. Which most endos do not check. So, in the meantime, i am already setting up for a diff. endo in nov. incase she will not give me more meds. Unfort. its an endo who lives in florida, im in AZ. He is 100% against RAI or Surgery, unless of course cancer is involved. He also told me he would like me to stay on f or at least 2 more years. He has a high remission rate succuss for his graves patients. I got his name from another board member, who is in remission so far for 4 years. Im not ganna lie, i freaked out too like you did, paniced and thought, i was going to have to have RAI. But I still insisted i try even more with meth. Im glad i stuck it out with the help of my graves board, and look.... feeling great. Just wish i knew then what i knew now~ IMO, 10 mgs is a good start, but after a month def. should probably lower, and if you start going hypo, dont give up, remember, you can still adjust meds and lower, untill you feel good. im sorry i have to repeat 30 MGS WAS WAY TO HIGH!!!!!!!


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## AZgirl

BOSOX ALSO READ THIS
http://www.suite101.com/content/graves-disease-treatment-antithyroid-drug-rxs-on-the-rise-a370917
ALSO GET A BOOK CALLED "Graves' Disease: A Practical Guide BY ELAINE MOORE. SHE had RAI and wish she hadnt. She studies graves and its a guide to help you with a million answers.... i admit, it was all mumbo jumbo at first for me, but the more i get to studying it, the more it makes sence, and the more i confirm my choice. Remember, your thyroid is the victom, not the disease. I focus on the antibodies and t rying to control them so they leave my thyroid alone, i stuggle with the fact that i would want to rid my thyroid, when its not at fault.


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## AZgirl

http://www.amazon.com/Graves-Disease-Practical-Elaine-Moore/dp/0786410116


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## AZgirl

one more thing, in that book, here is one paragraph,,,,,,,,yourd have to read the rest for the explanation before and after, but this is just one part i want you to see. And remember, if remission does NOT happen, at least you know you tried it before your other options.....

Elaine: Chapter 8, which discusses conventional treatment options, describes the advantages of block and replace therapy. In this chapter, I included recommendations from some of the top endocrinologists at Harvard University who state that all patients with GD should undergo a minimum 18 month trial of ATDs before even considering aggressive treatment. By 18 months most patients on ATDs will have achieved remission. Those who haven't will by then have a better idea of their disease course and can decide if they want to pursue ATD therapy or try another approach. Some people have symptoms that wax and wane causing them to have natural periods of remission that alternate with variable symptoms. These are factors that must be taken into consideration. One's unique disease course and personal health status are important factors in choosing therapy. While all patients need to have their symptoms monitored by a conventional practitioner, all patients do not need the same standard treatment.


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## Andros

bosox10 said:


> Andros- yes I'm on Propranolol ER 120 mg. My cardiologist put me on them so I just had to take 1 a day instead of 3. They are keeping my heart rate and BP down so I'm very happy.
> AZgirl- so you've managed on JUST meds? You haven't had the radiation or the surgery? I've wondered if it was possible to do that but worried about it just freaking out again one day. I'll do more research on remission. Thanks!
> 
> I actually slept last night (with a pill LOL) and I went to the mall tonight! I haven't been able to walk around or feel "right" since I was in the hosp over Memorial day weekend when I was first diagnosed. I def think the lower dose is helping.


Thank you for keeping in touch and I am relieved; you sound a "whole" lot better! Thank God!


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## bosox10

Ok really! I think I'm doing better and then break out in a cold clammy sweat just walking in the grocery store or making dinner! I want my life back!!! I'm going to be SOOOOOO agravated if the Endo doesn't give me some helpful advise tomorrow. I've been tracking my BP and even on Beta Blockers, my BP goes up to like 138/78 when I get "clammy". So over the yo-yo. Sorry, just had to vent. Now I'm not sure if it's too much meds, not enough meds, or just the plain meds period!


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## Andros

bosox10 said:


> Ok really! I think I'm doing better and then break out in a cold clammy sweat just walking in the grocery store or making dinner! I want my life back!!! I'm going to be SOOOOOO agravated if the Endo doesn't give me some helpful advise tomorrow. I've been tracking my BP and even on Beta Blockers, my BP goes up to like 138/78 when I get "clammy". So over the yo-yo. Sorry, just had to vent. Now I'm not sure if it's too much meds, not enough meds, or just the plain meds period!


If you don't mind a humble opinion, the best way to get your life back is to get that sucker out.

If I could do it over, I would not have wasted all the time I did on the anti-thyroid med. I really wouldn't. I never for one minute felt good.


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## AZgirl

cold and clammy? so are you sweating, with heart rate fast, or cold and tired?


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## bosox10

NUKING this little bugger, I've had enough! The Endo explained everything in a clear, caring manner and while I'm not exactly comfortable with swallowing radioactive material, surgery is not going to be an option since there are no nodules so it will be more of an "elective" option if I went that route, and my body just does NOT like the Tapazole. 
I was cold and clammy sweating but not with a really fast heart rate, just a bit of elevated BP. I have NOT taken the tapazole since yesterday and I feel great, other than being a little tired. No nausea, no cold sweat, nothing. This medication is just poison in me. The Endo said the most you're supposed to stay on it anyway is a year so if that's the case, the med's are obviously not without huge risks.

I went for bloodwork today, CBC, liver enzemes, thyroid stuff etc...I see the RAI guy on the 12th for the "dosing" and then make the appt. I feel better now that I've made the decision to do it. I wish there was another way but I hope to be able to effectively manage it this way and read everything under the sun until then!


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## webster2

I am glad you have an action plan. I hope you will feel better soon!


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## AZgirl

did your doc mention surgery? 
http://thyroid.org/patients/ct/volume4/issue3/ct_patients_v43_9_10.html
read the above link about RAI and eye issues... did your doc mention any of that? not saying this will happen to you, but usually a lot of doc forget to mention this,,,,,,,,,because if you develope TED, your no longer their patient, now your an opthomologists patient.


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## Andros

bosox10 said:


> NUKING this little bugger, I've had enough! The Endo explained everything in a clear, caring manner and while I'm not exactly comfortable with swallowing radioactive material, surgery is not going to be an option since there are no nodules so it will be more of an "elective" option if I went that route, and my body just does NOT like the Tapazole.
> I was cold and clammy sweating but not with a really fast heart rate, just a bit of elevated BP. I have NOT taken the tapazole since yesterday and I feel great, other than being a little tired. No nausea, no cold sweat, nothing. This medication is just poison in me. The Endo said the most you're supposed to stay on it anyway is a year so if that's the case, the med's are obviously not without huge risks.
> 
> I went for bloodwork today, CBC, liver enzemes, thyroid stuff etc...I see the RAI guy on the 12th for the "dosing" and then make the appt. I feel better now that I've made the decision to do it. I wish there was another way but I hope to be able to effectively manage it this way and read everything under the sun until then!


Good for you; enough is enough already. That is how I felt at the time and I have no regrets.

Tues. it is then; 7/12/11

You are in my prayers and thoughts.


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## bosox10

Thanks for the info Andros! I haven't had any issues other than tired eyes, and I've never smoked so hopefully that won't be an issue for me. The Endo said the surgical route was really a last resort, that a lot of people don't choose that and she didn't see anything in my test results to recommend that be my first choice. So Tues I go for a "dosing" consult with another Endo I. Her practice so I'll be sure to ask lots more questions.

So here's my latest dilemma. I AM FAMISHED!! I will literally eat a normal meal and finish the whole plate and still be starving when I'm done. I thought I was nuts until we went to Carabbas and I had a bowl of Pasta that normal would have made me uncomfortable and I walked out of there HUNGRY.

What in the world is going on??!! I'm not eating extra but it's so aggravating. I'm been drinking water to try and fill me up .


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## Andros

bosox10 said:


> Thanks for the info Andros! I haven't had any issues other than tired eyes, and I've never smoked so hopefully that won't be an issue for me. The Endo said the surgical route was really a last resort, that a lot of people don't choose that and she didn't see anything in my test results to recommend that be my first choice. So Tues I go for a "dosing" consult with another Endo I. Her practice so I'll be sure to ask lots more questions.
> 
> So here's my latest dilemma. I AM FAMISHED!! I will literally eat a normal meal and finish the whole plate and still be starving when I'm done. I thought I was nuts until we went to Carabbas and I had a bowl of Pasta that normal would have made me uncomfortable and I walked out of there HUNGRY.
> 
> What in the world is going on??!! I'm not eating extra but it's so aggravating. I'm been drinking water to try and fill me up .


You are lucky you are aware of the hunger. Many are not and just start surrepticiously w/larger portions and snacking and end up gaining weight.

Try with all your might to stave this off and try to get more protein in your regular meals as that helps to satisfy.

Good luck tomorrow and thank you for the "reminder!" That way,we know to hear from you soon and what the endo has had to say.


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## bosox10

HOLY SMOKES!! I gained 5lbs since my doctor visit last week on the 5th!!!! I'm so aggravated!

So my RAI is sched'd for this Friday the 15th at 10am. I'm not waiting one more second. I'm getting 12 Millicures, lots of internet searching will be done over the next few days.

My concern, although the Endo was not too concerned, is my new lab results. Not so much the Thyroid stuff but the rest. My original numbers are in my signature but here's the rest....

TSH, 3rd Generation <0.01 L range 0.40-4.50
T4, Free 1.1 range 0.8-1.8
T3, total 114 (this number is way diff from my orig #??)
TSI 173 range <140 baseline

Here's where I'm like, um, excuse me!....
White Blood Cell count 14.9 range 3.8 - 10.8
Red Blood Cell count 5.16 range 3.80 - 5.10
MCV 77.3 range 80.00-100.00
MCH 25.2 range 27.0 - 33.0
Platelet count 491 range 140-400
Absolute Neutrophils 10,639 range 1500-7800

So I think I'm dying and Endo is like, "Eh, could be dealing with some type of infection.." What??! When I was in the ER and first diagnosed as being Hyper, they said my white cells were high due to an UTI but I also had symptoms. I feel a little ichy with a litte scratchy throat right now but that is it!

So I have an appt in a month for more blood work and then a week after that, with the Endo again as it will be about 6 weeks after the RAI. I'm a little freaked out about Friday but hoping it will stop this insane hunger I have.

Thoughts on the new test results??


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