# on methimazole a month, now itchy



## StacyAr (Nov 10, 2012)

I read this could be from rapidly falling thyroid hormones...or a reaction to the drug itself that is one of the most common reactions. Since its Christmas week, do I have to try to find someone on call or can this wait? The endo also happens to be on maternity leave and her nearest counterpart is hours away. Ugh. The itching isn't terrible but it is definitely noticeable with one small area of a few hive looking things on my thigh. I can tell the methimazole is working because Ive recently been able to lower the beta blockers, gained back a couple pounds, and my cycle returned, constant hunger and hot.flashes have eased as has irratibility, plus ive actually slept more than 2 hours in a row (thankfully). I am definitely going to get in touch with Dr. But just Wanted to see if any of you guys had itching and what the outcome was. I am not wanting to switch to PTU unless my liver or wbc cannot tolerate the methimazole.

The literature ive read does not say skin reactions are a serious side effect, nor does it say to contact your endo immediately. It says it occurs commonly, comparatively. Anyone else get this and if so what came of it? Thanks. Oh p.s. I'm on a low dose... 10 Mg once daily. Due for blood work in two weeks. I wanted it sooner but endo wanted me on the meds.for about 6 weeks first.


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## Sandbar (Nov 6, 2012)

Yep been there - the itching is dreadful. I'd suggest you get labs as soon as possible because odds are you need a dosage reduction and immediately start taking a daily antihistamine. If despite the antihistamine the hives worsen and spread then you probably will need to stop the methimazole. Make sure to have some benadryl on hand in case you do have a true allergic reaction - lips/throat swelling to take right away and head to the ER. Benadryl isn't good for the daily choice though because it so sedating but it is the best for a drug allergic reaction - Zyrtec worked for me for just the itching.

In my case I didn't know to start the antihistamine and my doc took me off the methimazole and put me on PTU. I tried methimazole again many months later at a lower dosage and so far so good now. Isn't this all so much fun! Bah humbug. I hope you have a Merry Christmas anyway!


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## Andros (Aug 26, 2009)

StacyAr said:


> I read this could be from rapidly falling thyroid hormones...or a reaction to the drug itself that is one of the most common reactions. Since its Christmas week, do I have to try to find someone on call or can this wait? The endo also happens to be on maternity leave and her nearest counterpart is hours away. Ugh. The itching isn't terrible but it is definitely noticeable with one small area of a few hive looking things on my thigh. I can tell the methimazole is working because Ive recently been able to lower the beta blockers, gained back a couple pounds, and my cycle returned, constant hunger and hot.flashes have eased as has irratibility, plus ive actually slept more than 2 hours in a row (thankfully). I am definitely going to get in touch with Dr. But just Wanted to see if any of you guys had itching and what the outcome was. I am not wanting to switch to PTU unless my liver or wbc cannot tolerate the methimazole.
> 
> The literature ive read does not say skin reactions are a serious side effect, nor does it say to contact your endo immediately. It says it occurs commonly, comparatively. Anyone else get this and if so what came of it? Thanks. Oh p.s. I'm on a low dose... 10 Mg once daily. Due for blood work in two weeks. I wanted it sooner but endo wanted me on the meds.for about 6 weeks first.


It would be hard to say whether the itching is from the Methimazole or thyrotoxicois or both. If you have hives, I would rule out the traditional winter dry skin exacerbated by hyper.

Hope you can get through the holidays here and please let us know how you fare.


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## StacyAr (Nov 10, 2012)

Had the blood test today.. hope to hear by Thurs... in the meantime the very conservative Dr on call wants to switch me to PTU. I think that's premature as so many people have mild itching which subsides. Now I don't know what to do... I am requesting he cut the dose of methimazole instead if my thyroid is leveled out (based on pending blood work) before being so drastic. My actual endo that's on maternity leave doesn't like ptu and says she hardly ever prescribes it anymore, while the endo on call says he uses it all the time. Amazing the difference within the same practice. I'm feeling like some mild itching that may or may not be from the methimazole isn't reason enough to switch from the med my endo and I both prefer... he said other docs would not take this path but might prescribe an antihistimine and watch and wait, but says that's not how he treats. What do I do now? (Ive also read that many people who have itching from methimazole also have itching on ptu and wind up turning to antihistimines at that point anyway..so why jump the gun?)


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## jenny v (May 6, 2012)

I had some mild itchy skin while on PTU, if that helps. It went away after a few weeks but I used an OTC hydrocortisone cream to help control the itches until it did. I would hesitate to switch to a totally new med over just some minor itching (assuming it's not hives and you're not batty from itching).


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## StacyAr (Nov 10, 2012)

So how do I handle the on call endo?


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## Sandbar (Nov 6, 2012)

How long till your regular endo gets back? For the on call endo maybe make a deal with him that if your symptoms reach a certain level you both agree on then you'll stop and switch to ptu?

When I switched to PTU I did occasionally get some intense itching and I would just pop a Zyrtec for a couple of days and then stop and it would be okay. I did that maybe five times and after that it wasn't a problem anymore. Now that I've restarted the MMI at the lower dose I've had no itching or hives.


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## StacyAr (Nov 10, 2012)

Thanks!!!!! I lowered the dose to 5 Mg from 10. 
The endo on call approved it but pointed out rash aside, he'd have liked to see me remain at the steady dose of 10 I started with for A greater chance at remission. Seems he thinks lowering to half will possibly decrease chance of remission? 
I guess I'm surprised he just wants to stop and switch to Ptu. 
Caught me off guard and now I'm thinking that I'm going to be unable to tolerate the meds.

Let me ask you : what's the cut off between "side effect" (which can be treated with Zyrtec) and "allergic reaction", which is potentially dangerous? How is that determination made?
How would one know the difference at this point? And if it is an actual allergy, can I take Zyrtec and ignore it or is that a recipe for disaster? I'm just not sure what to think.
Did you have a rash or just itching?

P.s. in my haste I neglected to ask him the numbers (but will call tomorrow) but he said while my Tsh is.still suppressed and likely to remain so for months (it was undetectable at last screening) my free t3 is now in normal range. Will call tomorrow for exact count.


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## Sandbar (Nov 6, 2012)

Hi Stacy, the key emergency allergy symptom is swelling - especially of the lips/tongue or throat. If the rash becomes an all-over body rash that too is pointing the way towards the swelling about to start. But a rash on only part of you....depends on who you ask how serious that is. You might want to survey your pharmacist and doctors on that one. My methimazole rash was only partial but that was enough for my endo to declare that I should never take it again. However...I switched endos and the new endo was fine with me trying it again at a lower dosage which just shows how arbitrary it all is. Also 10mg to 5mg is a very big drop, you will probably have some transient hyper symptoms at minimum even if the new dosage is good. I even get that with a drop of only 1.25mg. Still each person is unique and I've read of others doing fine with a 50% drop.


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## Lovlkn (Dec 20, 2009)

> Thanks!!!!! I lowered the dose to 5 Mg from 10.
> The endo on call approved it but pointed out rash aside, he'd have liked to see me remain at the steady dose of 10 I started with for A greater chance at remission. Seems he thinks lowering to half will possibly decrease chance of remission?


No - cutting your dose will not reduce your chance at remission. I think they are concerned you will go hyper again if you cut your dose.

What are your last labs?

Consistent labs and consistent dose are in my opinion the best way to remission. Most ppl begin at 20 then drop within a few months - goal is lowest dose with no symptoms for a period of time. Some say 18 months - I say - when you feel comfortable to make a permanent decision. I also believe that no antibodies should be present when you decide to quit the med's, otherwise the doctor says you "must" make that decision for a permanent aka RAI or Total Thyroidectomy.

I know of several ppl who have been on anti thyroid med's for a long long time. If you like where you are with anti thyroid med's there is no rush to make a permanent decision.


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