Don’t Go Cold Turkey: Understanding the Risks of Stopping Methimazole Abruptly

Living with hyperthyroidism can be a rollercoaster of symptoms, from rapid heartbeat and anxiety to weight loss and fatigue. While medications like methimazole offer relief, the temptation to stop them when symptoms subside can be strong However, abruptly stopping methimazole can be risky, potentially leading to a rebound of symptoms and even more serious complications.

Before diving into the potential pitfalls of stopping methimazole cold turkey, let’s first understand why it’s prescribed in the first place.

Methimazole: Taming the Overactive Thyroid

Methimazole belongs to a class of medications called anti-thyroid drugs. As the name suggests, these drugs work by slowing down the production of thyroid hormones, effectively taming an overactive thyroid gland. This helps manage the symptoms of hyperthyroidism, which can include:

  • Rapid heartbeat (tachycardia)
  • Anxiety and nervousness
  • Tremors
  • Weight loss
  • Increased sweating
  • Fatigue
  • Difficulty sleeping
  • Diarrhea
  • Irregular menstrual cycles

While methimazole can effectively control hyperthyroidism, it’s crucial to understand that it doesn’t cure the underlying condition. This means that stopping the medication abruptly can lead to a rebound of symptoms, often more severe than before.

The Dangers of Going Cold Turkey

When you abruptly stop taking methimazole, your thyroid gland, which was previously suppressed by the medication, can go into overdrive. This can trigger a surge in thyroid hormone production, leading to a condition called thyroid storm.

Thyroid storm is a medical emergency characterized by:

  • Extremely high fever
  • Rapid heart rate
  • Agitation and confusion
  • Nausea and vomiting
  • Diarrhea
  • Jaundice (yellowing of the skin and eyes)
  • Seizures
  • Coma

If left untreated, thyroid storm can be life-threatening. Therefore, it’s crucial to seek immediate medical attention if you experience any of these symptoms after stopping methimazole.

Beyond Thyroid Storm: Other Potential Risks

Even if you don’t experience thyroid storm, stopping methimazole abruptly can still have other negative consequences, including:

  • Worsening hyperthyroidism symptoms
  • Difficulty controlling your thyroid levels in the future
  • Increased risk of complications from hyperthyroidism, such as heart problems and osteoporosis

The Safer Route: Working with Your Doctor

Instead of risking your health by stopping methimazole cold turkey, it’s essential to work closely with your doctor. They can help you gradually taper off the medication while monitoring your thyroid levels and symptoms. This approach minimizes the risk of rebound symptoms and allows for a smoother transition.

Remember, communication is key. Discuss any concerns you have about your medication with your doctor. They can address your worries and work with you to develop a safe and effective treatment plan.

Additional Resources for Support:

Don’t let the fear of taking medication for an extended period lead you to make rash decisions. By working with your doctor and understanding the potential risks, you can safely manage your hyperthyroidism and live a healthy, fulfilling life.

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You cannot continue taking methimazole to maintain a hypothyroid state any longer than you can allow yourself to remain in a hyperthyroid state because hypothyroidism is just as taxing on your body as hyperthyroidism.

Based on the “raw” mental state you claim to be in, I can’t help but wonder if you’ve returned to hyperactivity since stopping your medication. Methimazole is an antithyroid drug that inhibits the thyroid’s hormone production; however, it does not reverse Graves Disease. Once you cease using it and it leaves your body, your thyroid can resume releasing hormones. The whole idea is reach a happy medium where you are neither hyper nor hypo. Your Graves may go into remission after a while, but it usually doesnt happen that quickly.

Thank you for responding. I say raw state of mind because every little thing is bothering me. Oh my, I was nothing like this if I felt like I was regressing to the HYPER state of mind. My heart was racing a lot of the time and I was losing weight left and right. I felt the tremors back then. What I am going through is not the same. The last blood test showed 5. 11 for my T. S. H. Additionally, for patients with Graves Disease, the free T3 and free T4 were within normal range but not significantly normal. I get that Graves Disease really doesn’t go into a remission. I will always have it. It is an auto-immune disease. I am doing my best to counteract with diet and products that I come in contact with. I just feel like I am on the fence. A couple of weeks until blood test time. I’m curious if getting a true reading requires me to go without Methimazole and my herbal supplement for the full three weeks. I just stopped the MMI, last Friday. It’s only been 5 days. My blood test is going to be on the 12th. I was thinking to push back the appt with my Endo. To a week later so I can take the blood test without meds for 3 weeks. What’s your take on this?.

Irritability is, typically, a symptom of hyperthyroidism, but it can be a symptom of being hypo too. When our thyroid isn’t functioning properly, our adrenal glands take over to help compensate. that means we often have a lot more adrenaline that we, otherwise might have. Thats our “fight or flight” hormone.

Your TSH at 5. 11 wasnt “horrible”, but it was higher than normal. You stated that your Free T3 and Free T4 levels were “in range, but not in the better part for a Graves patient.” What were your actual levels? Im not sure what you mean by that. Since Free T3 and Free T4 levels are far more significant than TSH, it would be beneficial if you could share your actual results along with the reference ranges.

Although Graves is an autoimmune disease that you will always have, it does go into remission when the thyroid is no longer attacked by antibodies. In an attempt to combat your Graves Disease, what kind of diet are you following and what herbal supplements are you taking?

It takes about three days for the methimazole to leave your system, depending on a number of factors (dosage, weight, metabolism, etc.). Why did you want to wait 3 weeks to have blood work?.

I was told that is takes approx. three weeks without taking medication in order to obtain an accurate reading for Free T3/T4 and T S. H. I had been on MMI for 89 days in total. 2. 5mg for the final 7 days. My T. S. H. Level went from . 005 to . 01 to 5. 11 (range: . 40-4. 50) My Free T3 went from 9. 3 to 3. 0 to 2. 6 (range: 2. 3-4. 2) My Free T4 went from 2. 26 to 1. 1 to . 9 (range: . 8-1. 8) I had my TSI taken recently – It went from 109 to 169. (Range: <140) And, I had the TRAB taken. It went from 4. 62 to 21. 2 (range: <16. 0) I lost approx. 30 lbs. I am now 137. 6 at 5’5”. Which I feel comfortable with. It’s just the daily diarrhea that I haven’t gotten a grip on. I am post-menopausal which I think might have pushed me into this. Having my hormones in upheaval. The good thing that came from this (menopause) is that I have a handle on my migraines. (Very little to none) Another plus is that I shed every pound I had put on over the previous 25 years. I believe the menopause definitely had an impact on my weight gain. I am on an semi A. I. Paleo diet. I may occasionally indulge, but I avoid processed foods, bread, gluten, processed sugar, dairy, and nightshades (I can’t live without my ketchup). As of recent, I have lost my appetite. When I was full blown Graves (no meds), I couldn’t eat enough. I ate the strangest combinations. I eat hormone & antibiotic free meats. I eat organic salads and fruits. I eat nuts, such as cashews and walnuts, to stay energized. Dates, bananas, blueberries and apples help me through it. I don’t go overboard. My weight pretty much stabilized after starting the meds. And, in the back of my mind is becoming HYPO and gaining back this weight. I stopped taking the herbal supplement which has Motherwart, Bugleweed and Lemon.

Balm. I would take that four times a day along with the medication, and that helped me manage my Graves’ symptoms. Also, I think that helped put me into the normal ranges with my T3 and T4. I stopped the herbal supplement when I stopped the meds. The endocrinologist believed I was going towards HYPO so she wanted me to stop. I explained most of the questions here and in my first post. While I’m attempting to find a “calm” place in both my body and mind, I should discuss better meal and snack plans with a nutritionist. Additionally, when my mood swings, I go to a quiet area of my apartment and cuddle with my Golden Retriever until I feel like I can handle things better emotionally. I don’t want my husband or anyone to be in my path of me snapping at them. Just trying to keep it together. Thanks for listening (and your advice. ).

“Methimazole is rapidly metabolized and has a half-life of 6 to 13 hours. This implies that half of the methimazole that was previously present in your body vanishes every 6 to 13 hours. “.

This is the reason medicine builds up in our systems; ideally, we take the next dose before the previous one wears off completely. This is also the reason why medication gradually wears off. 2. 5 mg is not a lot of medication, so when you took your last dose, half of it was already gone in 6–13 hours. Depending on how quickly your metabolism worked, your body might have been free of methimazole in a few days. The best course of action is to wait a week or so before having blood work done to be absolutely certain that everything has disappeared. Of course, that does depend on the variables mentioned and some medications clear faster than others.

Since the medication should be out of your system well before three weeks have passed, the timing of your test is undoubtedly between you and your doctor. Having said that, even though I’ve heard of Motherwart and Bugleweed, I’m not familiar with their half-lives, so I’d need to find out how long it takes for them to leave the body because they might also affect blood tests.

Your Free T4 and Free T3 certainly lean toward the hypo side, without a doubt. If we had levels like those, the majority of hypothyroid people would be yelling for higher dosages of replacement thyroid medication. Though many doctors prefer to reserve those symptoms for hyperthyroidism, depression and irritability can certainly be signs of hypothyroidism. Brain fog, confusion, and other symptoms that can make us feel like we’re “losing it” can also be caused by hypoxia.

To see if it would help get rid of diarrhea, you could try increasing the amount of fiber in your diet to help bulk up your stools. Since you’ve sided with the hypo, diarrhea might not be associated with Graves; instead, it might be linked to a microbiome imbalance, which is frequently associated with autoimmune disorders. If you don’t eat a “lot” of fermented foods, like yogurt (you said you’re dairy free?), sauerkraut (not canned, as it needs to contain live bacteria), kombucha, and others, you might want to look into a good daily supplement. Numerous studies indicate that certain autoimmune diseases may be caused by an imbalance in our microbiome, and that we can prevent or treat these diseases by altering our microbiome. The problem is that we cant reverse damage to our thyroid thats already done.

Im also not sure if youre familiar with the goitrogens. thats a list of foods that inhibit thyroid function. For those of us with Hashimoto’s disease (which causes hypothyroidism), it is sometimes advised to avoid goitrogens while those with Graves disease should consume more of them. For a comprehensive list, search for “goitrogens” on Some of the vegetables on the list are kale, cabbage, broccoli, cauliflower, and other fruits and vegetables (be aware that some of these can increase gas production, which can worsen diarrhea). Cooking eliminates the goitrogenic properties of the foods.

That being said, is it possible for you to have both Graves and Hashimotos antibodies at the same time, with one of them being dominant at any given time? I’m wondering if you were also tested for Hashimotos antibodies when you were tested for Graves antibodies. In the early stages of Hashimoto’s disease, it’s also typical to have hyperthyroidism, which eventually transforms into hypothyroidism as the disease worsens and destroys thyroid function. Hashimotos antibodies are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TgAb).

What kind of fiber would you suggest? I occasionally hear the term “microbiome.” Can you explain what it means exactly? I take a womens probiotic every day. I had two tiny pieces of fermented sauerkraut that upset my stomach and gave me a lot of gas, which scared me. When you speak of damage to the thyroid, I am not sure where I am with that. I wasn’t diagnosed with nodules, goiter or cancer. I feel I am lucky/blessed in that area. My antibodies show Graves Disease caused my hyperthyroidism. The only thing my first Endocrinologist said to me is that my thyroid was heterogenous. mixed texture. I was advised to get a second ultrasound to check the thyroid now that I’m taking MMI and my numbers are improving. By the way, after eight days, I feel less “snappy,” colder, achy, less hungry, and a little more tired than normal with each passing day. I heard of goitrogens. I was strongly instructed by my Endo. Not to consume large amounts of any of these foods without first cooking them. I love cabbage (cole slaw :-), broccoli (with salmon :-), and cauliflower. I will find my original blood tests to see if Hashimotos was checked. I believe it was. My physician mentioned to me that Hashimoto’s and Graves are two sides of the same coin; I assume this means that they are both auto-immune conditions. I am noticing that my sugar intake has a direct impact on my joints and my eyesight. (And we’re talking about natural sugars from fruits. ) There’s got to be a happy median. Humans are so complicated. :-).

The microbiome: the microorganisms in a particular environment (including the body or a part of the body). In this instance, it refers to the bacteria in our stomachs. “We depend on a vast army of microbes to stay alive: a microbiome that protects us against germs, breaks down food to release energy, and produces vitamins” This “army” of bacteria aids in digestion; absorption of vitamins/minerals, etc. Not all of these bacteria are as helpful as others, and occasionally the less helpful bacteria manage to establish a foothold and take control. When this happens, it can cause a number of unpleasant side effects. For instance, last year I had a case of H. Pylori which is one of the bad bacteria. The majority of us have H Pylori, but occasionally, as it did for me, it takes over and becomes dominant. My symptoms included nausea after eating, gas/burping after eating, constipation that alternated with diarrhea, exhaustion, and acid reflux/GERD, among other things. To get the H, I had to take acid reducers and two different antibiotics for two weeks. Pylori under control. After that, I had to work on replenishing my “good” bacteria and producing enough stomach acid, among other things.

Most of the time, acid reflux disease (GERD) is caused by insufficient acid, which is a concern for many people with hypothyroidism.

It would have been pointless to consume the sauerkraut if it contained no live bacteria. Because the fermentation process kills the bacteria, canned sauerkraut and some bagged varieties don’t ferment. You have to read labels carefully to make sure whatever fermented food youre eating has live cultures.

Regarding Graves and Hashimotos, it is accurate to say that they are both autoimmune thyroid diseases. Furthermore, it is “sort of” true that they represent opposing views on the same issue because Hashimoto’s disease is invariably linked to hypothyroidism and Graves disease is always associated with hyperthyroidism. opposite ends of the scale. Most of the time, they fail to mention that people with Hashimoto’s disease frequently experience episodes of hyperthyroidism in the early stages of the disease as a result of the thyroid “dumping” hormones into the body in reaction to antibody attacks. These phases can alternate for years with hypo- or even normal-functioning phases of the thyroid, until the thyroid is completely destroyed and unable to produce hormones. I’ve discovered that before I finally settled into a permanent hypothyroid state, I fluctuated between hyper, hypo, and normal thyroid function for about 15 years. The issue is that, up until I went completely hypo and was diagnosed with a TSH level of 55 (this is not a typo), none of my symptoms were ever taken seriously or linked to my thyroid. However, the antibodies that cause Graves Disease force the thyroid to continue producing excessive amounts of hormones and won’t stop, which is why the majority of Graves patients have their thyroid removed or destroyed through radiation irradiation (RAI). All of this leads to the same outcome: we are required to take hormone replacement therapy for the remainder of our lives. Occasionally, we see someone who can put their Graves into remission, for short periods.

Since goitrogens inhibit thyroid function, I’m not sure why anyone with Graves Disease or hyperthyroidism would be advised “not” to eat them. We hypos are advised to cook them beforehand or not eat them because we need all the support we can get.

Because sugar (of all kinds) causes inflammation in our bodies, it directly affects most of us.

I neglected to mention that, if not properly digested, goitrogens (broccoli, cauliflower, cabbage, etc.) can produce an excessive amount of gas. again that goes to the health of the microbiome. Digestive enzymes can often help with this.

I think it’s a hormonal feeling to be up, but I understand exactly how you feel because I’m going through this right now. I started taking methima ole in early March 2018 and stopped on Monday of the following week to receive RAI treatment. My heart rate is already at 90-100 and I’m jumping through my skin with anxiety. looking forward to this thyroid thing being behind me.

I hope you are doing better soon!

I HOPE you are not referring to having your thyroid radiated (Albation) when you say “RAI treatment.” I gripe about being in between because I am aware of what it’s like to have a “calm phase” in my thyroid. ” I am in this position because we know that the medication, herbal remedies, diet, etc. were working for me. Finding out what kind of upkeep is required to keep me in a normal state is the next step. I didn’t want to enter the HYPO phase because those symptoms are different and, to put it mildly, uncomfortable. Are you aware that if you do RAI131, you destroy the thyroid, totally. And you become HYPO for the rest of your life. No ifs, buts or ors. Many people tell me things like, “Oh, I’ll destroy my thyroid and all my problems will go away, I just need to take a pill.” ” It’s not that easy. For one thing, your beautiful/lovely thyroid IS the victim in this scenario. The medical profession hasn’t changed their protocol for 50+ years. It’s just easier for them to say destroy it or remove it. If you have cancer, that’s one story; if not, I strongly advise you to read the posts or find out from others what their experiences were like having their thyroid removed or destroyed. “I” made my decision not to because I read how many people said it was a BIG mistake. And, that they were trading off one pill for another. Did you know that taking a radioactive material (RAI) can affect other things in your body. Radiation is radiation. The tracer amount test exhausted me for a few days. The doctors said nothing would happen. Doctors are NOT the know all, end all. Do some research. Do “the google” and look inside this forum. NEVER jump into something so severe as knocking out the function of a critical gland in your body. Using natural remedies for this problem will require more work, but it will be well worth it! How much methimazole did you take? Were your T S. H. Did the doctor prescribe anything for your racing heart, and are the Free T3 and Free T4 numbers returning to normal range? If so, why wasn’t Propanol or the herbal supplements Lemon Balm, Motherwart, and Bugleweed (Thyroid Calm) recommended by your doctor, which really helped me? My integrative endocrinologist recommended that to me. Thank you for responding and your kind words. I hope you reconsider. It’s not an easy decision. Especially knowing what will be your “new normal. ” Take Care.

My case isn’t that easy. I have a bad heart on top of the Graves. Myocarditis caused by a hole in my heart’s septum caused heart failure and a heart attack in me. My heart can’t be in a hyper state for any length of time. My symptoms started in January diagnosed with Graves in February. I’ve been on methimazole and inderal since. My trusted cardiologist informed me that if I stay hypertensive, heart failure will strike—not if—I get it. Since going off my medication for two weeks, I’m having a terrible time; inderal isn’t working as well as everyone would like.

My residence in New York is excellent, and I am fortunate to have access to the top physicians in the nation. I work in the medical field, so I understand that doctors aren’t the end all, but maintaining my heart’s functionality is what really matters to me. I am not young—I am in my fifties—and I nearly didn’t make it to my fifties because of myocarditis. I have heard all the horror stories and complications. I think all of my issues are from an autoimmune issue. Thanks for your opinion and point of view. I did get a second opinion as well unfortunately my options are limited.

I am a NYer, too. (Brooklyn) I, too, have a heart issue. A PFO (Patent Forman Ovalie) Hole between 2 of my chambers. I am in my late fifties. I am so sorry to hear you are going through such a hard time with this. I, too, have Graves Disease. (And, other autoimmune diseases. ) Email me at letgo411@gmail. com and we’ll talk. Take Care. Pam.

I just looked up the condition you have. It states it is caused by inflammation. Is it possible that the doctors suggested you start an anti-inflammatory diet? Thyroid function removal is not the solution to an autoimmune disease such as Graves Disease. That auto-immune disease doesn’t just go away. And, the likelihood of someone who has one auto-immune disease will have others. (Graves, Celiac & Rosacea are mine) All these have to do with inflammation. I’m sorry if I come across as pushy, but did the doctors suggest another medication if the Methimazole wasn’t working for you? I don’t doubt you have good doctors. I would know, I live here. I’ve had hyper symptoms for a long time, but the doctors never seemed to be able to figure out what was wrong. Is there anything that can be done to reduce inflammation if that is the root of your issue? I hope that whatever you do, you avoid removing something (like your thyroid gland), as the doctors believe that this is the source of your hyperthyroidism. How is removing your thyroid going to stop the inflammation in your body that attacks your heart muscle? The cause is your auto-immune disease: Graves Disease. You even said that in your last comment. I have done so much, other than the meds, to turn this all around. I went on an A. I. P. Diet, switching to fluoride-free toothpaste, altering personal soap products to remove certain ingredients, filtering my water to remove chlorine, and avoiding SLS (Sodium Laurel Sulfates and triclosan) There is so much toxic products out there that cause inflammation. The food we eat is a major factor. I can go on and on. I was terrified when I found out. I thought I was going to have surgery and be done with it. Then I took one month off to decide what was best for me. After all the research, I took my meds, I did the diet and change of products. ALL of this helped. It’s a mind diet. To be conscious of what I am touching and what goes in the mouth. I hope you will be okay. Take Care. Delete ReplyNote Required.

What If I Stop Taking Thyroid Medication Cold Turkey?

Should I stop taking medication cold turkey?

I’d never stop any medication cold turkey. Slowly weaning off or tapering to the right dose is the best method. I don’t believe our bodies respond well to abrupt changes. Same as sudden weather changes, we get headaches etc.

When should I stop taking methimazole (tapazole) before radioactive iodine therapy?

For years, there’s been no clear agreement on the best time for Graves’ disease patients to stop taking methimazole (Tapazole) before they undergo radioactive iodine therapy, or RIT. In Graves’ disease, the thyroid gland makes excess amounts of thyroid hormones, resulting in hyperthyroidism.

How long does it take to get off methimazole?

I’ve read of people getting off Methimazole all at once and doing okay, although many do have “withdrawal” symptoms (symptoms of being hyper) as their body purges the medication. From what I’ve read, it can take a couple of weeks for those symptoms to go away. Is TSH the only thyroid related test that was done? What about Free T4 and Free T3?

Can methimazole be taken twice a day?

Although methimazole can be taken once a day, split dosing (for example, taking 15 mg twice per day instead of 30 mg once per day) may be more efective for patients with severe hyperthyroidism. The new guidance also goes into greater detail on potential side efects with antithyroid medications.

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