Hello sir, I am 48 years old & a hyperthyroidism patient since 2004. Now on medicine tab methimazole 10 mg, ciplar 40 & lam plus. T3 & t4 are normal but tsh .01 which have been fluctuating if increase the dose abruptly changes within a month. I would like to know how long is the lam plus safe to continue because I feel better with lam plus thanks.

Dr. Prabhakar Laxman JatharEndocrinologist50yrs exp

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Hello, Thanks for the query. In hyperthyroidism usually three methods of treatment are employed. 1)To give anti0thyroid drugs as Methimazole for a period of 18 to 24 months. During this period or just on conclusion of this period TSH returns to normal range (0.5 to 4.5 mU/L), then treatment is discontinued. In a few cases the condition reverses completely and no further treatment is required. 2) In case THS further goes down, then occasionally Methimazole like drug may be used once again or Radio active Iodine is used to stop functioning of thyroid gland. Later patien becomes hypothyroid for life and is gven appropriate dosage of Levothyroxine and that condition is controlled. 3) In a few cases thyroid surgery may be undertaken if there are small nodules. However, surgery is the least preferred option. According to you you have the condition for quite a few years, but there is no mention of how long have been on Tablet Methimazole. If all these years you are on that, then that drug is unlikely to change the situation. So next best option is Radio Active Iodine ablation. If you have any questions please do come back. Thanks. 

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