You should go off it slowly. What Do Herpes Sores Look Like at Different Stages. This exact thing happened to me and then my endo put me back on it and my body couldnt tolerate it I was passing out and my symptoms were so much worse,. Egton Medical Information Systems Limited. When starting medication, your appetite may change, you may be feeling tired, or you could have a change in your bowel movements. We tapped the CDC for information on what you need to know about radiation exposure, Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them. Initial dose: Mild hyperthyroidism: 15 mg orally per dayModerately severe hyperthyroidism: 30 to 40 mg orally per daySevere hyperthyroidism: 60 mg orally per day Maintenance dose:5 to 15 mg orally per day Comments: Daily doses are usually given in 3 divided doses at approximately 8 hour intervalsUses: -For the treatment of Graves' disease with hyperthyroidism or toxic multinodular goiter in whom surgery or radioactive iodine therapy is not an appropriate treatment option.-To ameliorate symptoms of hyperthyroidism in preparation for thyroidectomy or radioactive iodine therapy. Can You Eat Soy If You Have a Thyroid Condition? I don't get it. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. Methimazole Monograph for Professionals - Drugs.com Could you be swinging back into hyperthyroid? Ive been on the 5 mg daily for a few years now. Recently, after a six month stint of being in the normal range, my bloodwork indicated I was hyper. I take individual vitamins and supps daily: B complex, C, D, LipoFlavinoid, potassium magnesium asparate, B2, CoQ10, (the last 3 for migraine) Flax capsules, Biotin. By rejecting non-essential cookies, Reddit may still use certain cookies to ensure the proper functionality of our platform. This medicine is available only with your doctor's . I have been having anxiety attacks and I have only been off it a week. It works by making it harder for the body to make thyroid hormone. Sounds like your doctor wants to work with you though if he gave you that choice. My current doctor, who is new to me, also wanted to wean me off but she tested my antibodies first. One thing my Endo and I agree on is that he will not stop a patient's medication entirely unless their antibody levels are within the normal range even if all their thyroid labs are normal. Sorry you're having these problems. Levels of hormone can swing up quickly. Then and only then did my doc increase my meds and will do bloodwork at 4 weeks instead of the usual 8 weeks. unusual bleeding or bruising. 0.84 t4 sounds pretty low so maybe that was part of the decision? Radioiodine in the treatment of hyperthyroidism. i have been taking 2.5 mg of methimazole every other day for the past 3 years which is 4x a week and now she told me to just take 2.5mg once a week for 6 weeks and then just stop. For myself, I found that I could not lower my dose too quickly or stop my Methimazole altogether. Upgrade to Patient Pro Medical Professional? swollen, painful, or tender lymph glands in the neck, armpit, or groin. In addition to the labs you have already ordered for our patient, you quickly decide to add a thyroid function panel, just in case. Surgical Management of Graves' Disease - American Thyroid Association It is not really safe to stop it suddenly. Medically reviewed by Drugs.com on Feb 20, 2023. All rights reserved. Im feeling exactly those symptoms minus the weight loss because that hasnt changed on 2.5. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. [4] Get your TBII or TRAb antibodies tested for Graves, anti-TPO and TGAb for hashimoto's. Not taking your medication also increases your risk of fatal conditions like myxedema coma if you are hypothyroid, and thyroid storm if you are hyperthyroid. Home Treatment For Low Thyroid: What Essential Oils Are Good For Hypothyroidism? With a thyroid condition, your symptoms can be a good reflection of how well the medication is working. I was on 10mg (5mg x 2)a day Carbimazole. Mine endo only did it once every 6mo and within that time my tsh was no longer detectable and I got super super sick. The maintenance dose is 5 to 15 mg per day. I doubt yours would be near that. Patient aims to help the world proactively manage its healthcare, supplying evidence-based information on a wide range of medical and health topics to patients and health professionals. But I was stressing about some dumb things before. Special Populations My blood pressure was constantly high until I was off of medications. It bounced around .53 to .25 then .50 again but never above. This was very irresponsible of them and I was not able to be well enough to work for a year after that. You will be able to stop your cholestyramine (if on it) immediately. Untreated Graves' disease caused severe problems for me. TSH above 1 is a good place to be in according to my endo. I would ask to do labs again. Your email address will not be published. Follow all directions on your prescription label. You will learn what these results mean very quickly and you can always learn more about them online. Increased pain. She has a past medical history of hypertension and she has been compliant with her medications. Endocrine causes of dangerous Fever. Methimazole and Drug withdrawal syndrome, a phase IV clinical study of However, thyroid disease is complicated, and you can develop new symptoms when you begin your treatment, either due to the wrong medication dose or the way that your body responds to the medication. Her vital signs are blood pressure of 184/106 mmHg, heart rate of 130 beats per minute, respiratory rate of 22 breaths per minute, and temperature of 102.7F. and he said that it could not be my thyroid because the Methimazole will be in my blood for 2-3 weeks. Herpes spreads by oral, vaginal and anal sex. Store at room temperature away from moisture and heat. We offer this Site AS IS and without any warranties. Is there side effects from stopping or withdrawal symptoms? When I started getting hyper symptoms from armour I tapered slowly and went off but my TSH never sprang back. I'd love to be able to start these again once I'm diagnosed and under the care of a naturopath. I feel wonderful now. But didnt feel any on the 5 mg. How long were you on Methimazole before weaning off? How long were you on Methimazole before weaning off? Tell your doctor if you are pregnant or if you become pregnant while using this medicine. The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. The state patrol who should be serving and protecting, was searching to destroy based on my appearance bulging eyes, unable to hold head back and count due to goiter,and the yellowing eyes and tremors crawling skin causes jerking movements. STIs are the most common cause of genital sores. Solomon B, Wartofsky L, Burman K. Adjunctive cholestyramine therapy for thyrotoxicosis. Said it was controversial. I tapered and stopped completely and felt so good. I am at 15 MG per weekI take 5 mg on M/W/F and my body is getting used to it but I have passed the two year mark and no signs of it abating. And other symptoms of hypothyroidism. Bridge to EM: Senior Medical Student Curriculum, GroundED in EM: A Third-Year Student Curriculum. Found that I could not take vitamin D pills, that they had to be the gel caps. Do not use methimazole in larger or smaller amounts or for longer than recommended. I did this (decided to lessen the dose) all by myself with a naturopath's advice (my "specialist" seems to have forgotten about me and never did the follow up in mid-March, and I am not disappointed =;) The biggest help has been to deal with my stress. It does not stay in the body for 2-3 weeks, this is just not true. Hello I'm glad I found this. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. Now I have to start all over again. Methimazole may also be used for purposes not listed in this medication guide. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Long-term methimazole therapy improves Graves disease - MDedge i teally feel I have late stage chronic lime. Treatment and prognosis of Graves disease in children and adolescents. Should I stop Methimazole over a high TSH? - MedHelp HyperT77 My Endocrinologist has started weaning me off of Methimazole. You should not breast-feed while using this medicine. My pcp didn't like that. It is also used before thyroid surgery or radioactive iodine treatment. I just have to say thanks for always replying to my posts. Hello, what you think of my lab results & should I see another doctor? Copyright 1996-2023 Cerner Multum, Inc. Gaitonde DY, Rowley K, Sweeney L. Hypothyroidism: An update. Doctor did not tell me this , it was my naturopath, but I am glad I listened to her. A list of national and international resources and hotlines to help connect you to needed health and medical services. As far as symptoms go, I have been gassy (for no reason), fatigued more than usual, depressed, short tempered,and I'm either too cold or too hot. Best, Rachel. Since 2007 I gained 60 pounds using effexor and tapazole. I was diagnosed with Autoimmune Hyperthyroidism in Dec., 2006. Anterior cervical discectomy, no fusion - what to expect? Seemed like it got stuck or something. It is generally well tolerated and has few side effects, but it does require close monitoring because of a low rate of some severe side effects, such as low blood counts. My gut feeling is that this method seems to make greater ense than the shock and confusion of going 'cold-turkey'. Do not take extra medicine to make up the missed dose. I remember being on armour thyroid. She also tells you that she has had recent blood work ordered by her primary care physician that was highly suspicious for some sort of thyroid disorder, but the results have not been made known to her yet. A previous ALiEM blog post further discusses some of the nuances associated with the diagnosis of thyroid storm. Good luck, hope you go into remission! Twice, I got worried because my hand and arm were deep red from the tightness of the cuff. doc. The Best IOL for 2022 RXSight Light Adjusted Lens, Will refractive surgery such as LASIK keep me out of glasses all my life. Are you losing weight? Thank God for my good health again. Methimazole is used to treat hyperthyroidism (overactive thyroid). A Community for those living with and dealing with Graves' Disease. Some side effects may occur that usually do not need medical attention. Is it possible that it is my thyroid or should I see my PCP for the attacks. Serious and sometimes fatal infections may occur during treatment with methimazole. All lab work has come back in normal ranges. Now down to 5 mg a day, 6 days a week (so 30 mg a week). PMID: 24176474. It works by making it harder for the body to make thyroid hormone. I tried this and my TSH rose from less than 0.001 (where it had been for 2 years) to 0.12 (in the right direction but not enough). Not taking your hypothyroid or hyperthyroid medication can cause undesirable, dangerous, and even life-threatening conditions, ranging from fatigue and changes in blood pressure to death. You need to be involved in the decisions regarding your care, and how you feel about your medication and its effects are of great importance. It should always be tapered incredibly gradually, there's always a small rebound period for me no matter how small I chop it with my pill cutter. Hypothyroidism (underactive thyroid). I hope you go into remission and you dont have to keep taking those god forsaken meds. Generic name: methimazole [me-THIM-a-zole] Common Methimazole side effects: Drug ineffective: 348 reports Hyperthyroidism (over activity of the thyroid gland): 336 reports Fatigue (feeling of tiredness): 320 reports Weakness: 271 reports Agranulocytosis (a deficiency of granulocytes in the blood, causing increased vulnerability to infection): 262 reports Headache (pain in head): 252 reports Cookies collect information about your preferences and your devices and are used to make the site work as you expect it to, to understand how you interact with the site, and to show advertisements that are targeted to your interests. I occasionally would ask my husband what the readings were. 2013 Nov;31(4):969-86. Methimazole Dosage Guide + Max Dose, Adjustments - Drugs.com By accepting all cookies, you agree to our use of cookies to deliver and maintain our services and site, improve the quality of Reddit, personalize Reddit content and advertising, and measure the effectiveness of advertising. yes. Anthing would be helpful. Growth of thyroid nodules, increasing goiter size. ALiEM is not endorsed by, sponsored by, or affiliated with the University of California San Francisco or any institution. I have had this for 2 years and I just got off the tapazole for at lease 6 weeks until the check my blood again. 6 years ago, no one will listen. Have been on it for 18 months. My levels are all in good range so Im confused why she wants to see if I can lower the dose. But yet they tell me I'm hyper. She is the author of "The Thyroid Diet Revolution.". When your lab tests are like yours (low TSH and high Free T4) you are hyper. Methimazole is an excellent medication for Grave's disease and other forms of hyperthyroidism which works by interfering with the production of the thyroid hormones. Shaky? The antithyroid drugs methimazole (MMI) and propylthiouracil (PTU) are used as one option to treat patients with hyperthyroidism, especially those with Graves' disease. I have not been on it for 6 days now. Herpes sores blister, then burst, scab and heal. I havent tried to wean off before. Clearly, there are sensible health reasons to take your prescribed thyroid medication. Got dosage down to 5mgs. DID YOU NOTICE ANXIETY OR RAPID HEARTBEAT OR COULD I BE ANXIOUS ABOUT GETTING OFF THE MEDICATION. I never was given clarity about what "the damage" entailed though:(. There may be two explanations for this benefit of long-term therapy, according . Your blood may need to be tested often. You must tell us if you are pregnant, even if you Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. It is also used before thyroid surgery or radioactive iodine treatment. Her overall presentation does not seem to add up in being secondary to urosepsis. Am Fam Physician. Just like a person with type 1 diabetes needs insulin, you need thyroid hormonefor survival. Didn't find the answer you were looking for? But it can also cause weight loss and a reduced need for sleep, which some people actually welcome. Brand names: Tapazole, Northyx By using this Site you agree to the following, By using this Site you agree to the following. The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. My methimazole was 5 mg once a day. I want to know if I should see another doctor. A list of national and international resources and hotlines to help connect you to needed health and medical services. Not all possible interactions are listed in this medication guide. rachelemacd At my last visit, my Dr suggested seeing if I could wean off my medicine. I dont think theres any harm in that as long as they are testing your blood frequently like every month. I take 5 mg at night and 2.5 in the morning. My GP suggestd similar action as my TSH levels started rising (only just out of range)and my FT4 dropped. Usual Pediatric Dose for Hyperthyroidism: Initial dose: 0.4 mg/kg orally per dayMaintenance dose: 0.2 mg/kg orally per day (approximately half the initial dose) Comments: Daily doses are usually given in 3 divided doses at approximately 8 hour intervals. Sulfamethoxazole-Trimethoprim for Skin and Soft Tissue Infections: 1 or 2 Tablets BID? Bartle W, Walker S, Silverberg J. Rectal absorption of propylthiouracil. I refused to take blood pressure the whole time. His goal is to wean me off very slowly. Weaning off of Methimazole What next? Swollen hands, feet, and face. What are the medication for hypothyroidism in cats? Nabil N, Miner D, Amatruda J. Methimazole: an alternative route of administration. :), The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. Hi, My doctor took me completely off Methimazole at 1 year with very poor resultsI was off the charts in 2 1/2 weeks and back up to 20MG a day to get me stable. Thats what Im saying. And there are no natural substitutes for antithyroid medications, either. They do better controlling their thyroid hormones using Regular L-Carnitine. An EKG is ordered, revealing an irregularly irregular rhythm, and an urinalysis is conducted, showing many bacteria. What Do Herpes Sores Look Like at Different Stages. I am so overwhelmed and only end up having a few days out of a month. Talk to your doctor about these issues, as they can be the effects of your thyroid hormone levels getting back to normal. So this is a surprise to me that I migh have Graves or toxic nodules as I feel I'm bouncing back with no symptoms of hyper. Methimazole is used to treat hyperthyroidism, a condition that occurs when the thyroid gland produces too much thyroid hormone. with 87 to 100 percent becoming euthyroid within a few weeks to a few months . I hadn't tested much in over a year- hoping this prior post link will work on this post to refresh anyone's memory who cares to 27M, 6'0, 174lb, Been on NP for about 4 months, Don't smoke or drink. I DONT KNOW IF I COULD STILL BE HYPER.MY LAB RESULTS HAAVE BEEN NORMAL FOR 1 YEAR. and Privacy Policy and steps will be taken to remove posts identified Your phone, computer, or another alarm can be programmed to give you a daily reminder. Methimazole is used to treat hyperthyroidism, a condition where the thyroid gland produces too much thyroid hormone. Hair loss. Thyroid medication can be expensive and can sometimes cause undesirable side effects, especially in the first three months of treatment. Your story is exactly like mine. Takiing Armour (thyroid hormone replacement) has seemed to cause your hyperthyroidism. Didn't find the answer you were looking for? Worsening of constipation or GI issues. I should have listened to him. Herpes spreads by oral, vaginal and anal sex. Thyrotoxic Crisis Oral Some clinicians recommend 60-80 mg daily. So hopefully youre getting bloodwork again soon to make sure things are ok? There are experiences, however, that may cause you to question the benefits of your medications and not stick with your treatment plan. Do Thyroid Problems Always Have To Be Treated? fatigue and hyperthyroidism and Graves' Disease. We offer this Site AS IS and without any warranties. This required my Endo to make a lot of lowering adjustments and I adjusted my carnitine dosages. I just wanted to tell everyone DON'T GIVE UP and DON'T TAKE THE RADIATED IODINE or have your thyroid removed (unless there is a growth of course). I'll hold the cetyl L-carnitine and start with L-Carnitine then. coming off tapazole what to expect | Other Drugs discussions Have been on it for 18 months. These are valid concerns, but they are not reasons to stop taking your medication; the risks of going untreated are far too serious. tightness in the chest. Thyroid Storm: Treatment Strategies - ALiEM I stopped Zinc, L-Lysine & alpha lipoic which made me feel amazing! By Mary Shomon I am weaning off methimazole i was only taking 10 mg a day down to 7.5 mg for 2 weeks feeling lightheaded and was wondering if anyone knew of any side effects? Before Tom died, I felt amazingly well off the armor even with low TSH. Stop using methimazole and call your doctor right away if you have signs of infection such as: sudden weakness or ill feeling, fever, chills, sore throat, cold or flu symptoms; painful mouth sores, pain when swallowing, red or swollen gums; or. Having irrational thoughts worries. Has anyone elses doctor done this? Vancomycin Loading Doses in Pediatric Patients: A Missed Opportunity? Ok. Dizziness. T3 total: 332; FT3 11.1; FT4 387, TSH <.005. HELP. Anxiety is a major symptom of hyperthyroidism. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Unfortunately, there isn't a natural or herbal replacement for thyroid hormone. decreased sense of taste. Hair loss. Dosage form: oral tablet (10 mg; 5 mg) You pituitary is trying to tell your thyroid to produce more hormones, but the Methimazole (anti-thyroid med) is preventing your thyroid from working. If you want to get notified by every reply to your post, please register. Take your doses at regular intervals to keep a steady amount of the drug in your body at all times. My TSH plunged this year after Tom's death and all my health scares (the eye bleeds - occular migraines - vertigo - stroke scare which turned out to be migraine aura - ugh) This must have tipped me into real hyper maybe graves. What dose were you on to start with? Written by Cerner Multum. Get your prescription refilled before you run out of medicine completely. Methimazole (Oral Route) Description and Brand Names - Mayo Clinic I am not so familiar with hyper as I am hypothyroidism; however, since Methimazole only has a half life of 4-6 hours, it clearly is a fast acting med, similar to a T3 med for hypo. When did you start going off it? Methimazole (Tapazole) - Side Effects, Interactions, Uses, Dosage Skip the missed dose if it is almost time for your next scheduled dose. A dosage change can start to be felt for me in 3 days and reaches fullness in about a week, but if it is too big a dosage change the symptoms can last for week (s) afterward till my body adjusts. Skipping or stopping your antithyroid medication or thyroid hormone replacement will lead to undesirable and possibly dangerous effects. 19 users are following. It flared up my GERD do now taking Prevacid and going to go to the counselor.. But I'm wondering now if it could be missing dosses? The doctor told me to take a Metoprolol once in the morning, then, around lunch time, take the 20 mgLisinopril, then, at dinner time, take another Metoprolol. pale skin, easy bruising, unusual bleeding. Why would she try to wean me off the medicine if my numbers didnt indicate remission? https://patient.info/forums/discuss/stopping-methimazole-543742. Always speak to your doctor before acting and in cases of emergency seek This can make it easier for you to bleed from an injury or get sick from being around others who are ill. "Can I take 5mg methimazole for Graves Disease for life" Mary Shomon is a writer and hormonal health and thyroid advocate. Instructions for Women Pregnant women cannot receive the therapeutic radioactive iodine, since it will harm the fetus. We recommend using methimazole (MMI; 0.25 to 1.0 mg/kg per day). Methimazole - StatPearls - NCBI Bookshelf My free T4 two weeks ago was 1.1 last week on the 19 th it went up to 1.2 ref range is 0.8-1.8. Been on Tapazole for 13 months after being diagnosed with graves disease. Vol 7 Issue 4 p.12-13 | American Thyroid Association The ENT in the group did suppression therapy. Some thyroid medications can also cause hair loss, which most people find frustrating and undesirable. He naturally handcuffed me and searched my car in which I had marijuwana and had already told him. Methimazole: Uses & Side Effects | Cleveland Clinic Hi, Should I stop Methimazole over a high TSH? If the hyperthyroidism returns, the antithyroid drugs are re-started. Thanks. The question is now . Use of the forums is subject to our Terms of Use My T3 and T4 are at mid to lower end of the range. Methimazole side effects. methimazole - UpToDate While you may experience some symptoms of overactive thyroid more than others, and you may even consider some of them beneficial, it is important to be aware of the strain this condition is putting on your heart, bones, and overall health. Thanks, THANKS FOR YOUR HELP LET ME KNOW IF YOU THINK OF ANYTHING. 0.84 t4 sounds pretty low so maybe that was part of the decision? MedHelp is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. I am a 52 year old female and I had been on 15MG Methimazole for the over 2 months and my Endo lower the dosage to 10MG (took the And I vote you find another endo even if you do even out - you want someone who knows their stuff to monitor you in case you relapse in the future. Okay I didn't know you had completely stopped the Methimazole, but I think you misread what I wrote. Most of us feel best with Free T4 at about the mid range point and Free T3 in the upper half to upper third of the range. 2 days on, one day off and this past week my endocrinologist gave me the choice of either going right off Tapazole or going off it slowly. Could the anxiety be stemming from you actually still needing the methimazole? We strive to reshape medical education and academia in their evolution beyond the traditional classroom. Tenner AG, Halvorson KM. Thyroid Problems: Extremes Are Never Good. The article suggested hyperthyroid patients and patients who have thyroid storm benefit from taking 3,000 mg of Regular L-Carnitine. If there is a contraindication for the use of methimazole, alternative methods to treat hyperthyroidism should be considered after discharge, such as radioactive iodine or surgery. Stomach/digestive issues (gassy feeling/bloating), depression and fatigue are certainly hypo symptoms, but many people who are hyper have them as well. Because I thought they might be responsible for lowering TSH. Propylthiouracil (PTU; 5 to 10 mg/kg per day) is also effective . Registered number: 10004395 Registered office: Fulford Grange, Micklefield Lane, Rawdon, Leeds, LS19 6BA. Stopping methimazole | Hyperthyroidism | Forums | Patient He wanted me at 0 TSH. All of this has been a real struggle for me since I have a huge phobia of taking meds. Posted Read This Before You Abruptly Stop Taking Your Thyroid Medication I am also trying to wean off and am having really really really bad anxiety is this normal???? Methimazole Uses, Side Effects & Warnings - Drugs.com Is there some other underlying issue that is taking place? Also did the same with Vitamin D and Magnesium. Available for Android and iOS devices. If your regular doctor can't explain why you have this problem, it can be fixedcheck out naturopathic ways to treat symptoms, you are worth it. To me, it really is the missed mimic of several disease states, as described above in our possibly uroseptic patient. However, since starting to wean off, my numbers have gotten closer to the Hyper T side again. Typical dosing for methimazole The dose of methimazole for adults ranges from 5 to 40 mg by mouth per day depending on how severe your hyperthyroidism is. Read our editorial policy. unable to get any financial help*SSI/DISABILITY DENIED X4, ***this post is edited by moderator *** *** private e-mails not allowed*** Please read our Terms of Use. My T's were always mid range. Patient is a UK registered trade mark. ACMT Toxicology Visual Pearl: Swollen Lips, PECARN Pediatric Head Trauma: Official Visual Decision Aid, A Starters Roadmap to EM Resources: Books, Websites, and Apps, D50 vs D10 for Severe Hypoglycemia in the Emergency Department, The Dirty Epi Drip: IV Epinephrine When You Need It, Tips for Interpreting the CSF Opening Pressure, Trick of the Trade: Mix Ceftriaxone IM with Lidocaine for Less Pain, Trick of the Trade: Urine Pregnancy Test Without Urine, Wellness and Resiliency during Residency: EM is a career with unresolved stories, Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License, Academic Life in Emergency Medicine - All Rights Reserved (except for the PV Cards and MEdIC Series PDFs), Block the production and release of thyroid hormone (preventing the opposing team from getting the ball and scoring), Block the sympathetic outflow (preventing the soccer ball from going out of bounds), Block peripheral conversion of T4 to T3 (preventing penalty kicks), Mechanism of action: Inhibit thyroid peroxidase, an enzyme involved in the production of T3 and T4 through the iodination of tyrosine residues on thyroglobulin, Agents: propylthiouriacil (PTU) and methimazole (MMI), No head-to-head trials have shown any benefit of using one thionamide over another in the management of thyroid storm.