Thyrotoxicosis with hyperthyroidism or without hyperthyroidism

The TFT report has been repeated and it shows T4 normal T3 is elevated and its 8.6 TSH now is <0.010 Anti TPO report is awaited As per this report of TFT, he is a case of T3 Thyrotoxicosis. Does he need Carbimazole along with Propranolol? Check attached report below

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Report not attached If patient have symptoms of overt thyrotoxicosis include heat intolerance, palpitations, anxiety, fatigue, weight loss, muscle weakness, and, in women, irregular menses. Clinical findings may include tremor, tachycardia, lid lag, and warm moist skin then start carbimazole along with propranolol Otherwise carbimazole enough

Most likely a case thyrotoxicosis due to Hoshimoto's thyroiditis. Brittle thyroid function . Can easily change from hyperthyroidism to hypothyroidism with anti thyroid drugs. Will eventually become hypothyroid requiring life long thyroid replacement. If clinically there are thyrotoxic signs and symptoms, suggest observation and 3rd monthly thyroid profile with FREET3 and T4

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