Hi
I wonder if anyone can put my mind at rest. I have been on high dose steroid inhalers for over 20 years to control my difficult asthma. However over the last couple of months it’s taken a turn for the worse and I have now been prescribed a 7 day course of 30 mg Prednisolone. Having read the instructions there is a warning about using them if you have an under active thyroid which I have and they can lower immunity! Is this also the case with a short course of steroids?
They're unlikely to affect immunity with short course and, even with several short courses in quick succession, the immune system easily sorts itself out as soon as they've stopped. It's more that, with long-term prednisolone, people can be more susceptible to colds and things and, by the nature of asthma, if they do get those then it's more likely to go to the chest (though not necessarily a given). All this is a world away from actual immunosuppression which I think a lot of people think inhalers and prednisolone cause - in the vast majority of people this isn't the case even with long-term high dose prednisolone.
I have diagnosed borderline low immune levels a few years ago which was caused by long-term high dose Prednisone but even with that, it sorted itself out after the steroids were reduced.
I'm not sure about the thyroid issues although I know of people who take medication for that alongside steroids. You could always ask your GP about it though.
Thank you so much twinkly29 that’s really very helpfulx
I never even noticed the thyroid warning! I have an underactive thyroid and take levothyroxine daily, and can't say I've ever noticed anything out of the ordinary from taking inhaled steroids or pred. i mean yes, I did get side effects but I don't think they were unusual or different from those with fully functioning thyroids!
I did get adrenal insufficiency from long term high dose steroids (this has now resolved so my adrenal glands work fine). I saw an endocrinology nurse for that and while she noted the thyroid issues, she never suggested any link to steroids, either the ones I took for asthma or the ones I needed for adrenal insufficiency.
I agree with twinkly that you might want to ask your GP. I'm just going from my own experience, and for all I know any potential issues with pred depend on the reason you have an underactive thyroid (technically mine isn't underactive, it's just not there at all, and never was).
Thank you Lysistrata that’s comforting to know that I should be ok to take them despite thyroid issue. It refers to under active thyroid in the Warnings & Precautions! However I am taking them now and I guess they will either kill or cure!
I don't want to hijack this thread too much but can you remind me how you resolved your SAI? My cortisol is still so low every time I do a test but I'd really love to try to wean off the HC if it's possible at any point as it feels scary to be dependent on them in a very life or death sort of way. How many months / years did it take you to wean?
Hmm not sure I have any magic answers, sorry! I was on steroids for AI for about 4 years in the end, and probably about 6 months at the end and some months in the middle on a lower dose than 20mg hydro (10mg since last December). Last year when I kept having admissions they told me to stick at 20mg for a bit as it kept going up and down. In the 6 months before my latest synacthen test I did start to wonder if it was improving as I no longer had low cortisol symptoms when my lungs kicked off.
I think I am unusual because I don't tend to take pred for asthma anymore, now that I know it doesn't help me! I still flare a lot but no pred, which helps the AI (Sorry, not helpful if you do need pred). I also think it helped that with lockdown I haven't had as many of my usual triggers, so hadn't had admissions for a while and been given pred anyway which can happen.
Thank you for sharing this!! Very helpful to here any / all experiences from other SAI folks with asthma!!
I think pred can interfere with the metabolism of thyroid hormones - which can mess with your levels. With long term use they may need to adjust the dose of levo but it shouldn't be an issue for short term courses.
That’s good to know Glty thank you for your reply.
I’ve been prescribed these before for my asthma and I have to say it did make me feel strange for a few days. I don’t have thyroid problems but I would chat with your doctor to put your mind at ease if your worried about the side effects take care.
No one's mentioned anything to me re thyroid stuff. I'm on levothyroxine for my thyroid (autoimmune hypothyroidism) and have been on a few courses of prednisolone for asthma and other reasons.
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