thyroid lobectomy while on prednisone

[Paperroses]

I'm down to 2.5 mg prednisone and I feel the best I have ever been since starting on the recovery five years ago.

I've been taking levothyroxine for the past 30 years and just recently had an ultrasound scan done. I was found to have two enlarged nodules with abnormal cells. After a needle biopsy I was told its benign but i need surgery to remove right side of thyroid.

I'm very concerned that this surgery may interrupt my tapering down and it may even cause a flare. I see the doctor this upcoming week and would like to suggest postponing the surgery while I'm still tapering down on the prednisone. I also fear that side affects of surgery could be confused with adrenal fatigue . Any thoughts or suggestions.

[PMRpro Ambassador]

Sorry to hear you need surgery. However, I wouldn't postpone it in the hope you will get to a lot lower dose of pred because you don't know whether it will be a couple of months (unlikely) or much longer.

Even if you were to get off pred soon, the propensity to relapse remains for life - and it is no more likely that the surgery would trigger a flare now than in some months after stopping pred. You can't say the PMR is in full remission for at least 6 months after stopping pred and, as I say, nothing it certain even then. Adrenal function isn't back to normal for a year after stopping pred. Obviously they think it is needed or they wouldn't be suggesting it be done now - it doesn't sound as if waiting a year or more is on their cards.

It is the endocrinologists who will be caring for you I imagine - and they DO know about adrenal function, it is their job. They will provide adrenal cover during the surgery and monitor you afterwards. I wouldn't worry about confusion of symptoms because it could apply whether it is done now or in a couple of years really.

[Pippah45]

I think I was on 7mg pred when I had a replacement hip a couple of years back. They raised my dose for something like 24 hours but then back again to 7. So I wouldn't worry about the Thyroid op in that respect.

After a few false starts with reduction I am on 2mg of pred.

[proactive]

I had an unplanned hip replacement due to a fall earlier this year and didn't think to up my prednisone. I was on 9.5 mg at the time and the hospital pharmacist questioned me as to the dose. They were not willing to cut pills, so I asked them to simply up it to 10 mg for the 5 days I was in hospital and went back to my usual dose once I was released. No flare of symptoms occurred and I have now done a slow reduction plan and am at 7.5 mg daily.

[Hidden]

I've been on levothyroxine for about 30 years and have had no feedback on any other issues - just annual blood tests for thyroid TSH levels. There has been no suggestion that there is any link between using Prednisolone with levothyroxine.