Low cortisol, T3, TSH and steroid injection in hip joint: T3 uptake improved by steroid injection?

[PiggySue]

Hi All

A whole new area for me to understand now (and a long post - sorry!).

I am T3 only so my TSH is normally supressed.

I have arthritis and bone spurs in my hips and was recommended a steroid injection into the joint of my right hip. This has worked really well so far, but I only had it last Wednesday.

Two days after the intra joint steroid injection I was driving and had a sudden bad pain from my middle upper back through to the middle chest. It was like a metal claw. The pain radiated up towards my jaw. I found somewhere to pull over and waited for the pain to subside. It took a long time (probably 5-10 mins). I called 111 on the car phone (first mistake, but I was frightened) and they sent an ambulance. The paramedics found high blood pressure and a high heart rate and said I needed to go to A&E for the cardiac blood test. By the time I had rested in the ambulance during the tests I started to feel better (and a sham!). They insisted that I should still go to A&E. Anyway, after some time I was discharged. My heart is fine, no enlargement or damage, also aorta fine and they also checked in case a lung lining had come away. All tickety-boo.

I have low cortisol, and so was sent for an SST in May. The results showed that I do not have Addison's, but were still not great (I didn't stim to 500, although not far off, but baseline was low as three other 9am blood tests showed and I have hyperpigmentation). I might try and find out about the ACTH test once I am 6 months away from the injection.

If I have Secondary AI, could the steroid injection have caused my T3 uptake to be better than it has been? I know (now) that the injection can cause the blood pressure to rise, but my TSH was 0.001 (I had taken a T3 of 25mg a couple of hours before, so could be that...?)

I really don't quite understand the HPA axis and how it affects everything else...I just want to feel better.

TIA

[Hidden]

You may not have Addisons but you could have secondary adrenal insufficiency where the pituitary is not sending the right signals to the adrenal glands. The treatment is the same but you need an Endo who understands these issues.

[PiggySue in reply to Hidden]

Hi Pauline S

Do you think that the steroid injection may have improved my T3 uptake?

[Hidden in reply to PiggySue]

It may well have done, it could also have made you feel a bit better improving your cortisol levels.

[greygoose]

Are you asking if the steroid injection indirectly caused the chest pain by increasing your absorption of T3? If so, I wouldn't think so, no. It might have increased your absorption of T3, but I doubt the T3 caused the chest pain.

How much T3 are you taking? And what was your last FT3 result?

[PiggySue in reply to greygoose]

Hi Grey Goose

Yes, asking whether it might have increased my T3 absorption (I don't believe it caused the chest pain, I think that might have been a rise in blood pressure caused by the steroid).

I was trying the CT3M and was taking 37.5 at 4.20am and then 25 at 12pm and 12.5 at 7pm. Since the injection I have gone back to 25 3x a day. My last FT3 was when I was taking 100 a day (in 3 lots) and was just slightly above range, but I can't remember how much.

In the past I have been taking 150mg of T3 pday, but no symptoms of overmedication at all...just TSH at less than 0.03 and FT3 a couple of points above range. I try to go by vitals and symptoms. The fact that I didn't show overmedication at that high dose makes me wonder if the problem is not just the Hashi's but also something in the HPA axis... Which low cortisol may also be a symptom of.

Blimey there is a lot to learn!

Thanks