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?
How much levothyroxine are you currently taking
Have you had dose or brand change in levothyroxine recently
Being under medicated for thyroid, and Low vitamin levels as direct result can cause tight chest and breathlessness
Steroids can lower TSH
Absolutely essential to get FULL thyroid and vitamins tested regularly
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.
Also EXTREMELY important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .
Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
Is this how you do your tests?
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
List of private testing options
thyroiduk.org/getting-a-dia...
If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3
£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code thyroiduk.org/getting-a-dia...
NHS easy postal kit vitamin D test £29 via
Medichecks Thyroid plus antibodies and vitamins
medichecks.com/products/adv...
Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test
bluehorizonbloodtests.co.uk...
Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test
Thriva also offer just vitamin testing
Hi SlowDragon thank you for your reply. I spoke to the Dr in this regard a couple of years ago as I am well aware that everything needs to be in range. I started taking a little extra to what I should have been taking as TSH was to low. When I told him what I had done he went ballistic at me! He said that I had no rights to do this as far as he was concerned I was in the correct range. He also noted it on my records that I didn’t follow Drs instructions. This upset and worried me greatly. As I found out the hard way doctors don’t like you trying to tell them their job. My hands are now tied basically!!
So how much levothyroxine are you currently taking
Do you always get same brand levothyroxine at each prescription
Thousands upon thousands of U.K. members forced to get FULL thyroid and vitamin testing done privately
Just testing TSH is completely inadequate
For FULL thyroid and vitamin testing you need TSH, Ft4 and Ft3 plus both TPO and TG thyroid antibodies plus vitamin D, folate, ferritin and B12
Come back with new post once you get results, members can advise on next steps
Sorry to say I do not know enough about steroids to comment.
Two years ago you posted and members commented helpfully. So am wondering what your answers to the questions/comments may have been 🤔 Do you have good levels of T3 ? Also B12 - Folate - Ferritin and VitD.
I think I would want to know my T3 level and vitamin and mineral results before embarking on another steroid. But hey that's just me 🌻
Hi Marz thank you for your reply. I spoke to the Dr in this regard a couple of years ago as I am well aware that everything needs to be in range. I started taking a little extra to what I should have been taking as TSH was to low. When I told him what I had done he went ballistic at me! He said that I had no rights to do this as far as he was concerned I was in the correct range. He also noted it on my records that I didn’t follow Drs instructions. This upset and worried me greatly. As I found out the hard way doctors don’t like you trying to tell them their job. My hands are now tied basically!!
Unless he tested the FT4 and FT3 in addition to the TSH then he really couldn't assess your thyroid function accurately and should not have expressed his anger.
Do you keep copies of your results with ranges ? Important to monitor your own progress and check what has been missed !
SeasideSusie has great experience and knowledge but she also carefully monitors her thyroid numbers along with the vitamins and minerals.
When I told him what I had done he went ballistic at me! He said that I had no rights to do this
You have every right to do that. It's your body, your health, your life. He is only there to advise you, not dictate to you. And, your treatment should be by informed consent. You're not a child, you're an intelligent adult, and should be consulted every step of the way. I hope you complained about him to the practice manager for that!
Well that’s the thing I didn’t because he made me feel as though I was in the wrong and in effect reported me for not complying with GPs instructions. This was before Covid so I guess I have left it too late to do anything about it now!!
Dose of levothyroxine should never be adjusted by TSH anyway, but especially on steroids
ALWAYS get full thyroid and vitamin testing before any dose change and again 6-8 weeks after any dose or brand change in levothyroxine
pubmed.ncbi.nlm.nih.gov/114...Orally administered prednisone, in a dose of 20 mg each day for nine days, resulted in a significant decrease in mean serum TSH levels
Faith007
Having lung disease myself I have occasionally had to have unavoidable short courses of steroids. Mine have been 40mg daily for 7 days, despite me trying to wrangle a lower dose or shorter course it's a case of you need whatever your ailment requires at the time. The prescriber knew I was hypothyroid and taking levothyroxine but when it's a case of needing the steroids there's not much you can do.
I have suffered no adverse effects from these, neither short nor long term.
I did not have thyroid tests done at the time, or near, when I was taking the steroids so I have no idea if, or how, my results could have been affected. When you're unwell enough to need steroids, you probably wont notice whether you are suffering thyroid-wise from them anyway.
The link that SlowDragon has given you says
Orally administered prednisone, in a dose of 20 mg each day for nine days, resulted in a significant decrease in mean serum TSH levels (p less than 0.01) without significant changes in levels of serum T4, T3, and thyroxine binding globulin (TBG). These findings suggest an inhibitory action of relatively low pharmacologic doses of prednisone on TSH release without changes in circulating thyroid hormone concentrations or inhibition of the peripheral conversion of T4 to T3.
So the predisolone wont be affecting your levels of T4 or T3 or conversion.
As you clearly need them I wouldn't worry about it and hopefully the 7 day course will be enough.
SeasideSusie thank you so much. It really helps to hear that you have taken Preds and have been relatively ok on them. As you say with Asthma it can be a matter of life and death and I definitely needed them in this instance thank you againx
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