Steroids and testing

[Kriticat]

I'm due for the next blood tests, but I'm on a course of steroids for wrist pain. They're due to finish in a week so will wait until then at least, but wondered if I should give them even longer to get out of my system?

[SlowDragon Administrator]

yes …..ideally at least 6-8 weeks

Steroids often affect TSH

[Kriticat in reply to SlowDragon]

Thanks SlowDragon , it seems lots of things affect TSH, but I'm trying not to look at that so much as FT3 and FT4, as mine seems all over the place and doesn't seem to bear any relationship to my symptoms. Luckily I don't have to convince an endo at this stage... thanks to you and this excellent group. Judging by my symptoms I am really to increase my T4 dose but want to test first, so will do it next week. Does the biotin in the b complex also only affect TSH?

[SlowDragon Administrator in reply to Kriticat]

you need to stop vitamin B complex 5-7 days before test

Can instead take separate folate and B12

[RedApple Administrator]

Here is an excerpt from an article on the Pituitary Foundation website:

Corticosteroids and the thyroid

Corticosteroids, such as hydrocortisone, reduce the secretion of TSH, which is a hormone that controls how much thyroxine our thyroid gland produces.

Although near physiological doses of hydrocortisone and resulting changes in serum cortisol levels decrease serum TSH levels, they do not usually change the active hormone FT4 levels, unless an undiagnosed underactive thyroid exists and is unmasked when corticosteroids are started.

Additionally, corticosteroids may lower the levels of a protein that exists in our blood and carries thyroid hormones, called thyroid binding globulin (TBG). However, the clinical impact of TBG or thyroid function tests changes caused by corticosteroids is minimal.

Therefore, replacement doses of hydrocortisone are unlikely to affect the thyroid hormones and the levothyroxine replacement dose.  

pituitary.org.uk/informatio... (Scroll down to the relevant section on the page)

I think this suggests that although TSH might decrease a little, FT4 isn't really affected. So if you're doing all three thyroid hormones, you should be able to assess accordingly.

I don't see a reason to wait long, if at all, but my brain's a bit sleepy right now so if anyone else interprets this differently, hopefully they'll comment here 😊

[Kriticat in reply to RedApple]

Thanks for that, RedApple , that seems pretty clear, and I'm trying to ignore my TSH levels as they are up and down, still adjusting my dose to try to get optimal FT3 and FT4.

[TiggerMe Ambassador]

Have you checked your sex hormone levels? Low estrogen causes joint pain and carpal tunnel

[Kriticat in reply to TiggerMe]

That's interesting... I originally went to the doctor to beg for oestrogen as it had worked wonders for a friend of mine... I was told I'm too far past menopause and it's dangerous for women my age to suddenly start taking it, so she sent me to an endocrinologist who diagnosed hashimoto's. But a year of treatment hasn't sorted it out yet... if I also have low oestrogen I'd seriously consider living dangerously rather than painfully. What tests should I ask for?

[TiggerMe Ambassador in reply to Kriticat]

Very old school thinking, why would it be good to be deficient in anything?? It would help balance your thyroid needs, have a read up, often best to be specific with what you would like to try, when the Meno Clinic passed my prescription on to my GP they hadn't a bloomin clue 😉

They don't need a blood test to prescribe estrogen or progesterone and you need both if you still have all your bits! 😊

I've used this one in the past to keep an eye on things, you can get away with the finger prick test if you don't come into skin contact with anyone using HRT. If you wait it'll likely be discounted as they often run offers.

Probably others offer similar...

medichecks.com/products/fem...

The newer transdermal and body identical are the way to go 🤗

[Kriticat in reply to TiggerMe]

Thank you so much TiggerMe , I will get tested and speak to my endocrinologist... I can go to a private lab here in Greece and order whatever tests I need, I just have to work out what the tests are called in Greek! I've been so focused on getting my thyroid hormones balanced I'd forgotten about oestrogen, and just believed that the doctors knew best... I now realise that's not true, and will do some research to see what i need once I have the results

Thanks again