thyroid and knee steroid injection.

[Molmo]

hi I’ve recently been diagnosed as having hypothyroidism and I’m taking thyroxine. A few days ago I had a steroid injection in my knee for an injury that hadn’t healed. My question is can the injection affect thyroxine. I’m totally shattered.

[SlowDragon Administrator]

welcome to the forum

Common to initially feel worse/more exhausted when we start on Levo

How much levothyroxine have you started on

Which brand of levothyroxine

What were your results BEFORE starting on levothyroxine

It takes 6-8 weeks for each dose levothyroxine to settle in

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

Also both TPO and TG thyroid antibodies tested at least once to see if your hypothyroidism is autoimmune

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

[Molmo in reply to SlowDragon]

hi

Slow dragon interesting info. Only had tsh and t4 tests so no idea if it’s autoimmune. Having said that my atrial fib at very low heart rate had disappeared and I’ve been absolutely fine for the last 11 months. The change has happened within days of a knee steroid jab, I’m wondering if there’s a connection?

[SlowDragon Administrator in reply to Molmo]

Yes can be

Or could be coincidence

You need to get full thyroid and vitamin testing

How much levothyroxine are you taking

[Molmo in reply to SlowDragon]

75mg

[SlowDragon Administrator in reply to Molmo]

That’s only one step up from standard STARTER dose

Unless extremely petite, likely ready for next dose increase

how long have you been on 75mcg

Get FULL thyroid and vitamin testing

Which brand levothyroxine are you taking

Do you always get same brand at each prescription

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

Also both TPO and TG thyroid antibodies tested at least once to see if your hypothyroidism is autoimmune

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG thyroid antibodies

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis.

Both are autoimmune and generally called Hashimoto’s.

Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Essential to test vitamin D, folate, ferritin and B12

Lower vitamin levels more common as we get older

For good conversion of Ft4 (levothyroxine) to Ft3 (active hormone) we must maintain GOOD vitamin levels

What vitamin supplements are you taking

Also VERY important to test TSH, Ft4 and Ft3 together

What is reason for your hypothyroidism

Autoimmune?

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

Post all about what time of day to test

healthunlocked.com/thyroidu...

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/testing/thyro...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/signs-and-sym...

Tips on how to do DIY finger prick test

support.medichecks.com/hc/e...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

Don’t test/post in a heatwave

Come back with new post once you get results

[Molmo in reply to SlowDragon]

hi

Thanks for the detailed answer.

ts4 and TSH tests are all that I have been offered. Both were in the normal range once I was taking 75mg ( about 10months ago) although I was taking my tablet just before the tests. I’m not taking any vitamins. Could I just take vitamin D and B12 and folate to be sure? I do try to avoid drs etc. I was under the impression that it was probably autoimmune and that that was good enough. Is this not the case?

[helvella Administrator in reply to Molmo]

Be very wary of the normal range!

This is a link to a very good article in the British Medical Journal discussing what the 'normal range' really is. Very readable.

The normal range: it is not normal and it is not a range

helvella.blogspot.com/p/the...

[SlowDragon Administrator in reply to Molmo]

Both were in the normal range once I was taking 75mg ( about 10months ago) although I was taking my tablet just before the tests.

Suggest you get copies of EXACTLY what results and ranges were

What time was test.

Ft4 would be falsely high if took levothyroxine before test

Approx how much do you weigh in kilo

75mcg is very low dose levothyroxine unless extremely petite

Could I just take vitamin D and B12 and folate to be sure?

Ideally ALWAYS test before starting any supplements

If seriously deficient in B12 you will need testing for Pernicious Anaemia before starting any B vitamins

If folate or vitamin D deficient you will need higher dose supplements

Thousands of U.K. members forced to test privately to make progress

Examples of posts Medichecks results

healthunlocked.com/search/p...

[Molmo in reply to SlowDragon]

These are my results the blood tests were first thing in the morning. I took the pills about an hour before the test. About 75kgs not petite.

TSH 6.2 T4 7.0

Levo accord 50mg

TSH 4.5. T4. 18.3.

Levo teva75 mg27/11/23

T4 7.4 -14.9 normal

TSH 0.4-5.3 normal

[SlowDragon Administrator in reply to Molmo]

on Levo TSH should always be below 2

So your results show you are in desperate need of next increase to 100mcg levothyroxine daily

Retest in 2-3 months

ALWAYS test

Likely to need further increases in levothyroxine after this

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

[Molmo in reply to SlowDragon]

Update. Taking 100, being tested mid October including a pile of other vitamin tests and a quick Hb for good measure. Thankyou slow dragon you made me contact my gp (who it must be said was right on what I needed). Thanks again. A friend in need….

[FolkMusMama]

hi Molmo, as a thyroid cancer survivor on 100mcg levothyroxine and 5 mcg liothyronine, I’ve never experienced an issue with cortisone knee injections in rhe six times I’ve had it done. My doctors never indicated there should be an issue or interaction. Have you reached out to your endocrinologist with your concern?

[Molmo in reply to FolkMusMama]

Thinking about trying to get a gp appointment. Seems like hard work right now. 😂