The Perfect Storm of Polymyalgia, Thyroid Levels, Chronic Kidney Disease and the negative impact of the Prednisolone I take for the PMR!

[Benos123]

Good Afternoon,

After posting the following results about one month ago

TSH 0.537 mIU/L (0.35 - 5.5) 3.6%

Free T4 (fT4) 17.9 pmol/L (11.9 - 21.6) 61.9%

Free T3 (fT3) 5.13 pmol/L (3.1 - 6.8) 54.9%

T4:T3 Ratio 3.489 

the main advices I received were:

a) Levels are on the low side if treating but would be considered euthyroid

b) Vit D at 66 nmol/L is very low and should ideally be 100 -150

c) Ft3 and Ft4 look pretty normal for someone not on replacement thyroid hormone

d) The Prednisolone, I've been taking since 2019 for my polymyalgia (PMR), will frequently lower/suppress my TSH level

And then to cap it all off, I discover in recent days that the prednisolone can also have a negative impact on my chronic kidney disease (CKD) results and which btw have varied since my diagnosis in 2021.

My situation now is that my present GP, unlike her predecessor who treated me between 2004 & 2009 and prescribed eltroxin (Levothyroxine) on the basis of my symptoms, will not treat me as my thyroid blood test results are all "in range" although the TSH is marginal.

In addition, and as my GP and the Endocrinologists and Nephrologists that I have seen on numerous occasions since 2021, have never made any mention of the side effects of me taking prednisolone, I'm now at a loss as to how and where I might progress this matter further.

All suggestions are welcome and in particular from those who might have been down this road before.

Kind Regards,

Ben.

[PurpleNails Administrator]

Sorry you haven’t had any replies.

My comment will bring your post back up the news feed & hopefully members can review.

I think the summary you added does sum it up. Your FT4 and FT3 are at a euthyroid level & medic would not consider replacement necessary.

Optimise vitamin D then retest.

[Benos123 in reply to PurpleNails]

Thanks for your reply.

Whilst I have in recent weeks increased my daily Vit D3 intake from 2000iu up to 3000iu, hopefully this will be reflected in my late November routine blood tests.

Of course this then makes me now wonder if that is sufficient?

[Benos123 in reply to Benos123]

I forgot to include this info from my vitamin D blood test results in my earlier post:

===========================

25-OH Vitamin D 66 nmol/L

Vitamin D Reference Range:

<25 nmol/L: Deficient

25-50 nmol/L: Insufficient

50-75 nmol/L: Adequate

>75 nmol/L: Optimal

>125 nmol/L: Risk of excess

25-OH Vitamin D may be underestimated in

people taking 25-OH D2 supplements

Please note new method in use from 15/01/2024.

New reference interval may apply.

==========================

And as all my vitamin D results in the past four years have been in the 60 to 80 range, there is no fear but that the same and somewhat indifferent GP has an out, and say's they are fine! Bless.

In light of the above can anyone advise what an ideal vitamin D level should be?