I am hypopituitary / Hashimoto’s.
I am hoping that the scientists amongst you can explain why the addition of Prednisolone 5mcg has increased my need for Levo.
It’s only been a couple of weeks but I am feeling increasingly hypo and so have raised my Levo by 25 mcgs. Feeling absolutely exhausted.
I haven’t had bloods done so don’t know for sure but physically I absolutely recognise the symptoms of under medication.
Does this mean anything to anyone?
thanks in anticipation .
Joesmum [Edited, as made a mistake in original response!]
I found the same when I started taking hydrocortisone for adrenal insufficiency. My hypothyroid symptoms got worse, and I've been on increased levothyroxine ever since. When I eventually wean off the hydrocortisone (my adrenal insufficiency is thought to be steroid-induced and reversible), it'll be interesting to see if I can reduce my levothyroxine again.
Prednisolone, like hydrocortisone, affects the level of cortisol in the blood (and cells). The hypothalamus recognises the change in level of cortisol and changes the amount of CRH that it produces as a result. The pituitary sees the change in CRH and as a result changes the amount of ACTH it produces (which then changes how much cortisol the adrenals produce). I am not aware of the pituitary changing the TSH production as well in this situation (it does in non-mammalian vertebrates, but not known to significantly in mammals), but one has to wonder whether either there is a small change to TSH production (mine has gone up), or alternatively if the altered amount of cortisol in the blood stream affects the TRH/TSH/FT4 pathway in some way...
Fatigue and brain fog means I'm not going to try to think about this right now, but just found this - pubmed.ncbi.nlm.nih.gov/624....
It’s comforting to know that you had the same reaction……. If you know what I mean!
But the hydrocortisone shouldn’t affect the production of TRH in the hypothalamus which as you say, then signals the production of TSH in the pituitary. The added hydrocortisone should only affect the production of CRH in the hypothalamus which as you so rightly say, signals the ACTH in the pituitary.
I wonder if the hydrocortisone is binding to something in the blood which is preventing the cellular uptake of the Levo??
Fascinating isn’t it. I do hope that you can eventually come off your steroids. What a blessing that would be.
Joesmum Edited my original response - hadn't spotted that the change in TSH production is only significant in non-mammalian vertebrates. Said I was rusty on thyroid stuff (concentrating on my adrenal insufficiency at the moment) 
Well judging from the way I feel, I may very well be a ‘non-mammalian invertebrate’ !!! 😂
Thank you for the link, which I've saved. Could this bit explain the need for a higher levothyroxine dose given that T4 concerts to T3? To be honest though, I too am finding it difficult to fully understand this paper.
'In the presence of cortisol, higher concentrations of T3 were required to decrease TRH receptors...'nn
what are you prescribed Prednisolone for
As you have central hypo and hypo pituitary is your adrenal system also affected ?
presumably you are tasked prednisolone at least 2 hours away from Levo/T3
Retest 6-8 weeks after adding prednisolone…..or 6-8 weeks after changing Levo dose
Hypopituitary can affect any number of the pituitary hormones. Mine amongst others also affects my ACTH which signals the adrenal glands.
I’ve been switched from Hydrocortisone to Prednisolone as it is long acting and only has to be taken once a day in the morning.
After a dosage change we retest after 4 weeks. If you’re central hypo or hypopit you won’t produce any TSH to speak of and therefore don’t need to wait the laborious 8 weeks for it to settle at its new level.
Prednisolone affects the TSH blood test results a bit.
Lowers it if memory serves ...Reduces result falsely I seem to remember.
levo increased and new results
Increased Levo, now feel awful again
Hoping to get levo dose increased
Increased T4 (levo)
Increased Levo and teeth grinding?!
