advice on blood test please 🙏🏻

[Margiepargie]

Hi,

I have Hashimotos and am taking 125mcg of Levothyroxine along with a host of vitamins. I was diagnosed with polymyalgia rheumatica earlier this year.

I was put on 20mg of Prednisolone and have been tapering to where I’m now down to 7mg. I’m due to have a blood test to check my inflammation levels and my thyroid in the next two weeks.

My question is, can anyone help with how best to get the thyroid blood test right without actually having to stop taking my steroids?

Any help would be greatly appreciated

[Sleepman]

I suspect you will not get true value and wonder if knowing values when stable on 7 mg pred is useful result anyway. It lowers TSH reading I think.

Do you feel well enough to delay the thyroid tests ?

[Margiepargie in reply to Sleepman]

Hi thanks for replying.

I feel okay… ish. I’m really tired most of the time, no energy at all but I’m putting that down to the steroids. My GP thinks it’s a good idea to have my bloods done every 6 weeks, for what I’m not sure. I think she has absolutely no idea about thyroid issues or PMR to be honest. She wanted me to go from 150 of Levo down to 100mcg. But I’m on 125 off my own back. Did that about 8 weeks ago I think. Do you think I should just putt off the bloods until I’m down a bit more on the Prednisolone ?

[Sleepman in reply to Margiepargie]

Mum was pushed from 100 to 75 mcg levo and PMR flare up followed or it seemed to me. What are you recent TSH etc ? Does not sound like a time for your doctor to be following a get TSH up/reduce levo crusade ? It takes months for levels of thyroid to change and possibly drop too low.

PMR seems have taken off this year. I had not heard of it till Mum had problems in early summer. There is no specific test. Mum self medicated from steroid she had for Asthma as she was in such pain. Sorted it qui kly and she got off it after a month or so.

I will try to dig out link to low TSH measurement doe to pred.

[Whiterose15 in reply to Sleepman]

Levothyroxine impacted on my overall health for 10 years. It gave me asthma too. I to gave it up and felt much better! I could have ended up om the medical merry go round. Well done your Mum. Seek a good Homeopath.

[Margiepargie in reply to Sleepman]

Thanks for replying.

This is a new Dr I’m seeing. The last one pretty much went with what I asked for. Thus one dies seems to be a bit, shall we say different.

I’d never heard of PMR before last year, and after reading up on it it was everything I was experiencing. The GP I saw at the time dismissed it and said I was too young ( I was 47). I’ve been seen by two different rheumatologists who have both said something different. The first said definitely PMR the second said not and is saying could be Psoriatic arthritis. So I’m none the wiser.

But your advice is greatly appreciated x

[Tina_Maria]

Corticosteroids such as prednisolone can slow the conversion of T4 to the active form T3, especially at higher doses.

How long have you been on the stable 7mg dose? If you have been on this dose for a while, you could take this as a 'baseline' and see where your thyroid levels are now. If it affects your thyroid levels, you might need to adjust your thyroid medication upwards a bit, whilst you are on steroids.

My mother was diagnosed with PMR a few years ago and she is also hypothyroid and on levothyroxine. She was on a maintenance dose for about the year and during that time she took a thyroid function test and her meds needed to be upped a little bit to compensate for the steroid treatment.

I think it would be a good idea to do the thyroid function test, as if you have too little thyroid hormones due to the influence of the steroids, this could impact on your tiredness and well-being independent of your PMR.

[Margiepargie in reply to Tina_Maria]

Thanks for replying.

I’ve been on 7mg for only a week. I think I might cancel my blood test and wait until I’ve been on 7mg maybe 3 weeks ( not sure if that’s long enough) then I’ll rebook. I’ve been told to keep tapering pred down 1mg every 3 weeks. So I might just stay on 7 for a bit longer. Thank you so much for your advice it really is appreciated x

[Sleepman]

Thanks TM. Uppig dose whole on pred is very thought provoking