There is a good chance that at some point you may be put on Prednisone for something. If you also have asthma or lung issues the chance goes up even further. Drugs.com defines Prednisone as ” a corticosteroid. It prevents the release of substances in the body that cause inflammation. It also suppresses the immune system. Prednisone is used as an anti-inflammatory or an immunosuppressant medication. Prednisone treats many different conditions such as allergic disorders, skin conditions, ulcerative colitis, arthritis, lupus, psoriasis, or breathing disorders.”
A lot of people who have thyroid conditions also have autoimmune issues that go along with the thyroid such as Hashimoto’s or Graves’ disease. As a lot of you know, once you get one autoimmune disease, it’s easier to acquire other autoimmune diseases, like asthma, arthritis, etc. and a key ingredient in a lot of autoimmune diseases is inflammation. Prednisone is a great drug for helping with the inflammatory conditions, for someone with asthma especially, it can be a life saver, in helping restore clear breathing back to the lungs, or reducing inflammation. It can also help heal inflammation which can help many injuries heal faster. Since it does suppresses your immune system to some degree, you need to keep that also in mind while on the medication. You will need to avoid people with contagious diseases even more than normal to avoid becoming ill. This is usually mentioned by most doctors when they prescribe prednisone. What they do not always mention, or even know to mention is how it will affect your thyroid levels and other health.
First you have the problem of the prednisone itself. The side effects of prednisone are long and lengthy. A lot of the side effects mimic hyperthyroidism, such as increased appetite, sleep issues, irritability, anxiety, blood pressure rising and more. This can make you feel like all the sudden your body is going into over drive. The worst part is that sometimes these side effects can last days or even weeks in your system after you stop taking prednisone. Along with the side effects, prednisone being a corticosteroid can make conversion of T4 to T3 (the form of thyroid hormone that your body more readily can use) much more difficult and even suppress it when you are on high enough amounts. This will actually send your thyroid levels DOWN towards more hypo. A good endocrinologist will know that testing your thyroid levels too soon after or during a round of prednisone will drastically affect your numbers. This will ALSO make you feel off. What you can end up with, is the prednisone making you feel like your system is in over drive, but actually driving down your available thyroid hormone that your body can use. My own endocrinologist will generally test me about 4 weeks after I finish a round of prednisone to see where my lab tests actually end up, as they tend to bounce back after I’ve been off the medicine for a few weeks.
Besides the thyroid levels, prednisone can also change your adrenal tests as one of the main components of your adrenals is cortisol, related to prednisone. So if you have labs to test adrenals, you may also want to wait a few weeks after you finish prednisone to get a more accurate result and separate out what your body is doing versus what the prednisone has affected. The Mayo Clinic talks about how prednisone works with your adrenals as well. One of the things prednisone is also used to treat is Addison’s disease, which happens when your adrenal glands do not produce enough steroids on their own. The body is a wonderful thing and has such a delicate balancing act to keep itself running well. Yes, there are definite risks and disadvantages of taking prednisone when you have thyroid disease, but you should also weigh the benefits of this therapy if your doctor has prescribed it. Myself, I have asthma as well as thyroid disease, and there have been many times that this has been the only thing that has gotten me back to breathing easier again. Each time my doctor suggestions prednisone in my life, I have to see if anything else will help, if not, it is a wonderful thing, even with the side effects to be able to breathe and to have less inflammation.
Obviously this is just a general overview and in no way everything you need to know about taking prednisone while having thyroid disease, but hopefully this will give you a good start on what to ask your doctor and what to keep in mind as you are on this therapy. I wish you the best of health!
Addition: October 2015
Another thing to keep in mind on prednisone, is that if you are diabetic or pre-diabetic, it can cause your blood sugars to rise while on steroids of any kind. So if you go to your doctor and your blood sugars have rising and nothing has changed but prednisone being added, that is most likely your answer.