My Wifes latest lab results a bit unexpected

[flyingfool]

For a quick reminder. My wife has had absolutely rock solid/stable FT4 results for over a year.  Not too unexpected as she has been on the exact same T4 dose of 137 mcg a day for that entire time.  The lab for whatever reason uses an unusually wide reference range. But using that range she hovered about 20% of the range over the tntire year or more.  

She started taking T3 5 mcg a day for awhile and then up to 7.5 mcg a day. Which obviously has raised her FT3 levels.  She has tried taking this 7.5 in various ways but has found that it makes little difference.  So her current routine is 5 mcg in the morning when first getting up. And then 2.5 mcg at 4PM.

At her last Dr visit in July she convinced her Dr to increase her T4.  The Dr upped the dosage to 137 mcg one day and 150 mcg the next day and to continue to alternate. So it averages out to be a 6.5 mcg a day increase. She has done that for the last I think 12 weeks. She takes her T4 before going to bed each night.

Her previous lab results were:

FT4 1.06 (0.78 - 2.19) = 19.9%
FT3 3.25 (2.77 - 5.27) = 19.2%

over time her FT3 leves have been at or below the FT4 level in terms of percentage of the range.

10/21/13 lab results were:

FT4 0.97 (0.78 - 2.19) = 13.5%
FT3 3.97 (2.77 - 5.27) = 48.0%

Now she has recently been sick with a cold that caused her asthma to act up.  As a result she was on antibiotics for the last couple weeks and also Prednisone for her asthma.

Since she started taking the Prednisone, she as of the last week or so has finished her both her antibiotics and Prednisone medication. She has been feeling hot and she is hungry and not getting good sleep.  And she is a person who LOVES to sleep!

I find it interesting that she has increased her T4 medication, yet the blood labs which have been rock solid for well over a year suddenly went DOWN.  Although her FT3 had a decent bump and is about the highest it has ever been since we've been recording her results. So clearly the additional T4 was doing something and is being converted since her T3 dosage has remained unchanged.

Question:  Her symptoms seem to be hyper like. But she did nto have these hot and hungry symptoms and sleep issues until AFTER she started takig the antibiotics and Prednisone. I tend to think that is just too much of a coincidence to be thyroid related and maybe a side effect of these other drugs.  Since she was on the higher dosage of Thyroid for well over 8 weeks prior to her starting the Predisone.

So could taking the Prednisone affect her FT4?  And does anyone know if the side effects of the Prednisone are hot, increased appitite and insomnia?  Which all just happen to correspond with being Hyper!

My wife was "happy" with the lowering of the FT4 levels because the Dr only upped her T4 the last time kind of to satisfy my wife.  And the Dr said that she didn't want to go directly to 150 mcg until her next test to see what happened to her FT4 levels and didn't want to get too high.  My wife wants to slowly increase her T4 until she gets mid range. And with this latest test showing that the FT4 is not going off the top of the charts like the Dr thought,  maybe now she has a good chance to have her up her T4 dose to a straight 150 mcg a day.

What are other peoples opinions?

[flyingfool]

Good point.  And she was also on nebulizer two or three  times a day with elbueterol (spelling???) for her asthma too along with the prednisone.  So I think she should wait a few weeks at least and see if she can go get blood drawn again.

[goolarra]

I just read that the half life of prednisone is just a few hours...how long it may take everything the prednisone jumbled to resettle is another question.  Of course, if the prednisone did lower her FT4 while she was on it, you might have to wait the infamous 4-6 weeks until the period of time she was on the prednisone is "off her calendar"???

[flyingfool]

Thanks.

I too believe that the Prednisone is throwing a monkey wrench into the whole thing.

How long might she have to wait to clear her system of the Prednisone?  I think she has been off of it for at least a week or maybe two now.

[goolarra]

Corticosteroids can suppress TSH thereby lowering FT4.  It would probably be a good idea to make sure the prdenisone is out of her system and retest before making any further changes.  I'd bet on her symptoms being side effects of the prednisone.  

[Red_Star]

Oh yeah probably more likely side effects of Prednisone since I just looked up the symptoms. But I like my antibiotic theory. :)

[Red_Star]

Maybe the antibiotics have affected the liver and the clearance of thyroxine and caused temporary hyperthyroid symptoms. Just a thought.  My appetite did not improve much being hyperthyroid. *cries*. :)