Steroids thyroid function

Hello Dr.
My autoimmune disease is not life threatening, however, corticosteroids are the only available treatment for Polymyalgia Rheumatica. There is no alternative. I have had many relapses, NSAIDs do not work for this disease and anybody who thinks they can control PMR without steroids soon realises that the only way to beat the pain and live relatively normally is with steroids. Naturally, the dose is tapered gradually, but most people have it for 3 or 5 years or more, many like myself suffer relapes particularly if they get a viral infection, undergo surgery or have a major crisis in their lives, and some people never recover from PMR. It is a devastating disease and without steroids it is crippling. Of course there are side-effects but if one is careful about diet, exercise and plenty of rest they can be reduced. After 8 years on steroid treatment my bones are still strong. A thyroid nodule was found during an MRI to check on my spine, and I am referred to see a specialist, but an endocrinologist friend read the US report and says I have nothing to worry about. Thyroid nodules are common.

I have thyroid disease from amiodarone and I am pregnant. Will the amiodarone affect my baby? Amiodarone can cross the placenta, and the iodine released from amiodarone can affect thyroid function in the developing baby, as described in Transient fetal hypothyroidism due to direct fetal administration of amiodarone for drug resistant fetal tachycardia. Am J Perinatol. 2001;18(2):113-6. Is it necessary to use steroids (prednisone) in the treatment of amiodarone-associated hyperthyroidism? The answer to this question generally depends on the clinical and biochemical severity of the hyperthyroid condition. Many experts advocate an individualized approach, with medications other than steroids used first, followed by introduction of steroids if indicated by the clinical circumstances. See A stepwise approach to the treatment of amiodarone-induced thyrotoxicosis. Thyroid. 2003 Feb;13(2):205-9. and Treatment of Type II Amiodarone-Induced Thyrotoxicosis by Either Iopanoic Acid or Glucocorticoids: A Prospective, Randomized Study. J Clin Endocrinol Metab. 2003 May;88(5):1999-2002.  

The use of androgenic anabolic steroids may be associated with development of cholestatic hepatitis and jaundice. Other, more serious hepatotoxicities such as peliosis hepatis and hepatocellular neoplasms are rare but may occur with prolonged use or high dosages. These latter toxicities may be fatal and often not recognized until they become life-threatening. Patients with preexisting liver diseases should be monitored more closely during therapy with anabolic steroids if they are used. If liver function declines or toxicity occurs, therapy should be withdrawn and the cause investigated.

Steroids thyroid function

steroids thyroid function


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