Anyone experienced low TSH reflecting thyroid issue?

Posted by ventmann @ventmann, 4 days ago

Been on prednisone for PMR for a little over 2 years. Currently in a slow tapper, which is going well for the PMR. My TSH level recently been low while my T4FREE is within the normal range. My primary care physician wants me to see an endocrinologist. Has anyone else with PMR experienced the thyroid issue?

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I am assuming you are seeing an Endo which is how you discovered the low TSH. If not I would think you need to find one to help sort this out. The short ans is "Yes, prednisone can play with your TSH." I asked MS Copilot, my AI tool, and this is what it told me.
Prednisone:
1. Inhibits TRH production in the hypothalamus → less stimulation of the pituitary
2. Directly suppresses TSH release from pituitary thyrotropes
3. At higher doses, may reduce T4→T3 conversion, but this is less common

I have seen changes in my thyroid numbers during the last 7 years I have been on and off my PMR treatment. My Endo runs tests every 90 days to monitor things. Recently the biologic I was on was also playing with my thyroid numbers. I had to stop the biologic due to other side effects, so that fire drill was cancelled. We had moved to every 6 weeks to monitor my numbers.

My Endo is super conservative and I tell her to watch her make changes is like watching frozen molasses drip. Hope you can find the right doctor to help with your management as well.

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Yes my TSH was a bit low . I did decrease my eltroxin a very minimal after talking to DR . GP. not ENDO which I am still waiting to visit 🙁 so many doctors !

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My TSH has been low low for 20+ years (Hypothyroidism.) It has not gone lower since PMR and/or Prednisone, Eliquis and Kevzasa.
I take 125mcg of Levothyroxin plus 5mg of Levothyroxin every morning. I think that is probably why I haven’t experienced the fatigue that so many describe.
I’d be interested in what your Endocronologist says.

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