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Does Prednisone Cause The Enlargement Of The Thyroid?
Question: My child is a 14 years old female. In February of 2014 she had to take predisone for 11 weeks. She was tapered off slowly; but when she went back in February 2015 for her yearly checkup her doctor noticed that her thyroid on the right side was enlarged. The doctor ordered an ultra sound & the results were that I fact the right side was enlarged but still with normal parameters. The blood results came back and showed that she is a little hypo. Staff told me that normal range for the test was 0.6 to 4.5 and that her results were .529. Could this still be a result of the predisone ? If it is will it normalize on its on? If so, will putting her on an exercise routine & maybe supplements too help get it back to a normal range? Or will thyroid medications be the only option I have?
Brief Answer:
Thyroid
Detailed Answer:
Prednisone usually affects the thyroid blood test in a particular manner. It tends to lower the TSH and thyroid hormone levels that are measured as
Free T4
Total T4
Total T3
However this effect is evident only as long as the prednisone is being taken and is often the result of significant doses.
I see your child was prescribed prednisone a year ago for 11 weeks. So now in this month, the effect of prednisone is not present, and should not impact the thyroid status.
The test result you have reported of 0.529 is likely that of TSH. Kindly confirm. I would also like to know at what age she began her menses and if the cycles are regular now.
A low TSH can have several implications and needs systematic evaluation.
When I see someone like her in my practice, I order the following tests in addition to a thorough physical examination:
CBC
CMP
TSH (repeat)
Free T4
Prolactin
The purpose for running these tests is to consider various possible explanations:
1 Normal
If the TSH and free T4 come back normal then her thyroid status is deemed fine, especially if prolactin is normal along with normal menstrual cycles
2 Low TSH, high free T4
This is indicative of an over-active thyroid. Further tests will be required to determine the cause of the. treatment will be directed at the cause
3 Low TSH, low free T4
In this circumstance an uncommon condition called 'Secondary hypothyroidism' will need to be ruled out. An MRI of the pituitary gland is usually required in addition to additional blood tests like 8 am (morning) cortisol.
I suggest you have her seen by a pediatric endocrinologist to comprehensively assess this matter
Thyroid
Detailed Answer:
Prednisone usually affects the thyroid blood test in a particular manner. It tends to lower the TSH and thyroid hormone levels that are measured as
Free T4
Total T4
Total T3
However this effect is evident only as long as the prednisone is being taken and is often the result of significant doses.
I see your child was prescribed prednisone a year ago for 11 weeks. So now in this month, the effect of prednisone is not present, and should not impact the thyroid status.
The test result you have reported of 0.529 is likely that of TSH. Kindly confirm. I would also like to know at what age she began her menses and if the cycles are regular now.
A low TSH can have several implications and needs systematic evaluation.
When I see someone like her in my practice, I order the following tests in addition to a thorough physical examination:
CBC
CMP
TSH (repeat)
Free T4
Prolactin
The purpose for running these tests is to consider various possible explanations:
1 Normal
If the TSH and free T4 come back normal then her thyroid status is deemed fine, especially if prolactin is normal along with normal menstrual cycles
2 Low TSH, high free T4
This is indicative of an over-active thyroid. Further tests will be required to determine the cause of the. treatment will be directed at the cause
3 Low TSH, low free T4
In this circumstance an uncommon condition called 'Secondary hypothyroidism' will need to be ruled out. An MRI of the pituitary gland is usually required in addition to additional blood tests like 8 am (morning) cortisol.
I suggest you have her seen by a pediatric endocrinologist to comprehensively assess this matter
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
It was THS and the office stated she was a bit hypo. Her menses started when she was 12 and she has regular cycles. I will follow your advice and that her to an endo for further testing. But are there ever situations where life style changes and supplementIon could increase her thyroid function, barring there are no other underlying causes?
Brief Answer:
Follow up
Detailed Answer:
I have noted your reply.
When the TSH is a bit high, it is possible to consider avoiding certain food items that can worsen the thyroid's function over time.
But her TSH is low, and even though this can represent a different type of 'hypothyroidism', there is typically nothing in her or your control ie there are no lifestyle changes that can improve her thyroid in such a situation.
However, first it needs to be ascertained what type of thyroid problem she exactly has, if any
Follow up
Detailed Answer:
I have noted your reply.
When the TSH is a bit high, it is possible to consider avoiding certain food items that can worsen the thyroid's function over time.
But her TSH is low, and even though this can represent a different type of 'hypothyroidism', there is typically nothing in her or your control ie there are no lifestyle changes that can improve her thyroid in such a situation.
However, first it needs to be ascertained what type of thyroid problem she exactly has, if any
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
U stated thst the type of thryoid condition she has needs to be asserted " if any".. Did your "if any " imply even though her labs are off and her thyriod is enlarge, thst after her endo runs a compete set of test on her , thst the results could find that there is no problem with her thyroid?
Brief Answer:
Second follow up
Detailed Answer:
Yes indeed so as I have explained above, that one of the possibilities is that if her next round of tests like TSH and free T4 are normal along with others then there is likelihood of her thyroid status being ok and not requiring any intervention at this time. Thyroid management is a complex condition which required expert and skilled care by thyroid specialists. Furthermore, physical examinations are also important in making final diagnoses.
Second follow up
Detailed Answer:
Yes indeed so as I have explained above, that one of the possibilities is that if her next round of tests like TSH and free T4 are normal along with others then there is likelihood of her thyroid status being ok and not requiring any intervention at this time. Thyroid management is a complex condition which required expert and skilled care by thyroid specialists. Furthermore, physical examinations are also important in making final diagnoses.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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