Hydrocortisone Injection Side Effect?

[yerrag]

My cat got sick and I had to consult a book "Dr. Pitcairn's New Complete Guide to Natural Health for Dogs and Cats." I came across a section that talks about hypothyroidism, and it mentions the use of hydrocortisone to treat skin allergies in dogs. It mentions that frequent use of it would result in hypothyroidism. Thankful for this insight brought upon by my cat's bout with a virus, from which she is still recovering from, I am reminded of one time when I was at a conventional vet, when I realized that vets employ treatments on our pets that would be equally applicable to humans, and more practical and less costly, which I would not find from our own human doctors.

Anyway, I have a bad case of keloids. A boil on my chest would heal and leave an ugly scar. It is bad that over the years, I have been to dermatologists who can only tell me that injections of hydrocortisone would be the only solution, and sometimes it would work, and sometimes it wouldn't. Over this period, I would have countless shots. I never thought of its side-effects until I read the book.

I think I'm paying the price now, as this realization is making me connect the dots to what ails me. I couldn't explain why I have an a very high blood pressure of 180/120, which is asymptomatic, where I function normally and have no headaches, and my immune system is strong such that I haven't had a fever for the past 16 years. But I think that my hypertension is linked to what I suspect is my hypothyroid condition. I wake up to 34.5 degrees C (94.1 F) and during the day it would go up only to 35.4 C (95.7 F). I have difficulty waking up, and also need coffee to keep my energy up often.

I used to run, and have great endurance after I had mercury detox 16 years ago, but have given up on it after my left knee started giving up on me. It may be that I would leap a lot, running up stairs as a habit and taking 4-5 steps at a time, creating stress on my knee. At least that is what I used to call payback for abuse, but now I am rethinking the cause of this as well. It could very well be that the pain is somewhat related to Hoffman's Syndrome, which from what I've read in Ray Peat's articles, is associated with bulging calves, which I have, and pain in the proximal joint, which is my knee. I'm not certain about this, but it is my hope I'm right, so I can get right to fixing my hypothyroidism, and get back to running again.

I've done a search on hydrocortisone on this forum, but have come up empty on mention of hydrocortisone use as causing hypothyroidism. Does anyone have some insights on this? Or some references to work with? Thanks.

 

[ecstatichamster]

I believe that Ray has talked about Cushing's disease. Cushing's disease is a condition of chronically high cortisol, and Ray says it's actually due to hypothyroidism.


Effects of cortisol injections are to dissolve connective tissue. There are some good studies on that, but since that's not really a question I won't bother providing the cites on that.


Ray Peat, PhD on High Blood Pressure – Functional Performance Systems (FPS)


Originally, diabetes was understood to be a wasting disease, but as it became common for doctors to measure glucose, obese people were often found to have hyperglycemia, so the name diabetes has been extended to them, as type 2 diabetes. High blood sugar is often seen along with high blood pressure and obesity in Cushing’s syndrome, with excess cortisol, and these features are also used to define the newer metabolic syndrome.

 

[PakPik]

I've done a search on hydrocortisone on this forum, but have come up empty on mention of hydrocortisone use as causing hypothyroidism. Does anyone have some insights on this? Or some references to work with?

"...an extensive study carried out at Harvard showed that corticosteroids have some calorigenic action; that is, they raise metabolism a little and do so independently from thyroid. But of far greater significance, they depress thyroid function."
On prolonged cortisone use: "the "cure" was worse than the disease for many patients"
Hypothyroidism: the unsuspected Illness" Broda Barnes, pg. 206

Peat has mentioned some specifics, for example how corticosteroids raise reverse T3, block conversion of T4 to T3 and so on. They also tend to increase estrogen production and lower progesterone, which further blocks thyroid function, liver, etc. On top of that they cause lipolysis, which readily liberates polyunsaturated free fatty acids, blocking even more thyroid function -on every level-.

Hydrocortosine is one of the least potent corticosteroids, so maybe its antithyroid effects are weaker than the stronger corticosteroids ones. But even Broda Barnes wasn't fan of any of them, and very rarely used low dose hydrocortisone when thyroid treatment alone didn't help his arthritis patients.

 

[yerrag]

Thank you for your helpful thoughts and references, Ecstatichamster and Pikpak. I've been this hypertensive for so long, have tried different ways to no avail, and practically given up on it, and with your help, I'm getting back into fixing it.

 

[PakPik]

is my hope I'm right, so I can get right to fixing my hypothyroidism, and get back to running again.

Not meaning to be critical, but running is extremely catabolic; stress hormones for example cortisol go through the roof. Oxidative stress goes sky high, producing excessive amounts of certain oxidation products tied to vascular damage. The effects linger for many weeks after the race ends, more than enough time to cause cumulative damage. There are plenty of studies out there on those deleterious effects of running if you'd like to check them out.

 

[yerrag]

Right. Thanks for the reminder. Dr. Kenneth Cooper, I believe, had written about that as well. He was a running proponent, until he realized his running pals started dropping out of the circle of life.

 

[yerrag]

I believe that Ray has talked about Cushing's disease. Cushing's disease is a condition of chronically high cortisol, and Ray says it's actually due to hypothyroidism.


Effects of cortisol injections are to dissolve connective tissue. There are some good studies on that, but since that's not really a question I won't bother providing the cites on that.


Ray Peat, PhD on High Blood Pressure – Functional Performance Systems (FPS)


Originally, diabetes was understood to be a wasting disease, but as it became common for doctors to measure glucose, obese people were often found to have hyperglycemia, so the name diabetes has been extended to them, as type 2 diabetes. High blood sugar is often seen along with high blood pressure and obesity in Cushing’s syndrome, with excess cortisol, and these features are also used to define the newer metabolic syndrome.

I haven't described myself. I'm not obese. BMI is around 25. And my blood sugar is around 85. So thankfully, I don't have Cushing's Syndrome. But I am likely hypothyroid, as taking loads of salt doesn't do squat for me, and from the article you linked, it states that "Hypothyroid people, however, are unable to maintain a normal sodium concentration in their body fluids even when they increase their salt consumption.”

I need to confirm my condition with some blood test panels: Thyroid- TSH, T3, T4, prolactin, cholesterol, what else can you think of? I'm going to add to this list so I can get the blood test this coming Monday.

 

[yerrag]

"...an extensive study carried out at Harvard showed that corticosteroids have some calorigenic action; that is, they raise metabolism a little and do so independently from thyroid. But of far greater significance, they depress thyroid function."
On prolonged cortisone use: "the "cure" was worse than the disease for many patients"
Hypothyroidism: the unsuspected Illness" Broda Barnes, pg. 206

Peat has mentioned some specifics, for example how corticosteroids raise reverse T3, block conversion of T4 to T3 and so on. They also tend to increase estrogen production and lower progesterone, which further blocks thyroid function, liver, etc. On top of that they cause lipolysis, which readily liberates polyunsaturated free fatty acids, blocking even more thyroid function -on every level-.

Hydrocortosine is one of the least potent corticosteroids, so maybe its antithyroid effects are weaker than the stronger corticosteroids ones. But even Broda Barnes wasn't fan of any of them, and very rarely used low dose hydrocortisone when thyroid treatment alone didn't help his arthritis patients.

Since it's been years (4 years) since I've had my last hydrocortisone shot, I would think the effect of hydrocortisone would have worn off already. What do you think?

 

[yerrag]

I haven't described myself. I'm not obese. BMI is around 25. And my blood sugar is around 85. So thankfully, I don't have Cushing's Syndrome. But I am likely hypothyroid, as taking loads of salt doesn't do squat for me, and from the article you linked, it states that "Hypothyroid people, however, are unable to maintain a normal sodium concentration in their body fluids even when they increase their salt consumption.”

I need to confirm my condition with some blood test panels: Thyroid- TSH, T3, T4, prolactin, cholesterol, what else can you think of? I'm going to add to this list so I can get the blood test this coming Monday.

From Ray Peat's article Preventing and treating cancer with progesterone., I got this list of tests to take:

Blood tests-
Thyroid blood panel (TSH, T3, T4)
Blood cholesterol panel
Prolactin
Albumin
Glucose
Sodium
Lactate x
Cortisol
Adrenalin x
Cortisol
Ammonium x
Free Fatty Acids x

Basal metabolic rate x

T wave on ECG x

Relaxation rate on Achilles reflex test x

The ones marked "x" I couldn't get a test for, from the laboratory I usually go to- Lactate, Adrenalin,
Ammonium, Free Fatty Acids; Basal Metabolic Rate; T wave on ECG; and Relaxation Rate. I would have to find a general physician in a hospital for these, but I would rather not because it's I usually just say Uh-uh to most of what they say. Since my problem outwardly is high hypertension, and inwardly hypothyroidism, I could already see the physician looking at me as an internet wacko.

Could I work with what I could get for now?

What would

 

[PakPik]

Since it's been years (4 years) since I've had my last hydrocortisone shot, I would think the effect of hydrocortisone would have worn off already. What do you think?

I don't know the exact answer to that, but I would imagine that any consequences of influences damaging or chronically stressing tissues in the body have the potential to linger for a long time even after stopping/avoiding them. As a personal anecdote, a relative of mine is suffering from the damaging side effects of chronic use of corticosteroid creams, or "Red Skin Syndrome"/ "Topical Steroid Withdrawal". People's skin can take up to several years to go back to normal, and she has been suffering despite having stopped the creams, so we need to be patient and aid her anyway we can. I'd imagine that chronic use the corticosteroids internally would impact the body even more, and cause internal tissue changes that may need time and favorable conditions to normalize or heal, but again I can't say for sure, I'm just sharing my experience and thoughts.

Problems with stress hormones other than cortisol may also have to do with disorders.

From Ray Peat's article Preventing and treating cancer with progesterone., I got this list of tests to take:

Blood tests-
Thyroid blood panel (TSH, T3, T4)
Blood cholesterol panel
Prolactin
Albumin
Glucose
Sodium
Lactate x
Cortisol
Adrenalin x
Cortisol
Ammonium x
Free Fatty Acids x

Basal metabolic rate x

T wave on ECG x

Relaxation rate on Achilles reflex test x

The ones marked "x" I couldn't get a test for, from the laboratory I usually go to- Lactate, Adrenalin,
Ammonium, Free Fatty Acids; Basal Metabolic Rate; T wave on ECG; and Relaxation Rate. I would have to find a general physician in a hospital for these, but I would rather not because it's I usually just say Uh-uh to most of what they say. Since my problem outwardly is high hypertension, and inwardly hypothyroidism, I could already see the physician looking at me as an internet wacko.

Could I work with what I could get for now?

I think Peat suggests including ReverseT3 with the thyroid panel, otherwise it would be hard to interpret T3.
You may ask your doctor for a hypertension panel or something along those lines, including aldosterone and perhaps kidney hormones related to hypertension. Maybe adrenaline tests as well.
I think Calcium/Phosphate/ Parathyroid issues can also have an impact on blood pressure. I suggest reading about that from Peat, and maybe consider some testing.
A liver panel would also be valuable in my opinion.

 

[yerrag]

I'm still having a hard time finding a lab that does reverse T3. I don't know if I should continue with the blood test if I can't get a rT3 test. I wanted to get a stronger confirmation of whether I am hypothyroid or not. But based on my temperature being low, 34.5C waking, and 35.5C during the day, I am hypothyroid, right? What if I just skip the blood tests, and just go ahead and take some supplements to address it, and just monitor my temperature as I go along? Although I'm still wanting to take the blood tests, whatever is available and not make not getting a rT3 test such a big deal breaker.

 

[yerrag]

I finally found a lab that can provide me rT3, but the price quoted is very high, at $190. I take solace in Ray Peat's article Thyroid: Therapies, Confusion, and Fraud :

Unless someone can demonstrate the scientific invalidity of the methods used to diagnose hypothyroidism up to 1945, then they constitute the best present evidence for evaluating hypothyroidism, because all of the blood tests that have been used since 1950 have been.shown to be, at best, very crude and conceptually inappropriate methods.

Thomas H. McGavack's 1951 book, The Thyroid, was representative of the earlier approach to the study of thyroid physiology. Familiarity with the different effects of abnormal thyroid function under different conditions, at different ages, and the effects of gender, were standard parts of medical education that had disappeared by the end of the century. Arthritis, irregularities of growth, wasting, obesity, a variety of abnormalities of the hair and skin, carotenemia, amenorrhea, tendency to miscarry, infertility in males and females, insomnia or somnolence, emphysema, various heart diseases, psychosis, dementia, poor memory, anxiety, cold extremities, anemia, and many other problems were known reasons to suspect hypothyroidism. If the physician didn't have a device for measuring oxygen consumption, estimated calorie intake could provide supporting evidence. The Achilles' tendon reflex was another simple objective measurement with a very strong correlation to the basal metabolic rate. Skin electrical resistance, or whole body impedance wasn't widely accepted, though it had considerable scientific validity.

A therapeutic trial was the final test of the validity of the diagnosis: If the patient's symptoms disappeared as his temperature and pulse rate and food intake were normalized, the diagnostic hypothesis was confirmed. It was common to begin therapy with one or two grains of thyroid, and to adjust the dose according to the patient's response. Whatever objective indicator was used, whether it was basal metabolic rate, or serum cholesterol. or core temperature, or reflex relaxation rate, a simple chart would graphically indicate the rate of recovery toward normal health.

Getting my basal metabolic rate would cost me $150, so that's out. Being more parsimonious these days, learning from my past mistakes of thinking what's spent would be a "one-time" event (haha) no matter how costly, I would just go with a serum cholesterol test, add in prolactin, lactate (or lactic acid), keep a daily record of my core temperature, pulse rate, and blood pressure; and lastly, have someone test me on my reflex relaxation rate (see Youtube).

In place of taking thyroid (which would mean having to see a doctor), would it be possible for me to just take some food that is rich in thyroid? I read Tara's post on chicken neck soup. I could start with that. I could also stop eating beans, even if I have them sprouted. Especially kidney beans, which I read about being very high in lectins. What else can I do short of taking Armour?

I may end up seeing a naturopath and getting Armour through him, but I hope I don't have to. My b.p. is high at 180/120, which is bad anyway you look at it for the potential harm it portends, but I don't have many signs of hypothyroidism such as obesity, insomnia, depression, lacking energy ( but I could be more energetic, who knows?), migraines etc. And my immune system has never been better. But my low temperature is worrisome at 34.5C when I wake up, and 35.5 during the day. My hair has been thinning, my scalp has scleroderma, and my libido could be better.

 

[PakPik]

Getting my basal metabolic rate would cost me $150, so that's out. Being more parsimonious these days, learning from my past mistakes of thinking what's spent would be a "one-time" event (haha) no matter how costly, I would just go with a serum cholesterol test, add in prolactin, lactate (or lactic acid), keep a daily record of my core temperature, pulse rate, and blood pressure; and lastly, have someone test me on my reflex relaxation rate (see Youtube).

Hi yerrag,

To be honest with you I am not a super fan of lab tests in the sense that they can be so expensive yet sometimes not reveal too much. However, there a a few tests that can be key and wouldn't hurt having as a means of getting baseline numbers or even hinting at problems with some organ or system. I personally favor as basic tests: complete blood count, basic thyroid test (even if only TSH), basic liver panel (enzymes, albumin), basic electrolyte panel (sodium, potasium), basic kidney panel, basic metabolic panel (cholesterol, lactic acid, for example), basic stress hormones (prolactin, cortisol are good tests for example). If hypertension is an issue, I would add calcium, phosphate, paratrhyroid tests. Most of these tests, at least in my country, are cheap.

Getting body feedback is very valuable in my opinion, so seems like a good idea to record your stats frequently.

In place of taking thyroid (which would mean having to see a doctor), would it be possible for me to just take some food that is rich in thyroid? I read Tara's post on chicken neck soup. I could start with that. I could also stop eating beans, even if I have them sprouted. Especially kidney beans, which I read about being very high in lectins. What else can I do short of taking Armour?

I don't really know. Some people say chicken neck soup is great for thyroid, others claim there isn't much hormone there. And yes, it is important to avoid toxic estrogenic things, I would give priority to lowering PUFA burden, fluoride exposure, plastic exposure, bowel toxins, etc. Liver health, energetic and nutrient status are also important for thyroid function and health in general, so a liver-thyroid supportive diet is important (adequate calories, carbs, protein, and micronutrients). Keeping stress transmitters and hormones in a healthy balance and cellular stress in check are also important for good sugar handling and therefore thyroid function. Adequate sunlight/red light is also important for mitochondrial function and therefore response to thyroid.

I personally would try getting hypertension related tests from a doctor to maybe discover where problems may potentially lie or at least to get baseline results.
I hope you can figure out your situation.

 

[yerrag]

Those tests would be helpful, and as you said, they don't cost so much, even where I'm at. Especially the liver panel. I've had a biological terrain analysis before with a naturopath, telling me my liver is weak, without knowing why it's weak. Now, it could just be that my liver doesn't have enough thyroid to work with, to lower estrogen levels, and to produce progesterone.

As for my hypertension, I haven't found a naturopath that could tackle it. And I don't want to go to conventional doctors. I tried taking a lot of salt, in order to expand the blood volume to lessen the blood pressure, but it won't work. My body isn't responding to it. More likely, it is just expelling the salt I took in through urine. I recall a Ray Peat article discussing this but can't remember the article. But I have the impression it is connected to the thyroid in some way.