Anonymous
Hi Nina,
It sounds like you have a very complex situation going on (taking Prednisone and Tapazole), and if your doctor can’t give you an explanation, of course no one here is going to be able to. Keep asking questions and perhaps you’ll be able to pin him down. Do let us know what you find out.
For what it’s worth, in my experience fatigue could easily be from being suddenly hypothyroid. Generally when I’ve been on high doses of steroids I’ve felt quite the opposite (energized and “high”), and have only felt a lack of energy when I went off the steroids. You could be different though, as the fact that your white blood cell count is high can contribute to fatigue.
Prednisone DOES inhibit the immune system. That is precisely the point of giving it to people with autoimmune diseases: to slow down the antibody attack. The disadvantage to this is that it also inhibits the good antibodies that protect us from bacteria and viruses, making them work harder to have the same effect.
Tapazole (and other antithyroid drugs) also work in a different way somewhat as immunosuppresive drugs, lowering the number of thyroid stimulating antibodies in many people; in some eliminating them completely over time. In rare cases it can suppress the immune system too much, causing a dangerous rise in the white blood cell count.
It’s possible that your TSH was rising because the Tapazole was working to lower your antibody count, and it was naturally time to lower your Tapazole dose. This is to be expected in the course of your treatment, and most people are maintained on a much smaller dose than this after the initial treatment.
Many people can maintain on as little as 5 mg per day, and if they take more, become hypothyroid. It sounds like your treatment is going well so far. If your requirement for Tapazole failed to lessen, it would be a sign that you probably were on a long road if you hoped for a remission.
I hope this answers some of your questions. Again, let us know what your doctor says.
Dianne W
Online Facilitator