Steroids and Thyroid Hormones: Unraveling the connection in rheumatoid arthritis patients

Rheumatoid Arthritis (RA) is a chronic autoimmune condition with persistent inflammation of the synovial joints. Glucocorticoids, or steroids as they are otherwise called, remain a cornerstone of treatment for acute inflammation in RA. The chronic effect of steroids on the system, however, extends beyond immunosuppression. One of these lesser-explored but clinically significant arenas is their impact on the endocrine system, the thyroid gland in particular. There has been recent evidence in favor of a bidirectional interaction between the alterations of thyroid hormone and the use of corticosteroids in patients with RA. The current article investigates mechanistic knowledge, clinical implication, and proposals for integrating monitoring of the thyroid in RA therapy.