LNN

Edit to my first post - I got the genes reversed. COMT does the dopamine breakdown and MAO-A does the serotonin breakdown. I originally wrote that the wring way. So my DS, who has an MAO-A mutation, would not do well on an SSRI. My daughter, whose MAO-A is fine, would do well on an SSRI. Sorry for any confusion. Too many letters jumbled in my head at the moment and haven't fully digested everything.

StillHopefull - see this thread http://www.latitudes.org/forums/index.php?showtopic=19929 on how I teased out this info from the raw data. Not hard. Trg- the link I posted above gave me a few ideas. My son has issues at COMT and MAO-A and a few BHMT snps. The two things I came away with was to look at adding methyl-takers like niacin or giving hydroxyB12 or adenoB12 to use up some methyl groups as it gets converted into methylB12. I'm going to try to accomplish this by adding a B-complex http://www.amazon.com/Source-Naturals-Coenzymate-Complex-Tablets/dp/B000GFPD2Y/ref=sr_1_1?ie=UTF8&qid=1363787806&sr=8-1&keywords=source+naturals+b+complex (read the section on MTRR where it discusses how COMT plays into this). It won't stimulate COMT or MAO-A but it will soak up some extra methyl groups. The second thing I saw suggested was using phosphtidylcholine and/or phosphatidylserine to stimulate BHMT, which is also effected by COMT status (read the BHMT section just below the MTRR section). I stared my son on phosphatidyleserine in december and like the improvements. The above link is 34 pages but I printed it out and went thru each section with my results in front of me. Then I jotted down ideas as i went along. This week, I'll copy and past the document into word and delete all the stuff I don't need. So if one kid doesn't have a CBS issue, I'll delete the CBS section. This will leave me with a customized summary for each kid and I won't have to wade thru the entire thing each time I need a refresher.

Smarty - I didn't see any side effects. Over time, lysine can cause anxiety and that's why we only did 3 weeks at full dose, then moved to every other day for another two weeks before stopping completely. I didn't see any anxiety but wanted to be cautious. Don't know what to say about whether EBV should be a concern for you but if I recall, it takes awhile for the body to make antibodies to EBV so I think we waited a month after we suspected EBV before we did a blood draw to confirm. Tried to give her body time to fight it and that didn't work. So maybe google on how long you should wait before testing. In the meantime, you might try CoQ10 to help with energy. It's expensive in most places but I've found an inexpensive one from Full Circle in my grocery store (Big Y but not sure you have them by you). Missmom - my daughter is not my Pandas child. She had a CamK of 179 and fits some Pandas symptoms, but has never had strep and she doesn't get full blown OCD - she gets stuck on worry thoughts, but they come without any compulsions, not even mental ones. So I haven't pursed a Pandas label for her. She has been treated for chronic infections and her behaviors certainly get worse when her body spends a lot of resources on fighting something, so I could probably get a PANS dx for her but her issues are better explained in my mind from methylation problems. EBV did not exacerbate her behaviors. (she was too tired to misbehave anyway). But I have to add the my Pandas/lyme son does not get a ramp up in behaviors from viruses. Only bacterial infections. I know some kids do flare from a virus but my kids fortunately don't. If you're worried about this, I'd put more emphasis on anti-inflammatories (motrin, enhansa) instead of increasing antibiotics.

Omega 6s are not bad for everyone. Omega 3s are not good for everyone. If you have pyroluria, you actually need to avoid Omega 3s and supplement with Evening primrose oil (a non-inflammatory omega 6). Here's an article on pyroluria FYI http://naturalinsight.hubpages.com/hub/Pyroluria-A-Hidden-Disorder If your son is avoiding Omega 3s, his body may know something you don't. But if pyroluria isn't a problem, and you're looking for an Omega 3 alternative, you can try flaxseed oil, which is available as a gelcap and doesn't have that fishy issue. Flaxseed requires an extra step in metabolism but ultimately provides Omega 3 benefits. also, FWIW - florastor (sacc boulardis) makes my son very agitated. I don't know why, but even tho it's supposed to be a "good" yeast, it doesn't agree with everyone. Just keep an eye out - if you see anger or agitation or loss of impulse control, remove the florastor for a week and see if you notice any improvement.

l-lysine worked wonders when my DD had EBV last year. Tried other antivirals - did nothing. 3 days into giving l-lysine, she felt so much better. You can google l=lysine+EBV or l-lysine+HHV and find pubmed and other research that supports its effectiveness. Three weeks of lysine and she was back in school full time.

I got DDs 23andMe results today (posted previously about DS results last week). I have always scratched my head about why NAC (n-acetylcysteine) made my DD flip out when it seems like it should be so good. Turns out DD has several mutations in her CBS gene, giving her trouble handling sulfurs. I never thought she'd be positive for this since she's taken bactrim for months on end without issue and bactrim is a sulfur abx. But NAC. MSM, alpha lipoic acid, glutathione supps and epsom salt baths are all bad for her based on her CBS mutations. (she gets very itchy and irritated with epsom salt baths). So puzzle solved. Her full report, using this site as my guide http://www.heartfixer.com/AMRI-Nutrigenomics.htm, has explained so much. Some supps will pass her lips no more, some will be started (much to her chagrin). Also, one thing I discovered thru one of my kids is that if you have an MAO A mutation and/or COMT mutations, you do not break down dopamine (MAO A) or serotonin (COMT) as fast as those without mutations. As a slow metabolizer, you end up with excess dopamine (if MAO A) and if you take an SSRI for anxiety (with COMT), it will "activate" you because you're adding more serotonin into the system and you already have more than you can break down. Instead, you need to support these mutations and help re-balance the system. Wouldn't be surprised to find Pandas kids have MAO A and/or COMT mutations. COMT is also influenced by your VDR Taq gene status - which makes dopamine from Vitamin D. Two puzzles solved today.

I feel for you. When DS was in the midst of it all, it seemed every few weeks we were dealing with some reaction or another. It felt surreal - horrible and exhausting and surreal. All I can tell you is we're in the home stretch - it does end at some point. On the constipation - you can try psyllium husk - it's a capsule that has fiber - it draws water into the colon. We all take 1/day. 2 if things aren't moving well. The other thing you can put on your "things to talk to LLMD about" - when it's time for the next blood draw, ask for his thoughts on checking TSH, T3 and T4. My DD has the same complaints about fatigue and not feeling well, tho she doesn't have lyme. Thanks to people here, I've been looking into thyroid. DDs TSH has been elevated twice now. So tomorrow I'll take her for a urine test to check for iodide and selenium deficiencies. Selenium deficiency is also implicated in chronic viruses http://drlwilson.com/Articles/SELENIUM2.htm. So just tack it on to your list of things to consider. It can also be tested with a blood draw but I'd much rather have my hand pee'd on than deal with the screaming and drama that comes with blood draws. Hang in there. It is so exhausting. But at least you're seeing signs of improvement!!!

TOaks - nice recap! I agree. For those parents debating whether to do 23andMe or Yasko, do the 23andMe. You get 1 million snps (Yasko tests a few hundred I think) and you get your raw data downloaded into a txt or excel file, which you can put onto a thumb drive and put it in your safety deposit box and re-run it thru the apps that analyze that data in another 5 yrs when even more is known. You can also run your 23andMe data thru a free app called Genetic Genie (tho the author asks for a $10 donation) and you get a report that looks almost exactly like the Yasko report you get, saving yourself $495. The two things I have not gotten from Genetic Genie that you get from Yasko is your NOS status (part of the Krebs/ammonia cycle) and your SUOX status (part of your detox/transsulfuration cycle). But...23andMe does test about 50 NOS snps - just not the one Yasko looks at. So I'm in the painstaking process of looking at each NOS snp one by one to see if I can learn anything (which admittedly stinks). I'm told 23andMe does not test SUOX snps - at least the ones Yasko looks at - but I haven't gotten to that end of the cycles yet to dig. In addition to running the Genetic Genie app to get a Yasko report, you can run your data thru another app from snpedia.com called Prometheus (cost is $2 or $5 depending on whether you download the .exe file onto your own PC (better security) for $2 or pay $5 to run it on their server (both Genetic genie and Prometheus claim to not keep any personal data). I had both the Yasko report and Prometheus reports in my hands in less than 15 minutes (tho I had to wait 7 weeks for DS's data from 23andMe and I am still waiting for DDs because they had to re-run it thru a second analysis and may not get enough data - may have to do the whole thing over for her and wait another 8 weeks - grrrrr). 23andMe is not perfect - their customer service gets lots of nasty reviews (I've not dealt with them yet). The long wait is infuriating. But in addition to methylation and some fun/quirky data about ancestry, I've learned about DSs risks for certain diseases, which is helpful. There are three disease risks that are locked and you have to click on two different screens to unlock them - your risk for alzheimer's, breast cancer and parkinson's. So if you don't want to know them, you can leave them locked. Like you, my goal in doing the tests is to get custom info on supplements/diet. Going to our LLMD and hearing "SAMe works for some but not for others" wasn't helpful. Now I know that SAMe would be good for my DS and bad for my DD. I've learned that DD with the MTHFR mutation needs methylfolate and methylB12. But DS has mutations in the methylation cycle that leave him with too many methyl groups (an overmethylator), which I never suspected by looking thru Pfeiffer's under/over methylator charts. It's tempting to think, "oh both kids share DNA, so what's good for one is probably good for the other." But my kids, once again, prove they are opposites. Unlike DD, DS needs to avoid methylfolate and methylB12. He needs regular folate so he can use up methyl groups when his body converts folate into methylfolate and he needs extra supplementation of adeno and hydroxyB12 and needs to avoid methylB12. More surprising is that I've been touting the benefits of tyrosine and tryptophan for depression and anxiety. According to the Yasko report, these are actually to be avoided by my son because of some mutations. So I stopped these for my son last week. Now, I do see some focus problems returning (I was using tyrosine to try to help his focus). I have not yet started adding the "right" B's (wanted to stop things for a week before I introduced anything new). So I'm hoping that by adding the right forms of B12 and some niacin, that will straighten out. The Prometheus report suggested that phosphatidylserine would be good for him - which I started giving in December after a year of internal debate. So it was nice to be told I was on the right track with that one and that his ADHD tendencies are genetic not just a PANS symptom. It will also help me with his diet, as I know which foods to encourage or minimize based on methylation issues. My goal is to reduce supplements to just the necessities. But at least now I have a custom roadmap. The other benefit is that I now know for certain that DS is at higher risk for some diseases and lower for others (saving me a little energy in that worry dept). I don't think I can protect him from everything or fix everything with supplements. But I do believe we can use certain supplements to bypass genetic roadblocks and avoid certain foods/supplements to prevent "over"dosing the body with certain amino acids and vitamins. This isn't the be all and end all, but it's a really valuable tool, IMO. And as I said, we now have data that isn't going to change. So today, science may not know what to do with snpABC. But in 5 yrs, they might know it plays a role in 123. So I think that's pretty cool. DH and I will be doing tests on ourselves soon - if I learned anything, it's that I can't assume that what's true for one family member is true for another. So more spit is in our futures.

You can try psyllium husk capsules if he'll swallow pills. It also comes in a powder you can mix with drinks but not sure on taste. Like other laxtaive products, it works by drawing water into the bowels, keeping stools soft and mobile. It's a fiber, so it also helps keep the colon clean. Another option is hiding TruFiber in a milk shake or smoothie. If you can use this successfully, you can also use the charcoal. The charcoal will absorb/bind toxins and the psyllium husk with absorb water and improve "transit" time and counteract the constipating nature of charcoal. (note that charcoal will sometimes turn the stool dark green - this is normal). BUT both products require lots of fluid intake to work well. And charcoal can effect your electrolytes, so some of the fluids should be juices.

She got very itchy and had a bit of hives.

I would not get any glasses until after your CI appt. My DD who wears glasses for an astigmatism ended up with a different script and bifocals - the bottom half, which is for reading, is a special prism lens that corrects for CI. So she does not switch glasses. The top part of the lens is for distance (non-CI), the bottom part for close up work (corrected for her CI issues). My DS does not need "regular" glasses and his bifocal has the top part regular glass (not correcting for anything) and the bottom portion is a prism lens for CI. This keeps him from having to put his glasses on and off thru the school day (which leads to a lot of scratches on the lens). Unfortunately, he does put them on and off a lot b/c he struggles to get used to the bifocal aspect and since he doesn't need them for things like recess, gym, etc, he takes them off a lot (and they are way more scratched than DDs for this reason). The special lenses were not covered by our vision insurance but the frames were. So given the expenses of this whole thing, I wouldn't bother with regular glasses until after you know what the CI optometrist recommends.

Like Bill, we used the one Burrascano suggests but unlike Bill, so no significant response. So we switched to the one I linked. My kids HATE taking a half pill, due to the sharp edges that result. They say it hurts on the way down. So we do a full pill every other day. Probably less than ideal, but I pick my battles these days. FWIW, I put our pills into 3 categories - 1. must be taken twice/day, 2. must be taken away from abx and 3. Can be taken any time On the breakfast schedule, I put all the ones that are twice a day (includes abx) plus a few 'any time" pills On the dinner schedule, I put the second dose of ones that are twice a day (incl abx) plus a few "any time" pills On the bedtime schedule, I put the pills that need to be taken away from abx (probiotics, magnesium) plus the remainder of "any time" pills This spreads it out and gives us a pretty consistent schedule, even on weekends - just the times change a little as dinner and bedtime are more flexible on weekends. I don't worry about dosing abx every 12 hours. It's just too impractical given the demands of that "2 hrs away from abx" requirement. Most of the abx our kids take have a half life of 90 min - 4 hrs (rifampin) or a long half life of 36 hrs (zith). So whether the second dose of abx is 10 hours after the morning pill or 12 hrs doesn't seem to be worth stressing over.

I haven't listened to it yet, but here's an interview with Ross Greene, author of the Explosive Child. http://www.creatingafamily.org/blog/adoptive-parenting/parenting-easily-frustrated-inflexible-child/

DD8, 53 lbs, takes 100mg once a day in the morning. Initially, she felt much better on it. Lately, fatigue has returned (have used it for 2 months). But I believe her issues are different than yours, so I wouldn't draw any conclusions from our experience. As for other antioxidants, we use milk thistle (silymarin) 300mg once a day to support the liver occasional resveratrol for DS/lyme as an anti-inflammatory/detox (DD is allergic to it) occasional alpha lipoic acid on days they complain of muscle pain, brain fog or a general sense of inflammation, also use it when they're fighting colds to help with detox have used vitamin C thru the winter. Not clear is it helped keep them healthy. I will run out next week and probably won't refill until the fall, as the kids are tired of taking so many pills psyillium husk - helps with stool softness/regularity. B6 as a glutathione precursor

I'm the mom whose optometrist spent an hour with each kid giving them a full eye exam. She did the usual thing where they put all the lenses in front of you and have you read the eye chart and say when things are clear and not clear. However, she also tested a larger variety of prism lenses in addition to the standard ones, then had the kids watch videos and tracked where their eyes moved, they tried on various glasses and had to read things outloud...it was a long exam. From that, we left with prescriptions for lenses. The cost was $200 for an hour appt. The second appt. was a 2 hr neurocognitive/reading evaluation. The kids had to identify the next pattern in a series of shapes, had to find errors in text where letters had been transposed or reversed, memorize shapes and find them on the next page, look down a long string with beads placed at various distances and say when they saw one line converging vs. two lines diverging, they took a computer test where they had to click when they saw certain things, both with and without glasses and/or eye patches. That was $475 and from it, we got a 12 page write up to give to the school, outlining what accommodations the kids should have in a 504 as well as an explanation of how the CI impacted their learning. I got my doctor's name from a friend and our LLMD. I think you had said you didn't want to go to a doctor who might automatically diagnose CI. But from my limited experience, a doctor either "believes" in it and treats or they don't. So you do need to call and ask "do you treat convergence insufficiency and if so, how?" or "are you a behavioral optometrist and what course of treatments do you provide?" The answer should be some combination of prescription glasses and vision therapy. Some doctors put more emphasis on glasses or therapy, but I think the doctor you chose should consider/use both tools in their practice, even if they prefer one tool over the other. It's like Pandas - either a doctor believes & treats or doesn't. You need to ask when you make the first call. My impression is that most behavioral optometrists are small shops. In my doctor's office, there are three people - the doctor, a woman who does vision therapy but also covers the front desk as needed and a receptionist. But when I called the receptionist the first time, she knew exactly what the practice specialized in, what the exams entailed, etc. If a receptionist isn't familiar with CI, then that probably isn't the primary focus of the practice.

seriously??!! it's all i can do to keep up with the problem sets!! you're making 23 and me awfully tempting! especially b/c ds's copper is higher after being on zinc. does it have any info about genetic mineral metabolism ? Ah - forgot to mention that all this time I will be spending on 23andme results is coming from the chunk of time I had carved out for the X7.0 online course - which was kicking my a**. Last week, I struggled to answer the first few questions on the problem set and felt incredibly stupid. then I go to that problem with the micelle and liposome and my knees buckled. Then I looked at the next two problems, worth something like 30 points, where you have to build your own molecule - and I was like "um, I think I hear my mother calling me." I so wanted to push thru and stick with it, but after an hour of reading and googling yesterday on just that one problem, I still couldn't make heads or tails of what the answer might possibly be. Then an "omen"! I got an email telling me the 23andme results for DS were ready and I had just the excuse I needed to give up with "honor". Can't carve out time for both projects and figuring out DS is way more of a priority. I'll still try to watch the video lectures and skim the reading. It is fascinating (and Carbons in the Corners was very helpful in terms of understanding methyl groups). But I signed up thinking some smart people were going to teach me biochemistry - not that I was going to have to teach myself. IMO, you cannot answer those problems with just the videos and readings and I can feel stupid in lots of other ways without needing MIT brainiacs helping me along. as for 23andMe - waiting 6 weeks for results s**ks and they have to re-run DD's sample thru a 2nd time b/c it didn't yield enough DNA the first time. So that may take up to another 2 weeks and if they still can't get anwers, we may need to send in another sample (no charge) and wait another 6-8 weeks. So that part stinks. But so intrigued with the data I have. I haven't gotten to the level of detail to know about minerals but I do want to see if I can get more info on DS's pyroluria. So I will be seeing if I can back into the problem by finding any research that identifies the SNPs that effect zinc utilization and then trying to see if DS has any of those SNP mutations. It seems so strange to think that I'm hip deep in this stuff when "only" 4 yrs ago, I first came to Lats wanting to find out how to get rid of my kid's OCD and now, after learning about the pathogenesis of streptococcus, how the M proteins of lyme and strep bacteria are similar, molecular mimicry, the flaws of lyme antibody assays, ERP tools, methylation, transsulfuration....I get a report that says "your kid may be prone to OCD".

Nancy - all I need to do is head over to a few FB pages or talk to a few other moms who've already done this and I quickly realize how much I still have to learn. My poor guinea pig kids E - after looking at Jennifer's Courtagen report and comparing it to the 23andMe report, the genetic Genie report (which is like Yasko's) and a sample of a Prometheus report (another app that analyzes your results for you - cost = $2) - I have to scratch my head ans ask why Dr T is so in love with Courtagen. Unless your child has clear signs of mitochondrial disease, I don't see the value. 23andMe gave me a file that I imported into Excel and it has 960,000 individual SNPs (with maybe 3-7 SNPs per gene). It includes both regular dna and mitochondiral DNA and clearly has way more info than the average person wants or needs. But it's $99 out of pocket and I get the raw data, so as science progresses, I can re-run my data thru one of these apps 5 years from now and the SNPs they didn't know what to do with now might be informative in the future. Not trying to be an infomercial. I'm sure 23andMe competitors give similar info. And even with this info overload, there's still the big question of what does it mean/what do you do about it? But it seems that that's also true of Courtagen and so far, I haven't heard any of Dr T's patients say that he sits down and goes over this with you in any great detail. Having compared the reports, I'd go with 23andMe - unless you do not want to know about anything non-pandas. DS's 23andMe report points out that he's at risk for heart disease and macular degeneration and noise-induced hearing loss. Well, I already knew that based on my own father's health issues. But it's still hard to see it in black and white. So if you're not interested in having certain fears confirmed, then I can see sticking with a specialty test like Courtagen. But I think having my son's bigger picture will be helpful. Because DD has MTHFR mutation and we have success with methylation supplements, I've been giving both kids a Thorne multivitamin that has methylfolate in it instead of regular folic acid. Figured, hey - with my family history, the methylfolate won't hurt him, right? Well, this is bad for my son because his above mutations suggest he should steer clear of methyl donating supps like methylfolate. I'll now put him back on his regular mutlivitamin with regular folic acid and cynoB12 and maybe his mood will improve a bit. (I can hope). So for me, having all this raw data is empowering. I will inevitably screw it up along the way. But probably no worse than I would without the info. So if you're the dabbling type, my vote would be for the $99 23andme test over Courtagen, unless there's a specific reason Dr T is doing this that I'm not aware of. JMO edit - BTW - the Prometheus report you can run off of snpedia for $2 lets you see how you metabolize certain drugs, including ibuprofen, coffee, etc (you get the raw data froma co. like 23andMe then upload the raw date into Prometheus - not complicated) sample report: My link

So I got one kid's 23andme results last night. Haven't had time to digest it all yet, but after running the raw data through genetic genie (which is a free app that essentially produces the same report for you that Yasko does), two of the mutations that show up is are homozygous MAO-A and homozygous COMT V158M. In the report, it says "When a (+/+) MAO-A is combined with a (+/+) COMT V158M mutation, one may be more prone to develop OCD, mood swings, aggressive and/or violent behavior, and personality disorders. Chronic infection can deplete tryptophan stores." I thought that was pretty funny. After waiting 6 weeks, I get a report that tells me my child is prone to OCD and infection-triggered issues with serotonin. Duh...But at least now I know what to blame (and will be spending lots of time trying to figure out what to do about it). Interestingly, this is for DS, who has normal MTHFR. In fact, his COMT mutations suggests he may have trouble with too many methyl donors (and could be easily overmethylated with the wrong supplements). "This can lead to irritability, hyperactivity, or abnormal behavior. They also may be more sensitive to pain." It suggests to avoid methylB12 and instead use hydroxyB12 or cynoB12 and says he may do well with phosphatidylserine - which I started giving in december and has helped him with his ADHD issues. You know, we bang our heads against the wall trying to figure out why our kids get hit with this stuff and react the way they do. yet in looking at some of this stuff, you start to see their bodies are just reacting the way they're programmed to react. It's not at all about "choosing" to behave the way they do. (however, ERP and CBT can alter a genetic response - so not saying thet get a free pass to misbehave or give in to compulsions). Interesting stuff. I'll be tied to the laptop for the rest of the week....

We use mag glycinate http://www.amazon.com/KAL-Magnesium-Glycinate-400-tablets/dp/B00013YZ1Q/ref=sr_1_1?s=hpc&ie=UTF8&qid=1363181530&sr=1-1&keywords=kal+magnesium I can't recall the details but when I looked into the various types when we first started supplementing, this was the one I settled on for absorption. I initially tried for 400mg/day dose (which is 2 large pills). But the kids developed very loose stools on that dose. We now dose 200mg every other day and only increase if there isn't 1 BM per day.

I can't find any reference to ATP6 8843T>C lle 106Thr. Multiple Heterplasmies in either snpedia.com or any literature - not even on sites for mitochondrial issues or the NIH. I'll PM you my email and you can send me a scan of the report. Not sure I'll be any help but I'll see if I can at least find some links for you.

You can buy inositol in capsule form. The only difficulty is that it makes it harder to titrate your dose upward in small increments. But once you reach target dose, you can give the capsule form. Alternatively, you can buy empty gel capsules and fill your own. I do this when I can only find a capsule supplement in X dose but only want to give half that much. I'll open the capsule and put half into an emtpy gel cap. Can get them at a health food store or on amazon. When my DS took inositol for a few months, he got tired of being forced to drink the entire drink in order to get a full dose. So I ended up just dumping the tsp of powder onto his tongue and he'd wash it down with a swig of water. It has little taste, sorta like powdered sugar. It took the edge off his anxiety but didn't help his OCD. Maybe you'll have better luck. For us, only getting rid of the infection has put the OCD into remission.

Smarty - that's actually a really good point. I had stopped giving DD zinc/B6 last fall b/c she started to complain that it tasted bad. Since Greenblatt uses your inability to taste zinc as a sign of deficiency, and b/c DD was only borderline pryoluria and had taken 1 Core/day for a yr., I stopped it. She's been getting cold sores a lot this winter - so I've been giving l-lysine. But the zinc would fit this piece too, so I'll re-start 1 zinc/day and see. Also going to stop giving a flaxseed/primrose supplement, as I read that unsaturated oils, including the Omega 3s and 6s, can cause TSH to rise. Thanks for helping me brainstorm!

Kerry - thanks for the doc info. It would be a hike for us but good to have for future ref. My DD is 8, so probably too young at this point. Kimballot - thanks for the idea - I'll ask the doc to run a test for antibodies at our next blood draw in May along with new TSH/T4 labs. That gives me a little time to look into other things but will certainly help rule a more serious condition in or out.

Oh goodie - I get to shop for another doctor?! A progressive/integrative one at that? One that also treats kids? Sounds like a cake-walk I did read that TSH will rise during the winter months and drop during the summer. I also read that tyrosine, which I give to DD periodically for depression/anxiety, can lower TSH. Does anyone have any experience with supplements rather than prescriptions? I'm waiting on 23andMe results any day now (been 6 weeks - grrr). And wont' do anything until I've had a chance to digest the results. But for the short term, with an eye on the sleep problem and complaints of low energy/body aches - anyone have ideas on how to relieve symptoms temporarily? Anyone know of an integrative or progressive pediatric md in southern New England? DH will kill me if I start mentioning Dr O but she is on my radar if this problem continues.

Spinning off from my thread on sleep issues, I dug up DDs recent thyroid tests. Can someone lend an opinion? Nov '12 TSH 3rd generation = 5.44 (High but no range provided) Feb '13 TSH, Highly Senstive = 5.89 (High, 0.27-4.20 mIU/L normal) Feb '13 T4 = 5.9 (normal, 5.5 - 12.8 ug/dL normal) Feb '13 T4 free = 1.05 (normal, 0.80 - 1.90 ng/dL normal) Nov '12 her d3 was 66 and C3d was 17 (2-25 normal) so happy with those numbers (C3d was once in the 90s). And while we're on the topic of labs, can someone explain what, if any, is the relevance of the BUN/Creatinine ratio? Her BUN and Creatinine levels are always within normal range but her ratio between the two is almost always high. In Feb the ratio was 43 (10-25 normal). LLMD doesn't give much weight to it but you know us neurotic mom types - what's up with the abnormal ratio? So I'm not sure what, if anything, to make of the labs. She doesn't have any obvious signs of either hypo or hyperthyroidism. Aside from the sleep issue (hyper), her only other "symptom" would be a tendency toward constipation (a hypo symptom) and that's most likely from not drinking very much.