Thyroid 101

[LNN]

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.

[dut]

Hi - all I know is that although the range for TSH is up to 5, any half decent endo dr will want to see it at around 1.5 and no higher. Also you want to be checking Free T3. Progressive endos and other drs say you should be checking Reverse T3 too as it, in my words , sucks up available T3 so all can look good on paper but you still have an issue.

 

A really progressive endo will treat based on symptoms rather than numbers. When I first got dxd and started on T3 supplementation (cytomel) the turnaround was significant in just 5 days and for me it was all mood/OCD-ish personality +/nailbiting/not being 'present'. And I was only just borderline low on numbers.

 

My endo has also told me (when I showed him some dd's nos.) that numbers can get worse shortly after infection but then pick up again on their own....

[LNN]

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.

[kimballot]

Have you checked for Hashimoto (autoimmune thyroid disease0?

 

My "non" PANDAS dd17 has elevated TSH. She had sleep issues (couldn't fall asleep at night, wanted to nap all day), hair thinning, and swollen eyelids that all started after a bout of swine flu followed by mono in 2009. Took 1 1/2 years and a trip to DR B to get someone to check her thyroid levels, which showed elevated TSH, but normal T4 & T3. Former pediatrician said "it is fine - probably just a testing glitch, since T4 and T3 are OK". Dr B encouraged us to look further. Subsequent testing showed elevated antithyroid antibodies, and continued elevated TSH. Started her on synthroid and symptoms cleared and TSH went down until she had a bad bout of systemic recurrent impetigo in 2012... then all thyroid symptoms returned including chronic, severe swollen eyelids, and now an enlarged thyroid upon palpation. TSH was elevated again. We increased her synthroid and did put her back on antibiotics for one month. Symptoms have subsided and she is finishing those abx now.

 

I am now making an appt with endocrinologist to follow her with this.

 

Bottom line: if TSH is over the limit in our kids, I'd check antithyroid antibodies and check all thyroid levels regularly - especially after infection.

[Ebersolk]

Not sure how old your child is but my daughter turned 13 in October. She has been having issues with her thyroid numbers for awhile so we saw:

 

 

Dr. Judith Goldberg-Berman

4 Dearfield Dr Suite 102

Greenwich, CT 06831

 

She does not take little kids.

 

At this time, we are still monitoring.

 

I believe she has worked with Dr. B and Dr. J as she knew of both of them and I got her name from Dr. J.

[putting together the piece]

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.

[LNN]

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.