Low TSH Levels in relation to Pandas

[coco]

I was wondering if anyone has had their child's thyroid level checked as part of bloodwork. Did anyone come back with low thyroid? The most common cause of hypothyroidism is the body's autoimmune reaction to itself, producing antibodies against the thyroid gland. Can having Pandas cause this as well? Dr. T, what is your experience with this? I ask this because I was looking through old med records from 2 years ago and my dds was borderline low, but we had no idea we were dealing with Pandas at the time. Could perhaps this be added to the list of possible diagnotic criteria??

[P_Mom]

YES! But, usually hyperthyroidism...but, I am not one to say it can't be hypo. I spoke to a Mom with a child in the original Swedo studies....the docs had her on thyroid meds because during her PANDAS episodes...her thyroid would be affected...causing many symptoms. They said because the thyroid contains cells similar to the of the basal ganglia and are also "attacked" during episodes. ???? Something to get checked in your kids....my opinion atleast.

 

Getting my sons checked via Dr. T!!

[momto2pandas]

I posted in my "top 10 things I've learned" post a while back ago (early Feb) about my thyroid odyssey. It was a huge part of the puzzle in improving my state once I got to be a young adult (early 20's). During that time my thyroid had gotten to where I was showing up on labs as extremely hypothyroid, but the tricky part came in the titration of the dose to get me back up to the levels I needed. The issue I was having was that T4 wasn't converting to T3 (the most active form) efficiently. You can read more about it in my old posts, but in order to get the right amount of "active" thyroid hormone in my system, my dose needed to be titrated to where the TSH was actually out of range in the other direction (so by TSH I appeared to be hyPERthyroid once I got to the dose of synthroid that actually made me EUthyroid clinically and by T3 [EUthyroid = healthy levels]). At the time it seemed like another one of those "weird one-off things about me" that I was getting used to being diagnosed with; now we know that elevated levels of inflammatory cytokines (present in e.g. chronic infection and inflammatory states) interfere with T4 to T3 conversion and can thus cause clinical hypothyroidism, even in the absence of anti-thyroid antibodies. You can also test for anti-thyroid antibodies to see if that's the problem - it's pretty common in autoimmune states.

 

Bottom line - if you're investigating thyroid issues, don't just have them do a quick check of TSH (which is frequently what is done) - have them check T4 and T3 too, to see if it looks like the conversion is going the way it should.

 

Interestingly, high dose synthroid has been found to be an effective treatment for rapid-cycling bipolar conditions (= pronounced mood lability) and I have wondered if this might be because these patients had the same issue that I had...not enough T3 in their systems....though they may not ever have discovered it if they were only getting the standard thyroid tests.

 

Just my 2 cents! Your mileage may vary!

 

 

I was wondering if anyone has had their child's thyroid level checked as part of bloodwork. Did anyone come back with low thyroid? The most common cause of hypothyroidism is the body's autoimmune reaction to itself, producing antibodies against the thyroid gland. Can having Pandas cause this as well? Dr. T, what is your experience with this? I ask this because I was looking through old med records from 2 years ago and my dds was borderline low, but we had no idea we were dealing with Pandas at the time. Could perhaps this be added to the list of possible diagnotic criteria??

[momto2pandas]

By the way, low TSH, per your subject line, means HIGH thyroid hormone levels, i.e. hyperthyroid.

 

 

I was wondering if anyone has had their child's thyroid level checked as part of bloodwork. Did anyone come back with low thyroid? The most common cause of hypothyroidism is the body's autoimmune reaction to itself, producing antibodies against the thyroid gland. Can having Pandas cause this as well? Dr. T, what is your experience with this? I ask this because I was looking through old med records from 2 years ago and my dds was borderline low, but we had no idea we were dealing with Pandas at the time. Could perhaps this be added to the list of possible diagnotic criteria??

[KeithandElizabeth]

My son has high T3 and his TSH are normal, but on the cusp of the low levels (hyperthyroidism).

 

Elizabeth

[dut]

My dd tested normal last year for TSH, T3&4, Free T4 and antibodies to thyroid. Her T3 was high but this year she was re-tested and her Free T3 is low. (I am borderline hypo.)

[momto2pandas]

Hm, that sounds like the opposite of what I've experienced! Go figure, maybe I am a one-off after all!

 

 

My son has high T3 and his TSH are normal, but on the cusp of the low levels (hyperthyroidism).

 

Elizabeth

[Dr_Rosario_Trifiletti]

Disorders of the thyroid, and endocrine disorders in general (notable exception is Type 1 diabetes) are usually fairly slow moving clinically. The symptoms generally creep up on you and when diagnosed have been going on for a long time.

 

Thyroid levels certainly affect one's moods and behavior. In fact, The syllable "Thy" usually refers to mood (dys-thy-mia, cyclo-thy-mia, etc). In general - very general- terms : low thyroid is associated with depression, high thyroid is associated excitation, mania

 

I usually measure a thyroid panel (T3, T4, TSH) in every new patient and ask carefully for a family history of thyroid disorders. I haven't seen an obvious association of thyroid disorders with PANDAS but I check anyway because of the potential of such an interaction and because thyroid disorders are generally EASILY TREATABLE.

 

I would also point out that chronic use of SSRI meds such as prozac, zoloft, luvox, etc are known to be associated with apparent hypothyroidism. So if your child is or has recently been on any of those for >2-3 months, I would definitely consider checking a thyroid hormone panel.

 

see

 

http://www.ncbi.nlm.nih.gov/pubmed/7779834

 

 

Dr. T

[smartyjones]

I was wondering if anyone has had their child's thyroid level checked as part of bloodwork.

 

 

fyi - my son did have a t4 and tsh check with his initial bloodwork. they were within normal ranges although his aso was very high. it would be curious to see if high titers correspond with normal thyroid and if those that don't have raised titers have inappropriate thyroid.

[kg5123]

Hi coco

 

I think thyroid is a very elusive but intriguing issue for my 15-year-old son.

When my son's PANDAS episodes were pronounced significantly in December 2008, his TSH level was also abnormally low indicating he had acute hypothyroditis. He had his TSH reading checked because various apparent thyroid-related symptoms including excessive complaint of hotness in the middle of the severe Connecticut winter storm, constant sweat and tendency to run out of breath even with mild exercise. Those day, his seemingly typical PANDA symptoms of severe vocal tic and OCD frare-up came together with the thyroid problems. At that time, the parents suspected that the thyroid pboblem triggered tics and OCD. This was because removal of the thyroid problems by taking beta blocker led to the easing of tic. But by now,

the parents have been convinced that both symptoms -- thyorid symptoms and tics -- had been caused by the same problem of low IGG and failure on 14 of 16 pneumo titers, about which literature says low IGG is capable of causing auto-immune problems like those in thyorid. To remove this fundamental problem of low IGG, the son started to receive monthly IGG at Dr B's office in Darien, CT, in February 2009. Next IVIG, set for March 31, will be his about 20th since then. Fortunately, he has been free from tics in the past one year. Regarding low TSH, he has been taking beta-blocker and vitamin D, which both of which are apparently instrumetnal in keeping the rekindling of the thyroid problem at bay.

[coco]

Thank you all, and Dr. T, for your responses. My dd's getting the bloodwork done this week and I will let you know how she makes out.