Advice on this thyroid issue? UPDATE with conclusion

[Ann.without.an.e]

DD has been exhausted for some time (I have had concerns for 2-3 years, but those concerns are peaking). She is fourteen and I know that teens are supposed to be tired, but she is far more tired than normal. Her periods are sporadic and she is becoming more and more distant from her friends/slightly depressed like. She eats nothing. Seriously, my four year old eats more than her. She does this to maintain a BMI of 25.6. She is not big, but she is far too big for what she eats. She began avoiding sugar a few years ago because she noticed that it made her too tired. She began cutting dairy and gluten a while ago too. No change in weight.

I took her to the ped on Monday to test her blood levels (thyroid, diabetes, etc). They called and said that everything was "normal", but I asked what her tsh was and they said 4.67. To me, that seems too high for a 14 year. I have Hashimoto's and I actually began medication at a 4.5. At a 2.75 and above my periods only come every 3 months or so, my PMS is indescribable, I am cold, I am exhausted, I am moody, and my hair starts falling out. My endo says that I am what they call "thyroid hormone resistant". It takes far more circulating hormone for my body to function correctly.

So, what would you do? I would love to try something natural before meds anyway. Her diet is already good so what else should I consider? At what point should I take her to my endo and ask him to review her?
My paternal grandmother, my father, and I all are hypothryoid. The family history is strong.


UPDATE #1 - Post number 39
UPDATE #2 - post number 43-with labs

UPDATE #3 - post #53 - the conclusion we came to :)

[dvdmt08]

You might look into supplementing with D3, magnesium and selenium.  These along with a gluten free diet have helped me. 

 

BTW if I remember correctly 4.67 is definitely in the rage to medicate.

[Harriet Vane]

Take her to the endo now. Even if you choose to do something more natural, at least you will be armed with a more thorough, targeted evaluation and better information. The difference between what a specialist knows and what a gp knows is light years.

[Gisel_le]

Normal range is less than 4. Optimum level is 1. Please take her to a specialist or at least get a second opinion. Did they just check TSH? How about free T4 and T3? Hugs to you.

[Ann.without.an.e]

What role do ya'll think Iodine plays?  It seems so controversial.  I know that some attempt supplementing with Iodine.  We actually use Real Salt which has no Iodine added.  Having Hashis, I know Iodine is supposed to be a double edged sword.

[Ann.without.an.e]

Normal range is less than 4. Optimum level is 1. Please take her to a specialist or at least get a second opinion. Did they just check TSH? How about free T4 and T3? Hugs to you.

 

 

I think I will call and ask about this today.  I should have asked when she called.  I was taking a walk with a friend and I didn't have paper to write down all the numbers.  

[abacus2]

Normal TSH levels are now considered to be below 3. The recommendation used to be below 5. I had a reading in the 4 range years before my diagnosis after my first child was born when my TSH was 92. I am sure my health would be much better today if I had received appropriate treatment at the time of that first abnormal test.

[Ann.without.an.e]

Normal TSH levels are now considered to be below 3. The recommendation used to be below 5. I had a reading in the 4 range years before my diagnosis after my first child was born when my TSH was 92. I am sure my health would be much better today if I had received appropriate treatment at the time of that first abnormal test.

 

 

I know that some labs say it is abnormal if it is above a 3, but my pediatrician's lab uses a 5 scale.  In their mind, she is normal?  Not sure how to approach that?

[Ellie]

Did they only test TSH? Because if they didn't test T3 and T4 then there still is not an accurate diagnosis.

 

My TSH routinely comes back in the normal range, but my T3 and T4 are low. I have had to whine and complain in the past to get my primary care doctors to test for T3 and T4. Finally, I was referred to an endo. Twenty years of being undermedicated is a bad thing.

[Ann.without.an.e]

I have  requested a hard copy of the lab report and I am picking it up this a.m.  I will post whatever I find when I get it :)

[Jann in TX]

My dd began thyroid supplements at age 13.  She would have been much better off starting earlier--but we did not have an accurate DX.  The Ped said all of her levels were normal.  My dd's TSH was similar to your dd's.

 

My dd had similar symptoms as well-- her periods were sporadic and she had signs of depression.  She held her weight even though she had excellent eating habits (and even dieted without me knowing)-- she also exercised for at least 2 hours every day!  My dd also developed anger management issues--

 

We finally listened to a friend and took her to a local Dr who is also a naturopath.  He immediately ordered a full thyroid panel and within one week she was started on Armour Thyroid.  He also prescribed some supplements--but these would NOT be a substitute for thyroid replacement (a very safe drug).  This Dr is well known for his Paelo Pharmacy --but his wife takes Armour Thyroid for her thyroid issues!

 

Thyroid supplments made a huge difference for dd.

 

Hashimotos is a GENETIC autoimmune disorderr (we have a strong family history of it).  Supplements can help with other issues--but I would not recommend trying to stabilize thyroid levels that are this far off with them.

 

[TammyinTN]

Jann is spot on...find a doctor who will prescribe NDT-Armour or the equivalent.   Get yourself a copy of Stop the Thyroid Madness.   There's also a facebook page for STTM, and they will answer many of the questions you have and help you evaluate your lab results.    

[Ravin]

I started thyroid supplement at age 11, and shot up 6 in. In the following 9 mo. If the ped wants to ignore family history and symptoms along with a debatable number, I'd get to the endo ASAP.

[Ann.without.an.e]

What if her other numbers are in range (I haven't made it to pick up that report yet)?  Would you still make an appt for an endo?  Also, I asked him to test auto immune thyroid numbers and he looked at me like I had three heads and said it wasn't necessary at this time.  I am a little peeved because I scheduled to see a different doctor, but then he took her place last minute.  Not my fav. doctor :(

[Parrothead]

What role do ya'll think Iodine plays? It seems so controversial. I know that some attempt supplementing with Iodine. We actually use Real Salt which has no Iodine added. Having Hashis, I know Iodine is supposed to be a double edged sword.

It speeds up my already sped up thyroid. I tried taking it because I have an enlarged yet hyperactive thyroid.

 

If you aren't getting any iodine you need to supplement. I've never heard anything bad about iodine and hypothyroidism.

[Ravin]

What if her other numbers are in range (I haven't made it to pick up that report yet)? Would you still make an appt for an endo? Also, I asked him to test auto immune thyroid numbers and he looked at me like I had three heads and said it wasn't necessary at this time. I am a little peeved because I scheduled to see a different doctor, but then he took her place last minute. Not my fav. doctor :(

I would. Family history and symptoms should not be ignored. Good diagnoses are not based on lab numbers alone.

[Ann.without.an.e]

Lab report in hand...

 

TSH 4.67

He didn't test T3 but he tested

T4 Free - 1.18 (seems in range)?

 

Thanks ya'll

[Ellie]

Lab report in hand...

 

TSH 4.67

He didn't test T3 but he tested

T4 Free - 1.18 (seems in range)?

 

Thanks ya'll

 

I don't know if that's in range or not, but I *know* that both T3 and T4 need to be tested. I'd push to see an endo.

[dvdmt08]

It speeds up my already sped up thyroid. I tried taking it because I have an enlarged yet hyperactive thyroid.

 

If you aren't getting any iodine you need to supplement. I've never heard anything bad about iodine and hypothyroidism.

 

Chris Kresser has some great information about Hashimotos and iodine.   http://chriskresser.com/iodine-for-hypothyroidism-like-gasoline-on-a-fire

[Parrothead]

Chris Kresser has some great information about Hashimotos and iodine. http://chriskresser.com/iodine-for-hypothyroidism-like-gasoline-on-a-fire

Well, then. That is a totally different perspective than I my previous research on iodine and thyroid. I suppose in the end one should really not experiment on one's self. Instead get the appropriate testing before using supplements.

[Harriet Vane]

I guess I don't see what harm there is in seeing your endo?? There are genetic concerns, and your dd is exhibiting symptoms that concern you. Your dr's interpretation of the lab results is questionable, and either way, your dr has not determined what is causing the symptoms your daughter has. The only thing you lose in going to the endo is the money for the visit, but no matter what the outcome of that endo appt, you still gain valuable information, so I don't think you actually lose anything by having the evaluation.

[Jann in TX]

Very few Pediatricians have experiene with thyroid issues. 

When I mentioned irregular periods to my dd's Ped she said that it is 'normal' for teens to be irregular.  My dd was spot on regular for 2 years before the symptoms (thyroid issues and irregular periods) began!  The Ped then wanted to put dd on birth control pills to keep her regular and an anti-depressant for the depresion!!!!!! 

DD has never been back to that or any other Ped.  She moved on to a GP and now her multiple specialists too! 

 

DD's Endo. has been great at explaining the hows and whys to dd.  The Endo and her GP are also on the same page as far as treatment options (although her GP pushes lots of supplements).

 

My dd has not been dxed with Hashimotos--but she has been dxed with PCOS/insulin resistance. Thyroid, insulin and hormone levels are all connected.  If one is off they other systems get off as well.

 

 

[Ann.without.an.e]

I guess I don't see what harm there is in seeing your endo?? There are genetic concerns, and your dd is exhibiting symptoms that concern you. Your dr's interpretation of the lab results is questionable, and either way, your dr has not determined what is causing the symptoms your daughter has. The only thing you lose in going to the endo is the money for the visit, but no matter what the outcome of that endo appt, you still gain valuable information, so I don't think you actually lose anything by having the evaluation.

 

 

 

There isn't really harm in seeing a ped. endo.  If there is something I can try to keep from having to put her on meds I woudl like to try that first though.  I hate that I have to take meds every day :(  If there is a way to spare her from that then I am all for it :)

[Ann.without.an.e]

Well, then. That is a totally different perspective than I my previous research on iodine and thyroid. I suppose in the end one should really not experiment on one's self. Instead get the appropriate testing before using supplements.

 

 

 

Chucki,  Iodine can be great for a sluggish thyroid.  It can be terrible for Hashimoto's or any other auto-immune thyroid condition.  Something about the Iodine fires up the attack on the thyroid?  or something like that

[Jean in Newcastle]

If her body is lacking something that her body isn't making for her, then it is in her best interest to get it through a pill or some means.  There are more natural pills (like Armour) but they are still providing what the body isn't making on it's own.  I take a natural thyroid pill and also 200 mcg. of selenium to support the thyroid.  But I have a doctor to run period tests to see what my levels are like.  

[Jean in Newcastle]

dp

[Ann.without.an.e]

I called the pediatric endo on Friday and spoke with the nurse there.  She said that their lab is abnormal over a 4.0 for my dd's age and that they definitely medicate when tsh is higher than a 4 and symptoms are present.  So, there you go :)  Now I just need to decide if we want to try some natural alternatives first (like vitamins, etc).  Not sure?  Natural remedies help me feel better on medication, but I have found that they cannot take place of meds.  I have always wondered if I had tried more natural options before going on meds would that have helped then?  Not sure?

[dirty ethel rackham]

I called the pediatric endo on Friday and spoke with the nurse there.  She said that their lab is abnormal over a 4.0 for my dd's age and that they definitely medicate when tsh is higher than a 4 and symptoms are present.  So, there you go :)  Now I just need to decide if we want to try some natural alternatives first (like vitamins, etc).  Not sure?  Natural remedies help me feel better on medication, but I have found that they cannot take place of meds.  I have always wondered if I had tried more natural options before going on meds would that have helped then?  Not sure?

 

If she is hypothyroid, she needs meds.  I wouldn't pussy-foot around with this and natural options.  Just like you wouldn't deprive a diabetic of insulin, you shouldn't deprive your daughter of the thyroid medicine she needs.  I fought for 5 years to get a diagnosis, then I had to fight for meds instead of supplements.  I am a different person on thyroid meds (NatureThyroid) and am so thankful for them.  I am usually medication averse, but this is one pill I am more than happy to take for the rest of my life!

 

[Ellie]

There isn't really harm in seeing a ped. endo.  If there is something I can try to keep from having to put her on meds I woudl like to try that first though.  I hate that I have to take meds every day :(  If there is a way to spare her from that then I am all for it :)

 

Just because you take her to an endo doesn't mean she has to take any meds he prescribes. Right now you're shooting in the dark. At least if you go to the endo you'll know what the actual problem is (one hopes!).

 

ETA: DOH!!! ::face palm::  You did take her to the pediatric endo. Sowwy. Even so, he didn't test both T3 *and* T4, so you still don't have a complete workup. And I just don't think that supplements instead of good thyroid meds is the way to go. Honestly. 

[Ann.without.an.e]

Just because you take her to an endo doesn't mean she has to take any meds he prescribes. Right now you're shooting in the dark. At least if you go to the endo you'll know what the actual problem is (one hopes!).

 

ETA: DOH!!! ::face palm::  You did take her to the pediatric endo. Sowwy. Even so, he didn't test both T3 *and* T4, so you still don't have a complete workup. And I just don't think that supplements instead of good thyroid meds is the way to go. Honestly. 

 

 

 

No, no I haven't taken her to a specialist.  She has only seen a general pediatrician and then I spoke with a nurse at the ped. endo about the lab levels they require to medicate.  She said they consider anything over a 4 to be high so, obviously, they would want to investigate a 4.67 more and possibly medicate.  

[Ann.without.an.e]

If she is hypothyroid, she needs meds.  I wouldn't pussy-foot around with this and natural options.  Just like you wouldn't deprive a diabetic of insulin, you shouldn't deprive your daughter of the thyroid medicine she needs.  I fought for 5 years to get a diagnosis, then I had to fight for meds instead of supplements.  I am a different person on thyroid meds (NatureThyroid) and am so thankful for them.  I am usually medication averse, but this is one pill I am more than happy to take for the rest of my life!

 

  

 

I totally know what you are saying here.  Synthroid changed my life!  Massively!  I remember struggling before meds and I hate to see her struggle this way.  Yet, dd doesn't want to go on meds right away.  She really, really wants to wait.

[dirty ethel rackham]

I totally know what you are saying here.  Synthroid changed my life!  Massively!  I remember struggling before meds and I hate to see her struggle this way.  Yet, dd doesn't want to go on meds right away.  She really, really wants to wait.

 

I would still take your daughter to the appointment and, perhaps, the doctor can outline what her options are for the best results.

 

[Jann in TX]

Hy daughter's growth was PERMANENTLY stunted due to not getting enough thyroid in her early teen years.  The irregular periods also took a toll-- because if she did have one-- watch out (mood swings and PAIN).  There can be permanent damage if one (especially in the teen years) goes without necessary amounts of thyroid in their system.

 

My dd did grow a few more inches after she started the thyroid supplements--but she is well below where her early growth chart predicted and is more 'squatty' than she would be with a few more inches of height.

 

We went the 'supplement first route'...remember dd's Dr is also a naturopath... he prescribed over $200 per month in supplents-- they made zero difference.  Dd had relief only 2 days after starting the Armour thyroid.  If she misses a dose she knows it-- if she misses 2 doses the WHOLE WORLD knows it!  DD still takes calcium/magnesium supplements but that is about it.

[Jann in TX]

About taking a tiny pill every day.  If you try the supplement route she will be taking a HANDFUL of pills several times each day...  natural thyroid has been prescribed in the USA for over one hundred years.  It is considered one of the safest and most studdied supplement/drug.

[Ann.without.an.e]

Okay, okay ..... I will make the appointment.  Just to check   :)

 

I am on Synthroid and have had a difficult time getting someone to prescribe a more natural option.  I feel good on Synthroid and it is considered a safe drug.  Should I try again to find someone to let me try something different?  I feel good though, other than weight that won't budge, so I hate to mess with that.

[dirty ethel rackham]

If Synthroid is working for you, I see no reason to change it.  Lots of people do well on it.   I was on Synthroid, but it did do as much as I needed it to do.  As it turns out, my body doesn't utilize the synthetic hormones well so I needed the natural hormones. 

[abacus2]

I understand the overwhelming and discouraging prospect of starting pills at a young age that you take for the rest of you life. Have you shown dd how tiny your Synthroid is? You could also encourage her that if taking pills is just driving her crazy and she wants to skip a day or two the world won't end. If she does that she will likely find she likes feeling better more than the pills bother her.

[Ann.without.an.e]

We finally had our endocrinologist appt today and it went great. Thanks for your encouragement to pursue this. We won't know for sure if/what is going on but the dr pulled a full thyroid panel, an antibody panel, and he also wanted to eliminate celiacs since ds has crohns. We'll see! I do feel better exploring this though - thanks :)

[TranquilMind]

Way too high.  Should be in the 1.0 range.  I hope you get it worked out.
 

[TranquilMind]

Synthroid is a good option for many, many people. I understand the prefer-not-to-medicate thinking but, as you know, thyroid meds can be a straight-from-heaven gift for those who need it. It sounds like your daughter's quality of life could be drastically improved with the right dosage of thyroid meds. Go to the endo. He or she may have other options, too, but I would strongly encourage you to be open to thyroid meds.

Synthroid is not a good option for others, who do better on the natural thyroids that contain T1, T2, T3, T4 and calcitonin, not just T4, as Synthroid contains. 

The natual thyroids are Armour, Naturethroid, Erfa, and a few others. 

[Ann.without.an.e]

Synthroid is not a good option for others, who do better on the natural thyroids that contain T1, T2, T3, T4 and calcitonin, not just T4, as Synthroid contains.

The natual thyroids are Armour, Naturethroid, Erfa, and a few others.

 

I actually discussed this with the endo today. If the numbers come back high again I asked about armour and though he strongly prefers Synthroid he is willing to try it. I am happy about this since the pharmacist told me the chances of getting a ped endo to prescribe it is slim to none :)

[Ann.without.an.e]

We got the labs back. Her tsh has dropped a tiny to the upper threes but her antibodies are high. Over 350!

 

We are in that in between .... To medicate or not to medicate?

[Ann.without.an.e]

I also know that this ped endo will let me try armour if I am determined to go that route - if that matters?

[kewb]

I would try the armour.  She is displaying symptoms and it will probably help  What does the endo recommend?

[Ann.without.an.e]

I talked to a nurse and he is supposed to call me tomorrow. She said that since dd is symptomatic he should prescribe if I ask. He may want to wait unless i want to try meds. This was only her opinion. i think I want to ask to try meds, especially since he will begrudgingly prescribe armour. If she wasn't symptomatic I would want to wait. I would rather not have her on meds, but I really hate to see her struggle.

[Harriet Vane]

If she is symptomatic, then have her take drugs. Thyroid testing really does not accurately reflect how awful a person feels.

[Ann.without.an.e]

This is what my gut tells me...thanks ya'll :)

[Mom-ninja.]

My endo has started me on meds because I was starting to show symptoms. My T3 and T4 are still hanging in there in the "normal" range, but my Hashimoto antibodies are still crazy high and my TSH was way out of normal range.

 

A friend of mine has a son who had undiagnosed Hashimoto's for who knows how long. He also has stunted growth. He is 15 and shorter than my 12 yr old who is 4'9".

 

I hope your dd starts to feel better soon.

[Ann.without.an.e]

My endo has started me on meds because I was starting to show symptoms. My T3 and T4 are still hanging in there in the "normal" range, but my Hashimoto antibodies are still crazy high and my TSH was way out of normal range.

 

A friend of mine has a son who had undiagnosed Hashimoto's for who knows how long. He also has stunted growth. He is 15 and shorter than my 12 yr old who is 4'9".

 

I hope your dd starts to feel better soon.

 

 

Do you know if your friend's child with stunted growth had normal thyroid levels other than the anti bodies?  DD is barely 5' and has a shoe size 5.5 and she is going on 15.

[Mom-ninja.]

I don't know what his numbers were only that he was diagnosed with Hashimoto's after years of the mom telling the doctor she felt something was wrong because he was so tired all the time. I know he went to a pedi endo and was put on meds right away.

 

Does your dd have any family genetics of being petite? It may be that her thyroid issue hasn't affected her growing. Some people are just small. I'm the tallest female in my family. I'm 5'1; wear a 5.5 shoe so your dd sounds plenty big enough for me at 14.  :)   Whereas my friend's ds is 4'9 at 15. For a boy that's pretty small.

 

I'd ask her endo if he thinks her growth has been affected in any way.