ksr5377 Posted October 25, 2019 Share Posted October 25, 2019 I'm not sure where what to do right now. My daughter's pediatrician ordered some blood work and according to the Dr. it showed that her free t4 was low. The Dr. re-ordered that test to verify, and according to Dr it was low again. So she referred us to an endocrinologist. I just got a call from the endocrinologist that said all the tests (the ones from pediatrician) were fine and that daughter doesn't need to be seen by endocrinologist. So now I'm sitting here wondering if I should have a second opinion from an endocrinologist or if our pediatrician doesn't know what she's doing? Quote Link to comment Share on other sites More sharing options...
prairiewindmomma Posted October 25, 2019 Share Posted October 25, 2019 1. Did they run the antibodies tests? I strongly feel that if she has Hashimoto’s she should be monitored and medicated more closely than if she doesn’t have antibodies. The autoimmune aspect affects fertility, etc. 2. My endo felt strongly my kids should be monitored through puberty as an under active thyroid affects final height. She will also do a bone scan to estimate bone age if a kid stops growing prior to 16. 3. There are crap endocrinologists out there, and thyroid issues are often ignored if an endo specializes more in diabetes. YMMV, but just my experience.... 4. Stop the thyroid madness is a good website to educate yourself. You can check lab values there. If she is low and symptomatic, I would keep pushing. Ped is likely right. 2 Quote Link to comment Share on other sites More sharing options...
prairiewindmomma Posted October 25, 2019 Share Posted October 25, 2019 Need to clarify...free T4 is low... Do you mean she is between 0-3.0, as in it is not being stimulated much, or her thyroid levels were low because her TSH is high and her FT4 levels were off? You don’t have to share, but I wanted to ask a clarifying question to make sure I understood... Sorry, chaotic house here today.... 1 Quote Link to comment Share on other sites More sharing options...
PeterPan Posted October 25, 2019 Share Posted October 25, 2019 2 hours ago, ksr5377 said: I just got a call from the endocrinologist that said all the tests (the ones from pediatrician) were fine and that daughter doesn't need to be seen by endocrinologist. Docs vary in how they interpret labs. You need to get the numbers, post them, and decide for yourself. Some docs literally just look at TSH (the thyroid stimulating hormone) and use a really high cutoff before they say to do anything. Your ped was running presumably the TSH (which apparently is elevated by his standard) *and* the actual thyroid levels like the Free T4. You don't necessarily need an endo, but you might need a doctor who has a better reputation for being good with thyroid. Ask around. But to start, can you look at her records and see what the labs were? You should have access to this. 1 Quote Link to comment Share on other sites More sharing options...
Ellie Posted October 25, 2019 Share Posted October 25, 2019 2 hours ago, ksr5377 said: I'm not sure where what to do right now. My daughter's pediatrician ordered some blood work and according to the Dr. it showed that her free t4 was low. The Dr. re-ordered that test to verify, and according to Dr it was low again. So she referred us to an endocrinologist. I just got a call from the endocrinologist that said all the tests (the ones from pediatrician) were fine and that daughter doesn't need to be seen by endocrinologist. So now I'm sitting here wondering if I should have a second opinion from an endocrinologist or if our pediatrician doesn't know what she's doing? Your dd needs to have not just Free T4 but also Free T3 tested (doctors will test TSH no matter what, even though no one should be treated, or even diagnosed, based on TSH results alone). Her labs should be optimal, not "normal:" TSH in the lower fourth of your lab's ranges; Free T3 in the upper fourth; Free T4 in the upper half. Get another referral. Keep asking for referrals until you find a doctor who will order Free T3 *and* Free T4, and who know the difference between "normal" and "optimal." That doesn't have to be an endo, BTW; your own doctor can order those labs. But you might need an endo to order the necessary labs to see if your dd has Hashimoto's disease, an autoimmune disease which attacks the thyroid. Check out this article about Hashi's and children. 1 Quote Link to comment Share on other sites More sharing options...
ksr5377 Posted October 25, 2019 Author Share Posted October 25, 2019 (edited) When I asked the nurse at the pediatrician's office what exactly was off, I was told that her free T4 was at .5 and that was considered low. Honestly, that's all I know at this point because the next step was to go to an endocrinologist. I'm thinking I need to have them send the referral to someone else. If it matters, what we were initially at the doctor for was to talk about the possibility of ADHD as well as ask for a referral to a therapist. DD is very low energy, inattentive, has trouble sleeping and has chronic constipation. DD has said she might be depressed because it's hard for her to want to do anything. Our pediatrician gave us the therapist info but also wanted to run some basic labs to see if anything else was going on. Thank you for all the info so far! Edited October 25, 2019 by ksr5377 Quote Link to comment Share on other sites More sharing options...
Ellie Posted October 25, 2019 Share Posted October 25, 2019 46 minutes ago, ksr5377 said: When I asked the nurse at the pediatrician's office what exactly was off, I was told that her free T4 was at .5 and that was considered low. Honestly, that's all I know at this point because the next step was to go to an endocrinologist. I'm thinking I need to have them send the referral to someone else. If it matters, what we were initially at the doctor for was to talk about the possibility of ADHD as well as ask for a referral to a therapist. DD is very low energy, inattentive, has trouble sleeping and has chronic constipation. DD has said she might be depressed because it's hard for her to want to do anything. Our pediatrician gave us the therapist info but also wanted to run some basic labs to see if anything else was going on. Thank you for all the info so far! Read the article I linked about Hashimoto's in children. Yes, .5 is really low for FT4. It an indication that she is hypothyroid. Symptoms of hypothyroid include depression, sleeping problems, and chronic constipation. Of course, other things can cause those, but we know that her thyroid is low, so... You need to be the bulldog for your daughter. Yes, get another referral, and keep asking for referrals until you find the doctor who will do the correct labs and treat your dd properly. Keep all the print-outs of all the labs. Read as much as you can about thyroid issues; Stop the Thyroid Madness is a good place to start. If you do Facebook, check out Hashimoto's 411. 1 Quote Link to comment Share on other sites More sharing options...
Soror Posted October 26, 2019 Share Posted October 26, 2019 (edited) I'd get a copy of the tests and a different dr. If the ranges are the usual(.8-1.8) she is BELOW the range for normal thyroid function, let alone optimal. For a regular dr. to refer you, it is generally out of range and worth investigating. The normal range is wide, she isn't in it. She needs more tests, antibody tests for sure to check for Hashi's. Edited October 26, 2019 by soror 1 Quote Link to comment Share on other sites More sharing options...
ktgrok Posted October 26, 2019 Share Posted October 26, 2019 Also, if and when you do more lab work on her, ask them to throw in a celiac antibody test as well. People with thyroid issues are more likely to have celiac than the general population and some of her symptoms also go along with Celiac. 2 Quote Link to comment Share on other sites More sharing options...
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