Pediatric Endocrinology Expert Forum
High TSH and high T4 in 6 year old
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Questions in the Pediatric Endocrinology forum are answered by Dr. Deanna L Aftab Guy. Topics covered include adrenal problems, diabetes insipidus, menstrual irregularities, obesity, parathyroid abnormalities, pituitary abnormalities, puberty concerns, rapid growth, rickets and bone disease, short stature, and thyroid.

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High TSH and high T4 in 6 year old

Hi, I am trying to understand some of my daughters lab results.  In July I took her to the pediatrition because she had gained 11 lbs in 6 months with normal eating habits.  Her labs came back with a TSH of 5.86 and her free T4 was 1.5.  The Ped. told me everything was normal and gave me a food pyramid.  I think I should also point out that my daughter is very active even to the point that she jumps on a rebounder while watching t.v.  At the beginning of this month (March) I took her to an endocrinologist when I realized her weight has gone up a total of 20 lbs in one year.  We again did labs and her TSH came back at 6.34 and her T4 is 1.4.  The Dr. told us it's unusual for both to be high and wants to do more labs in May to see if the TSH or T4 change again.  I am thankful he wants to keep an eye on this but don't know if I am being unreasonable if I ask if we can take action in any way right now.  I am worried her weight will just continue to increase.  She now weights only 3 lbs less than her 10 year old sister.  She is now in the 25 percentile for height and has always been in the 50 to 75 percentile.  My main concern is that she seems very uncomfortable.  If I take her shopping for an hour she complains about her feet hurting and when I finally looked at her feet they were red.  She also seems to get yeast infections and gets a bit stinky when she has her clothes on for long periods of time.  As soon as she gets home she usually takes off her clothing, I am assuming because she is uncomfortable.  Do you have any suggestions as far as what I should be asking her Dr. I am not educated Medically and don't want to be overbearing but I do want to help my daughter.  Thank you in advance.
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Thank you for your patience, my responses seem to be out of order with folks.
So rising tsh, not very high but above normal with normal free T4, this is subclinical hypothyroidism, meaning the brain has to keep up with the thyroid to stimulate it, have they measured thyroid antibodies?? If so if this is positive she has autoimmune hypothyroidism and I would treat, there are many approaches, I probably would treat with a little synthroid and repeat in a month. You ask your peds endo to repeat the labs if it has been a few weeks and push for treatment if she continues to gain weight and slow in growth.
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