Thyroid Cancer / Nodules & Hyperthyroidism Expert Forum
Hashimotos
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Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.

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Hashimotos

My 14 year old was just diagnosed with hashimotos. Her TSH was 1.19, free T4 was1.3, antibodies were 420, and ultrasound revealed an enlarged thyroid gland with a nodule of .9 x .8 x .5 cm. Her pediatric endo put her on 50 mcg levothyroxine. After 6 weeks on the medication, her TSH dropped to .07, free T4 was 1.2, free T3 was 2.5 and antibodies continued to climb to 852. She was a mess on the meds (insomnia, irritable, high strung) but her pediatric endo wanted to leave her on the meds. I took her to another endo (not pediatric). He wanted her off the meds. He said it wasn't helping her any, he wasn't concerned about her antibodies, and sometimes nodules shrink on their own. Which doctor do I listen to??? She's only 14 !!!
97953_tn?1193367871
TSH of 1.19 is normal and does not require meds.  TPO antibodies mean there is an autoimmune attack on the thyroid but with current normal thyroid function.  The nodule of 0.9cm is very small and would not justify medication anyway (the idea of using meds "suppressing" nodules in patients w/ normal TSH is somewhat outdated).   Would monitor the situation w/o meds with annual (+/-) TSH and ultrasound recheck.
2 Comments
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4451049_tn?1387157037
Listen to your child! I can't stress that enough! And given the fact that her antibodies increased that much, I'd take her off of the medication! Maybe she'd have a better response to Armor thyroid or something like that.

Good luck!
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97953_tn?1193367871
Mark Lupo, M.D.Blank
Thyroid & Endocrine Center of Florida
Sarasota, FL
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