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12 year old with hypo school issues
My 12 year old son has been diagnosed as hypo and takes levothyroxine. His levels were just tested:
T3 184,
T4 9.1
TSH 0.5
He still appears very very sluggish and tired all the time. He is labeled as a gifted child, however when he takes long math tests, he cann not seem to score above a C, making very careless mistakes. I am very concerned because he will no longer be allowed to remain in the gifted program.
It appears everything is normal and he should not be having any hypo issues or problem.
What do you think about his levels?
T3 184,
T4 9.1
TSH 0.5
He still appears very very sluggish and tired all the time. He is labeled as a gifted child, however when he takes long math tests, he cann not seem to score above a C, making very careless mistakes. I am very concerned because he will no longer be allowed to remain in the gifted program.
It appears everything is normal and he should not be having any hypo issues or problem.
What do you think about his levels?
Please also let us know how your son is doing energy and behaviour wise. With that and the ranges, we can better comment.
Carb craving and an unsatisfied appetite (weight gain) are issues my daughter has definitly had in the past when she was on synthetic t4 (Synthroid) and her freet3 was too low in normal range. She was not converting enough of the storage hormone (t4) into the biologically active hormone t3 that the body must have to function properly (we're talking cellular level here!!) I feel it messes with your blood sugar ( similar to hypoglocemic behavior) when your thyroid hormones are not in balance. The endocrine system is a closed loop system, and when there is a break in this loop, many things get out of wack in the proper operations of the body. (Each one of these glands are dependent on the other!) Proper balance of these hormones is crucial and just being at any old place in normal range does not mean that they are fine! Not only does it effect metabolism and energy, it also effects organ function, brain cognition, joint and muscles, mental outlook and emotions and much much more! Thyroid hormone (T3) is crucial for "LIFE"! If the available t3 (FREE T3) is higher in the normal range and the freet4 is also mid to high range then they should both feel better. What often happens, is that the freet4 is fine because they are on a t4 med., but the freet3 is low normal, This is not good and where our issue was! To get my daughter's t3 up there, we had to give her t3! I chose to do this with Nature-Throid. This can also be done by adding synthetic t3 (cytomel) or through compounded meds (either desicatted or synthetic). All of these meds must be prescribed and are usually covered by insurance.As far as the generic issue goes, there's lots of opinions on this (different fillers and binders and allergic reactions). This could be your childrens issue, so you could try a change to a name brand. You should not take thyroid meds with food or milk or iron. We always take our meds an hour before food or two hours after.All suppliments we take before bedtime. I hope I've been some help! Please keep us posted on those freet3 and freet4 ranges, and make sure you get a copy of the lab results from your new doctor. Good luck and God Bless!
Thank you everyone for sharing your advice and knowledge. I am going to make an appt. with a new doc. Hopefully, he will run free t testsing on both of my children. How long does is usually take to notice a difference. My son never is able to tell me if he feels better or not. "I dont know Mom." is all I ever get out of him.
Since his tsh is way at the low end of the range, and he is still gaining a lot of weight, dO you think if must be too much snacking? His levels t3 t4 and tsh are all in normal range- just havent checked the frees, which I plan on doing asap. I think I am understanding you to say, he can any of the hypo symptoms if the free t 's are not in the normal range. ( including weight gain- sluggishisness, and moody, lack of ability to concentrate in school) Does insurance cover the Nature-Throid?
Another question, BOth children do not take medicine on an empty stomach. I always figured it didnt really matter because levels came back in the normal range. What do you think about that? Same with using the genrics ( we use generic for both synthroid and cytonmel) Since the labs came back normal, I felt it was o.k.
Sorry to keep asking you all these questions- you probably feel like you anwered them already. I wish we could sit and discuss over lunch! Thank you so much for your help and time!!!
Same with my daughter, but her issues are depression/moodiness
Since his tsh is way at the low end of the range, and he is still gaining a lot of weight, dO you think if must be too much snacking? His levels t3 t4 and tsh are all in normal range- just havent checked the frees, which I plan on doing asap. I think I am understanding you to say, he can any of the hypo symptoms if the free t 's are not in the normal range. ( including weight gain- sluggishisness, and moody, lack of ability to concentrate in school) Does insurance cover the Nature-Throid?
Another question, BOth children do not take medicine on an empty stomach. I always figured it didnt really matter because levels came back in the normal range. What do you think about that? Same with using the genrics ( we use generic for both synthroid and cytonmel) Since the labs came back normal, I felt it was o.k.
Sorry to keep asking you all these questions- you probably feel like you anwered them already. I wish we could sit and discuss over lunch! Thank you so much for your help and time!!!
Same with my daughter, but her issues are depression/moodiness
Ask the school counselor to give him a 504 for medical issues. A 504 is a documentation that requires a doctors note and the teachers HAVE to do whatever the doctor says in the note. This will give him some accommodations until he gets his meds under control.
Hi again! Nature-Throid is also a desiccated (porcine) hormone. It must be prescribed, and it is in short supply right now (supply/demand issue as many switched from Armour brand to it, all at once) It should be available again by mid. November and hopefully this will never happen again, but that is another subject! Natural desiccated thyroid hormone was around way before the synthetics. (Levo.,Synthroid, Cytomel etc.) Your daughter is getting her t4 and t3 seperatly and syntheticly, mine is getting hers together and naturally. Desicated hormone is suppose to be the closest substitute for real thyroid hormone. Since my daughter has no gland, I prefer to keep her as close to possible to what a real gland would provide her. (That is t4,t3,t2,t1, calcitonan and selinium). Your daughter could be having issues with the Levo. brand? You could try a change to Synthroid with Cytomel. You say that her t4 and t3 were in range, but if they are low in their range, then it could be she needs her meds raised to get the free t3 and free t4 high in their range. This is where my daughter feels best. When they are lower in the normal range she has lots of joint and muscle pain along with being tired and moody! There are other options that you can explore with meds. Don't stick with something that is not working. Our kids need to feel their best so they can enjoy just being kids. Don't settle for less! If you think they are on the right med, then work on those levels, if that doesn't work, try changing the t4 med, if that's not the answer, then switch directions completly as we had to do. (Even if that means changing doctors) You will eventually figure it out and it will be worth the effort.
Nature-throid is a combo med at a ratio of about 4 to 1 T4/T3. Cytomel is a T3 only med.
Probably many reasons why some doctors only test for TSH. Among them are the fact that TSH was probably the best overall test available many years ago and it became the standard way of checking thyroid function because it supposedly correlated with thyroid hormone levels. Probably there is also an association with insurance coverage, where TSH was the only test that was supposed to be run, for cost purposes.
Now tests for the actual thyroid hormones are available and considered reliable, but are not routinely used, and in some cases doctors almost refuse to run FT3, because they say it is unnecessary, that FT4 tells them all they need to know. Of course this assumes that your body always converts T4 to T3 adequately, which is frequently not the case. Regular members of this Forum realize the importance of testing for both FT3 and FT4, so we try to make sure that is always done.
Regarding your other question, Cytomel, which is a T3 med, is frequently prescribed if a patient is not converting T4 adequately to T3 and the levels are out of balance. If the patient converts T4 adequately, then a T4 med is used more often. The most important thing is to test and adjust FT3 and FT4 levels with whatever meds are necessary to alleviate symptoms. Frequently this requires that FT3 and FT4 levels are adjusted into the upper part of their reference ranges. The logic for this is covered in my previous post about the need to correct the reference ranges, as was done previously for TSH.
If you will get the testing done and post the results and reference ranges, members will be glad to help further.
Now tests for the actual thyroid hormones are available and considered reliable, but are not routinely used, and in some cases doctors almost refuse to run FT3, because they say it is unnecessary, that FT4 tells them all they need to know. Of course this assumes that your body always converts T4 to T3 adequately, which is frequently not the case. Regular members of this Forum realize the importance of testing for both FT3 and FT4, so we try to make sure that is always done.
Regarding your other question, Cytomel, which is a T3 med, is frequently prescribed if a patient is not converting T4 adequately to T3 and the levels are out of balance. If the patient converts T4 adequately, then a T4 med is used more often. The most important thing is to test and adjust FT3 and FT4 levels with whatever meds are necessary to alleviate symptoms. Frequently this requires that FT3 and FT4 levels are adjusted into the upper part of their reference ranges. The logic for this is covered in my previous post about the need to correct the reference ranges, as was done previously for TSH.
If you will get the testing done and post the results and reference ranges, members will be glad to help further.
Wow thanks for explaining the difference between the Ts! Makes sense. Why do you think the doctor only tests for tsh. I had to ask for the t3 and t4 test. The doc did that and the t3 and t4 fell into range. I will now ask for free t3 and free t4. My 16 year old who suffers extrmem depression/anxiety takes cytomel and levothoyxine. Is it the cytomel that is prescribed when the frees are not in range?? IF so, then I will be at a loss again, because it is not working.
I also was a teacher for 9 years, so I know how exhausting it can be. Being a single mom on top of that,would really add to it. To have kids that are not feeling well, with their health decisions being left to you, is very overwhelming, especially since thyroid issues are so complicated! However, you are a teacher so you can figure all this out no matter how complicated! If I can make some since of it, I know you can to, it's just a process I had to, and am still going through. There is really a big learnig curve when it comes to all of this, but it does get easier as you "keep digging!"Read, study and talk to others who can relate (who have thyroid issues). That has helped us the most to get moving in a better direction (See my journal entry on my profile page).I would suspect that your daughter's depression is probably related to being hypothyroid.Lexapro and psychiatrist will probably not be needed if she gets her hypothyroidism treated more optimally. The fatigue and exhaustion (tired in morning can also be a sign of too little available thyroid hormone (freet3)! My daughter was like a zombie in the morning when she was ill with low t3 and t4 at the end of summer.( due to a change in Armour Brand med.) It wasn't until I got her on a new med (Naturethroid)at the right dose, that she began coming out of it.) Now she wakes up fine, is happy and ready for her day! Early bed time and consistency/routine/schedule is important when dealing with thyroid issues, especially in children. A book that helped me so much recently is "Overcoming Thyroid Disorders" by Dr. David Brownstein (Amazon. com). It's an easy read and he is "right on"! I know it seems easier to just trust the doctors for all your info. and hope that they are truly the expert! However, in the world of thyroid it is often not the case and can ultimitly make things harder on all involved. You are the person best qualified to be the exprt here! So dig in and be determined, and all of your families' health will be the better for it! You can do this!!!!
Only a small part of the total thyroid hormones in the blood are "free" by which it means that they are not bound up with protein. When bound up with protein, the hormone is inactive. Only the free portion, FT3 and FT4 are biologically active. These "free" hormones largely regulate metabolism and many other body functions. That is why total T3 and total T4 tests are largely considered obsolete, in that they don't show what you really want to know.
In addition to that, the reference ranges for FT3 and FT4 are so broad that just being in the low end of the range is frequently inadequate to prevent hypo symptoms. On this Forum we continually hear from members that are told their thyroid test results were "normal", yet they continue to suffer hypo symptoms. In my opinion, the reason for this is as follows.
The reason the reference range for TSH is called "normal", is that it's based on a large population of patients' test results. From that data base the decision was made that about 5 % of people would fall out of this "normal" range because they were possibly hypo or hyper. From this decision limits were placed at plus and minus two standard deviations (which places 2.5% of the results outside each limit) from the overall average and that was called the "normal" range, supposedly representing people who had no thyroid problems.
After many years of bad experience with this "normal" range for TSH, they finally acknowledged 6 years ago that there were a lot more patients out there with hypo and hyper problems than previously accepted when they originally used their data base to established the range.
After excluding from the data base those patients who were suspect for hypo and hyper, they again analyzed the remaining data base and established limits that included 95% of the total data base and called these new limits "normal". This changed the reference range from .5-5.0 down to .3-3.0, which is a huge change. Unfortunately this change hasn't yet been accepted or acknowledged by most labs and doctors, even though the change was recommended by the AACE over 6 years ago.
Also, realize that the reference ranges for the "Frees" were established the same basic way. These ranges have never been reexamined and modified like the range for TSH. I am absolutely convinced that this is the reason why so many hypo people fall into the lower end of the ranges for FT3 and FT4 and are still told they are "normal".
In one my past lives I had a lot of training and experience in statistical analysis. Based on that experience, if I had to estimate what a revised range for FT3 would be if the data base were purged of suspect hypo and hyper people, like was done for TSH,then I would say the FT3 range should change from 2.3-4.2 pg/dl up to about 3.2-4.3. And FT4 probably would change from .60-1.50ng/dl up to about 1.0-1.55. Quite a difference, huh? Think maybe that is why we hear from so many people that have hypo symptoms, yet they are in the "normal" ranges for the "Frees"? I'd bet my last dollar.
So, I suggest that you get both kids tested for free T3 and free T4 (FT3 and FT4) and then get copies of all lab reports and post results here and our many experienced members will be glad to help interpret results and make suggestions.
In addition to that, the reference ranges for FT3 and FT4 are so broad that just being in the low end of the range is frequently inadequate to prevent hypo symptoms. On this Forum we continually hear from members that are told their thyroid test results were "normal", yet they continue to suffer hypo symptoms. In my opinion, the reason for this is as follows.
The reason the reference range for TSH is called "normal", is that it's based on a large population of patients' test results. From that data base the decision was made that about 5 % of people would fall out of this "normal" range because they were possibly hypo or hyper. From this decision limits were placed at plus and minus two standard deviations (which places 2.5% of the results outside each limit) from the overall average and that was called the "normal" range, supposedly representing people who had no thyroid problems.
After many years of bad experience with this "normal" range for TSH, they finally acknowledged 6 years ago that there were a lot more patients out there with hypo and hyper problems than previously accepted when they originally used their data base to established the range.
After excluding from the data base those patients who were suspect for hypo and hyper, they again analyzed the remaining data base and established limits that included 95% of the total data base and called these new limits "normal". This changed the reference range from .5-5.0 down to .3-3.0, which is a huge change. Unfortunately this change hasn't yet been accepted or acknowledged by most labs and doctors, even though the change was recommended by the AACE over 6 years ago.
Also, realize that the reference ranges for the "Frees" were established the same basic way. These ranges have never been reexamined and modified like the range for TSH. I am absolutely convinced that this is the reason why so many hypo people fall into the lower end of the ranges for FT3 and FT4 and are still told they are "normal".
In one my past lives I had a lot of training and experience in statistical analysis. Based on that experience, if I had to estimate what a revised range for FT3 would be if the data base were purged of suspect hypo and hyper people, like was done for TSH,then I would say the FT3 range should change from 2.3-4.2 pg/dl up to about 3.2-4.3. And FT4 probably would change from .60-1.50ng/dl up to about 1.0-1.55. Quite a difference, huh? Think maybe that is why we hear from so many people that have hypo symptoms, yet they are in the "normal" ranges for the "Frees"? I'd bet my last dollar.
So, I suggest that you get both kids tested for free T3 and free T4 (FT3 and FT4) and then get copies of all lab reports and post results here and our many experienced members will be glad to help interpret results and make suggestions.
What is the difference between t3 and free t3/ t4 and free t4
My son's t3 and t4 are in the normal range
I am an elem ed teacher ( also hypo), single mom, with two children ages 12 and 16 who are hypo. It is so hard going back and forth with doctors and medicine changes. ( there is so little time work hours ) I also take my daughter to psychiatrist for depression. They put her on lexapro, which made her too sleepy to get out of bed in morning. I know both children need a change, just cant quite seem to pin point exactly what needs to be done for either. .
My son's t3 and t4 are in the normal range
I am an elem ed teacher ( also hypo), single mom, with two children ages 12 and 16 who are hypo. It is so hard going back and forth with doctors and medicine changes. ( there is so little time work hours ) I also take my daughter to psychiatrist for depression. They put her on lexapro, which made her too sleepy to get out of bed in morning. I know both children need a change, just cant quite seem to pin point exactly what needs to be done for either. .
Take it from a mom who has a child who was born without a thyroid gland, you always get a copy of the lab sheet! On it you make sure that the freet3 and freet4 are tested. If your doctor won't look at the t3 levels, then you find a new doctor for your kids.Many pediatric endos. only look at the TSH and freet4 because they are usually prescribing only a t4 synthetic medication. They just assume that the storage hormone t4 converts into the proper amount of t3 (active hormone) within the body. Problem is, they never know for sure because they never check! My daughter was not converting enough of the t4 into t3 within her body and had many hypo. symptoms/ health issues. She is now on desiccated porcine hormone (Naturethroid) which has lots of t3 in it. She is doing much better now that all her throid hormones are kept at a higher and more optimal level for her individual needs. I hope this helps you with your sons. Sub optimal thyroid replacement (due to the wrong levels or the wrong med for that particular person) can cause lots of health issues if not corrected.
I dont have the lab sheets, only got the info over the phone. What would I need to be looking for on the lab sheet? We have no idea why both of my children are hypo. Actually my 16 year old suffers more than my son because of depression. ugggghh
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