16 year old daughter???labs???please help

[hermom7]

My daughter had these tests done last year at my request due to losing an excessive amount of her beautiful thick hair - it has not grown back.  She was fatigued and had trouble staying her healthy weight although keeping up with acitivities:
RDW -                        Results 18.5 (high)                                    Range % 11.7-15.0
Neutrophils -                Results  72  (high)                                     Range % 38-63
Lymphs -                      Results  24 (low) %                                   Range 27-47
**** The thyroid tests were requested by me, however I recently noticed that one of the tests was not calculated properly for her age.

Thyroglobulin, Quantitative - Results 4.9                                     Range age 13-18 years           9.0-27.0
***THE LAB DID RANGE OF 0.5 - 55.0
                                                                                          

Thyroxine (T4) Free, Direct, S                   Results 1.05                             Range 0.79- 1.49
TSH  -                                                    Results - 0.612 -                       Range 0.360-5.800
Thyroid Peroxidase (TPO) AB                   Results <10                             Range 0 - 34

One year later, she is pale, has vitiligo on her legs, dry skin on hands, legs, arms, period every 19 days lasting 7 days, heavy - now she has depression and can't explain why she is feeling "this way".  Very unlike her.  

Thyronxine (T4) Free, Direct, S                 Results  0.98                             Range 0.93 - 1.60
Thyroxine (T4)                                         Results   7.7                              Range 4.5  - 12.0
Reverse T3                                              Results  291                              Range  90 -  350
Thyroid Peroxidase (TPO) Ab                    Results  12                                Range  0  - 34
Triiodothyronine, Free, Serum                    Results 3.0                                Range 2.3 - 5.0

Doctor that ordered the tests did so at my begging request (my hormone replacement doctor) - his nurse saw old test and thought she should be retested. He is out of town until Wednesday. My doctor has all the above information but just moved. He has seen her once - no word from him although before going I would like to know if she need additional testing.

Any insight would be greatly appreciated.  I feel so awful that she has come to this point.  

Thank you....

[hermom7]

Thank you so much for the information.  Was able to get a quick appt. at the same office that didn't notice the lab made a mistake last year on her thyroid test, but with a different dr.  I know this isn't going to be easy, but she is definitely suffering and it is no longer in silence.  She is a grin and bear it type personality; I know she is feeling very badly for her to break down.  I look at her and it is as if the life source has been sucked out of her.

I take thyroid, my sister took thyroid but was not diagnosed until she was 63 years old although she tried....and passed a couple years later from ALS  My father (94 yrs.) has had thyroid surgery - I don't remember exactly what the surgery involved other than he had it partially removed and takes Synthroid.  He was probably my age when he had surgery.

Rachel, I have CFS/FM which causes many of the same symptoms as hypothyrodism as well as hypothyrodism itself.  The vitiligo on her legs/stomach and my history will not make a convincing argument for low thyroid with a close-minded physician. Almost exactly a year ago her hair began to come out in handfuls.  This was my first "feeling" she had something wrong.  She also would sleep 12-14 hours and still be very tired. Now, she is unable to sleep as much but is very fatigued, pale, etc.  My daughter has been menstruating since the age of 10 years.  Her periods are getting closer and closer together.  She will sometimes vomit at the onset, so I'm in agreement that her estrogen/progesterone - adrenals should be checked as well.  

Gimel -I'm copying the "conversation starter" and crossing my fingers.  I appreciate both of you taking the time to give me your pov.  I have noticed that the reference ranges keep changing for "normal" thyroid. She isn't my first child, so maybe I just didn't pay enough attention to everything...

[gimel]

With her FT3 and FT4 in the lower end of their ranges, along with the many symptoms, I would say she is hypothyroid.  You might have a hard time getting the doctor to agree, because her TSH is toward the low end of its range, and the doctor would say that her thyroid hormone test results are "normal".

Note that the reference range for TSH was recommended to be changed over 6 years ago by the AACE.  The new range was recommended to be .3-3.0.  Unfortunately most labs and doctors have yet to adopt the new range.  Even more important than TSH, which is a pituitary hormone that is affected by many variables, are the actual biologically active thyroid hormones, FT3 and TF4.  FT3 correlates best with hypothyroidism.  TSH does not correlate very well at all.  

I think you are going to have to get your doctor to recognize that the broad ranges for FT3 and FT4 have never been revised, as TSH was.   As a result the ranges are too broad and the low end is too low.  The ranges should be considered as guidelines within which to adjust your FT3 and FT4 levels to alleviate your symptoms.  Unfortunately most doctors think that results anywhere within the range is a reason to declare you as "normal" and do nothing further.  In my opinion, the best approach to treating a hypo patient is to test and adjust FT3 and FT4 with meds as required to move the levels into the upper part of their range until symptoms are alleviated.

I think you will find this article to be very worthwhile reading and maybe giving a copy to your doctor might start a good conversation about treating her by her symptoms and FT3 and FT4 levels.

http://www.hormonerestoration.com/Thyroid.html

[Rachel4]

First, what led you to have her thyroid tested?  Do you have problems with your thyroid? if you have autoimmune thyroid problems that would increase her chance for any autoimmune disease. Maybe look into some other autoimmune diseases that could be causing this.

Second, what about adrenal or sex hormone testing?

I know that is just more testing suggestions, but hopefully it helps.

Don't give up the pursuit of what is causing this. I wish my mother had been more involved when I was 16 and only a few years into this journey. I'm 26 and 10 years later I've been up and down. I hope for an easier journey for your daughter!