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Could my teen have a thyroid problem?
My daughter has been suffering since the age of 11 with weight gain, depression, dry skin, brain fog and heavy periods. She is now 13 and still suffering from the above symptoms but now for the last 6 months she has been also having extreme panic attacks and insomnia to the point where she's hardly getting any sleep. If she does sleep she's having nightmares. We have had to take her out of school because it's so bad. Doctors are quick to just label it depression and social anxiety but none of the medications they have prescribed have worked at all and in fact have made all her symptoms worse. I finally demanded a complete blood workup and to have her thyroid tested. I just picked up the results and it says her Free T4 is in the low range at 0.72, But her TSH is within normal range at a 1.23. Her Total T3 is in normal range but at the lower end at 88. Her creatin levels were also low at 0.6 as well as low vitamin d levels of 17.35 but not sure if they relate to the thyroid. Any thoughts on if it could be her thyroid?
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Unfortunately being an Endocrinologist does not guarantee a doctor that will treat clinically, as described above. Many of them specialize in diabetes not thyroid. Also, many of them have the "Immaculate TSH Belief and only pay attention to that. Wrong. If they test beyond TSH, then they use "Reference Range Endocrinology", by which they will tell you that a thyroid test that falls anywhere within the range is adequate. That is also wrong, as discussed in the paper linked above.
I suggest that you try to get the current doctor to read the paper and consent to treating clinically, as described. If that doesn't work, you will need to find a doctor that will treat clinically. If you will tell us your location, perhaps we can give you the name of a doctor that has been recommended by other thyroid patients in your area.
I suggest that you try to get the current doctor to read the paper and consent to treating clinically, as described. If that doesn't work, you will need to find a doctor that will treat clinically. If you will tell us your location, perhaps we can give you the name of a doctor that has been recommended by other thyroid patients in your area.
1 Comments
I would love a recomendation if you know of one in our area. We are located near San Jose, CA. I was the one that had to push for a thyroid test. I kept asking if we should do one from the start but her doctor just went off her symptoms she was complaining about. After examine her neck he said he saw bo signs there was anything wrong. From there without any bloodwork they prescribed her two different SSRI's (Celexa and Zoloft) and one anti-physcotic (Risperidone). She had very bad side effects trying everyone of them at different times. That's when I finally pushed for a complete workup to see if it was anything else causing it within her body. They were just saying she had clinical depression along with social anxiety.
Sorry for the typing errors in the first reply. Corrected in the following.
Your daughter definitely has a thyroid problem. TSH is a pituitary hormone that is affected by so many things that at best it is only an indicator, to be considered along with more important indicators such as symptoms and also levels of the biologically active thyroid hormones Free T4 and Free T3. She has many symptoms of hypothyroidism plus her Free T4 was way too low in the range and, assuming that her Free T3 will be consistent with her Total T3, that would also too low.
A good thyroid doctor will treat a hypothyroid patient clinically by testing and adjusting Free T4 and Free T3 levels as needed to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not just test results. You can confirm all this by reading at least the first two pages of the following link, and more if you want to get into the discussion and scientific evidence of all that is recommended.
http://www.thyroiduk.org.uk/tuk/TUK_PDFs/diagnosis_and_treatment_of_hypothyroidism_issue_1.pdf
The doctors are overlooking your daughter's hypothyroidism because they pay too much attention to TSH. Your daughter's TSH is in range because she doesn't have primary hypothyroidism, but central hypothyroidism. With central there is a dysfunction in the hypothalamus/pituitary system that results in TSH levels too low to adequately simulate the thyroid gland to produce hormone.
Your daughter needs to be started on thyroid medication and then gradually increase the dosage as needed to relieve symptoms. Many of us have found that we needed Free T4 at the middle of the range, at minimum, and Free T3 in the upper half of the range, and adjusted as required to relieve symptoms. In addition hypothyroid patients are frequently too low in the ranges for Vitamin D, B12 and ferritin. So she should be tested of those and then supplement as needed to optimize. D should be at least 50, B12 in the upper end of its range and ferritin should be at least 70.
If her doctor is resistant to any of this, then you should give him a copy of the link and ask that she be treated clinically as described.
Your daughter definitely has a thyroid problem. TSH is a pituitary hormone that is affected by so many things that at best it is only an indicator, to be considered along with more important indicators such as symptoms and also levels of the biologically active thyroid hormones Free T4 and Free T3. She has many symptoms of hypothyroidism plus her Free T4 was way too low in the range and, assuming that her Free T3 will be consistent with her Total T3, that would also too low.
A good thyroid doctor will treat a hypothyroid patient clinically by testing and adjusting Free T4 and Free T3 levels as needed to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not just test results. You can confirm all this by reading at least the first two pages of the following link, and more if you want to get into the discussion and scientific evidence of all that is recommended.
http://www.thyroiduk.org.uk/tuk/TUK_PDFs/diagnosis_and_treatment_of_hypothyroidism_issue_1.pdf
The doctors are overlooking your daughter's hypothyroidism because they pay too much attention to TSH. Your daughter's TSH is in range because she doesn't have primary hypothyroidism, but central hypothyroidism. With central there is a dysfunction in the hypothalamus/pituitary system that results in TSH levels too low to adequately simulate the thyroid gland to produce hormone.
Your daughter needs to be started on thyroid medication and then gradually increase the dosage as needed to relieve symptoms. Many of us have found that we needed Free T4 at the middle of the range, at minimum, and Free T3 in the upper half of the range, and adjusted as required to relieve symptoms. In addition hypothyroid patients are frequently too low in the ranges for Vitamin D, B12 and ferritin. So she should be tested of those and then supplement as needed to optimize. D should be at least 50, B12 in the upper end of its range and ferritin should be at least 70.
If her doctor is resistant to any of this, then you should give him a copy of the link and ask that she be treated clinically as described.
1 Comments
Thank you so much for all that information. I really appreciate you taking the time out of your day to answer my question. We go back to her doctor next week and I'm going to push for a referral to an endocrinologist. I am also going to push for other tests on her thyroid that they haven't done. I read somewhere else they need to do complete testing of the thyroid to rule out Hashimoto's, etc.
Your daughter definitely has a thyroid problem. TSH is a pituitary hormone that is affected by so many things that at best it is only an indicator, to be considered along with more important indicators such as symptoms and also levels of the biologically active thyroid hormones Free T4 and Free T3. She has many symptoms of hypothyroidism plus her Free T4 was way too low in the range and issuing the her Free T3 will be consistent with her Total T3, that is also too low.
A goo thyroid doctor will treat a hypothyroid patient clinically by testing and adjusting Free T4 and Free T3 levels as needed to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not just test results. You can confirm all this by reading at least the first two pages of the following link, and more if you want to get into the discussion and scientific evidence of all that is recommended.
http://www.thyroiduk.org.uk/tuk/TUK_PDFs/diagnosis_and_treatment_of_hypothyroidism_issue_1.pdf
The doctors are overlooking your daughter's hypothyroidism because they pay too much attention to TSH. Your daughter's TSH is in range because she has, not primary hypothyroidism, but central hypothyroidism. With central there is a dysfunction in the hypothalamus/pituitary system that results in TSH levels too low to adequately simulate the thyroid gland to produce hormone.
Your daughter needs to be started on thyroid medication and then gradually increase the dosage as needed to relieve symptoms. Many of us have found that we needed Free T4 at the middle of the range, at minimum, and Free T3 in the upper half of the range, and adjusted as required to relieve symptoms. In addition hypothyroid patients are frequently too low in the ranges for Vitamin D, B12 and ferritin. So she should be tested of those and then supplement as needed to optimize. D should be at least 50, B12 in the upper end of its range and ferritin should be at least 70.
If her doctor is resistant to any of this, then you should give him a copy of the link and ask that she be treated clinically as described.
A goo thyroid doctor will treat a hypothyroid patient clinically by testing and adjusting Free T4 and Free T3 levels as needed to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not just test results. You can confirm all this by reading at least the first two pages of the following link, and more if you want to get into the discussion and scientific evidence of all that is recommended.
http://www.thyroiduk.org.uk/tuk/TUK_PDFs/diagnosis_and_treatment_of_hypothyroidism_issue_1.pdf
The doctors are overlooking your daughter's hypothyroidism because they pay too much attention to TSH. Your daughter's TSH is in range because she has, not primary hypothyroidism, but central hypothyroidism. With central there is a dysfunction in the hypothalamus/pituitary system that results in TSH levels too low to adequately simulate the thyroid gland to produce hormone.
Your daughter needs to be started on thyroid medication and then gradually increase the dosage as needed to relieve symptoms. Many of us have found that we needed Free T4 at the middle of the range, at minimum, and Free T3 in the upper half of the range, and adjusted as required to relieve symptoms. In addition hypothyroid patients are frequently too low in the ranges for Vitamin D, B12 and ferritin. So she should be tested of those and then supplement as needed to optimize. D should be at least 50, B12 in the upper end of its range and ferritin should be at least 70.
If her doctor is resistant to any of this, then you should give him a copy of the link and ask that she be treated clinically as described.
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