Does my 15 year old daughter have hypothyroidism?

Question

My 15 year old daughter has the following symptoms and is just having her bloods tested to include thyroid testing.

Exteme tiredness/fatigue and she often needs a long nap
Dry skin 
Delayed puberty - periods only started recently
Insomnia
Extreme coldness in hands and feet and she wears socks and gloves at night
Hair is not in good condition
Dry skin
She has had 2 instances of visual disturbances where she saw lights and vision went fuzzy in one eye
(Doctor said possible migraine)

She is tall at 5'9" and a size 8-10 (UK sizes) so weight is not a problem

Any thoughts?

Best wishes, Sarah

gimel · Accepted Answer

With those symptoms, your daughter is going to need a good thyroid doctor that will treat her clinically (for symptoms), by testing and adjusting the biologically active thyroid hormones, free T3 and free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels..  As LM said above, free T3 is the most important because studies have shown that it correlates best with hypo symptoms.  

So you need to find out about testing for free T3 and free T4, along with the TSH that they always test for.  Also, it would be a good idea to find out if thyroid antibodies are present by testing for TPO ab and TG ab.  These tests will help determine the possible presence of Hashimoto's Thyroiditis, which is the most prevalent cause of hypothyroidism.  Hypo patients frequently are low in Vitamin D, B12, and iron/ferritin, and selenium.  I have no idea if you can get those done, but it would be useful to do so.  If you are successful, then I suggest that you get a copy of the lab report and post results and the reference ranges shown on the lab report and members can help interpret and advise further.  

From the experience of members from the UK, I expect that you might have problems finding a doctor that is willing to test and treat your daughter in the above manner.   What we hear usually is that the UK doctors only want to test for TSH and medicate accordingly.  That doesn't usually work, for many reasons.  You are going to have to learn a lot about hypothyroidism testing and diagnosis, to best help your daughter through this.  Being 15 is tough enough without having all those hypo symptoms.

I do happen to have the names of two doctors, one in Edwinstowe, Mansfield, and the other in the London area, that members have recommended as good thyroid doctors.  If this is anywhere near enough for you I'll be glad to forward names by PM.

Please keep in touch and let us know how it goes.  We have many experienced and knowledgeable members that are more than happy to try and help.

gimel · Answer

The reference ranges for FT4 (and FT3) are so broad that just being in the low end of the range is frequently inadequate to relieve symptoms.  Many of our members report that symptom relief for them required that FT3 was adjusted into the upper part of its range and FT 4 adjusted to at least midpoint of its range.  

Based on her symptoms and the low-in-the-range FT4 result, I'd say that she needs thyroid meds.  Knowing a little about the NHS, I think your biggest problem is to find a doctor that will treat her clinically, by testing and adjusting both FT3 and FT4 levels as necessary to relieve symptoms, without being constrained by resultant TSH levels.  But I am sure that is what she needs.

Another thing to discuss with the doctor is her ferritin.  I know it is in range, but very low.  this sometimes also accompanies hypothyroidism, and can affect her energy.  Along with that many hypo patients have low vitamin D and B12, so worthwhile to check that also.

I understand even less than I know about Eosinhphilia, so I'll leave that to others or to you and the doctor.  

I know this is a long shot, but I do have the names of two doctors that were recommended by Forum members in the UK.  One is in Edwinstowe, Mansfield and the other is in the London area.  If either would be of interest, let me know.

Sparkysarah · Answer

Thanks for your support and I have listened to advice given and gone back to surgery and got the exact results which I would be grateful for interpretation and input. I forgot to say that my daughter also has asthma and allergies. She uses a symbicotr turbohaler 200 2 puffs twice daily.
                            Actual Result           Normal Level
Serum TSH Level          1.9                     (0.2-5.5)
Serum Free T4 Level   12.9                    (10-24.5)   

Serum Ferritin              24 ug/L              (10-300)

Plasma Fasting
Glucose Level              4.9 mmol/L         (3.4-6.0)

RCBs                          4.69                   (3.80-5.80)
HB                             13.8                    (11.5-16.5)
Haematocrit                 0.418                 (0.37-0.47)
MCV                           89.1                   (80-100)
MCH                           29.4                   (27.0-32.0)
Platelet Count              271                    (140-400)
WBCs                          6.9                    (3.6-11.0)
Neutrophil Count           3.3                     (1.8-8.0)
Lymphocyte Count        2.05                   (1.2-5.2)
Monocyte Count           0.52                    (0.1-0.8)
Eosinophil Count          1.06                    (0.1-0.8)   High
Basophil Count             0.03                   (0-0.2)

So  hope that someone can throw some light on this for me. Most of the results look fairly normal although T4 level is on the low side of "within normal limits", and eosinophil count is high.  No T3 level done as far as I can see and is this more relevant to detecting hypothyroidism?

Cheers for now and thanks for help in advance

Sarah

NB Notes on results stated Eosinophilia could be due to atophy, infection, parastici infection or drugs. Is this to do with while blood count????
Possibly due to asthma drugs ? But I was told all results were normal!!!

flyingfool · Answer

Test again but you  must insist on Free T3 and Free T4.  It is not that uncommon to have "within range" TSH and still be hypo.

Although you may by the sounds of it have a hard time getting a Dr. to do that.  I know here in the states I'm having difficulties getting a Dr. to run the tests here.  After much insistence we FINALLY got the Dr. to test for the free T3 and free T4.  But they still refused to test for the Hashimoto's antibody.

Totally frustrating why a Dr would not test for the #1 reason for Hypothyroidism.

Sparkysarah · Answer

Just to let you know that all my daughters blood test results came back "within normal limits" so I think this is just going to be one of those unexplained things that where we sit and wait and see. She seems a bit better now anyway and she is not at all concerned about her health.  I amgoing to take her to get her eyes tested and scan of optic nerve just to check that out to put my mind at rest.

Thank you for all your informative responses.

Best wishes

sarah

LazyMoose · Answer

Its possible but the blood test you sre waiting for will help tell the picture. I dont remember if in the UK, there is hesitancey towards measuring free T3, that is the most important test.

Your interpretation of her symptom list can very well be from other things too. Does she have more going on your unaware of? Most people with hypothyroid have more 'going wrong' as you can read in one of the top posts here yesterday / today.

Does my 15 year old daughter have hypothyroidism?

Am I normal person with full health life ?

thyroiditis with normal test blood

Thyroid and Tinnitus

Get to know about Hypothyroidism

Am I normal person with full health life ?

thyroiditis with normal test blood

Thyroid and Tinnitus

Get to know about Hypothyroidism

You are reading content posted in the Thyroid Disorders Community