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Hypothyroidism and decreased athletic performance

My 13 yr old daughter was diagnosed by our PCD with Hypothyroidism about a year ago. She is currently taking 50 micrograms of Levothyroxine/day. Prior to her diagnosis she complained of fatigue and shortness of breath during exercise. She was also small for her age. Within a month of going on meds she had gained 10 lbs. after not gaining a single pound for more than a year. She has again plateaued on weight gain. She is now 5 ft. 5in tall and weighs 92 lbs. about 5 lbs less than she weighed a month ago during a  Dr. visit to check her T3 levels that came back normal. She is also complaining again about being tired all the time, and fatigue is present in her athletic performance. She plays both Club volleyball & basketball at a high level that also involves physical training in weights, etc. She does not appear to be gaining any of the benefits from this exercise & weight training. In basketball after just a couple minutes on the court her movement is literally as if she just got done running a marathon... my husband calls it the "cement boot" look.  She is laboring to move. She began menstruating last Spring and indicates that she is doing so normally. Her diet is average, but she is consuming a lot of protein and carbs from things like eggs, chicken, whole grain pastas & breads, whole milk, etc. She could stand to eat a few more vegatbles & fruits but overall her caloric intake is adequate. Our concern is that there may be something else going on.  Over the summer she had no problem playing in 5-6 basketball games/day during tournaments & now she is lucky to make it through one without being physically spent. I've read some articles about high level exercise acutally causing hypothyroidism and would like to know if we need to have her further evaluated by a pediatric endocrinologist.
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734073 tn?1278896325
It's very important to keep a copy of every blood test. They are required to give you a copy if you ask. I'd bet the farm that she didn't check!
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Avatar universal
thank you both for your insights, I will definitely be watching her over the next couple of weeks as she adjusts to the higher dose of Levo. The Dr. may have test the FT3 she just didn't give me a number or even mention it when we spoke. I'll have to call back and ask for the print out of all the results and go from there.
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734073 tn?1278896325
P.S. pediatrric endo. probably won't prescribe it! (They are usually anti. t3 and anti desiccated) Our family practice md now treats my daughter and she is doing much better now that her freet3 is where it needs to be!  (high normal range NOT low normal range!!!)
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734073 tn?1278896325
The prescription desiccated hormone that is working well for my daughter is Nature-Throid.(3 months now) It's hard to find right now, (supply and demand issues). Will be readily available again soon (mid November to December). Just incase you want to get her t3 up in this way!
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Avatar universal
Although TSH is only an indicator of thyroid problems, her TSH exceeds the currently recommended level of .3 - 3.0.  Also, with her symptoms and the other test results, she obviously does need more meds.  I wish that the doctor had tested for FT3 instead of total T3.  FT3 is the most biologically active thyroid hormone. It is four times as active as FT4 and Ft3 correlates best with hypo symptoms.  If her FT3 is consistent with her total T3, then it will also be in the lower end of the the very broad reference range, indicating that she may need to supplement her meds with a source of T3, rather than just increasing her T4 med. (I assumed that she is taking a T4 only type med).  

We hear from many members with similar situations, by which I mean that their FT3 is low within the range, yet they still have hypo symptoms.  It sounds like that your doctor is at least willing to treat your daughter with meds, when some would not want to go any further.  So I think if you get FT3 tested and discuss with her doctor what I expect will be a result that is low in the range, you may be successful in getting meds required to increase her FT3 level.  In my opinion the very best way to treat a thyroid patient is to continually test and adjust FT3 and FT4 levels with whatever meds are required to alleviate symptoms.  Symptoms should be all important. Frequently we hear that this requires that the FT3 level is adjusted into the upper part of its range and the FT4 level to at least midpoint of its range.
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Avatar universal
Since I had no numbers to refer to I insisted on seeing the Dr. and more labs on Tuesday (we just had labs done 3 weeks ago and Dr. said everything was normal).  Dr. admitted she hadn't actually tested the T3 since she was first diagnosed. When she called with results yesterday she started out saying this & that were "normal" again so I asked for numbers and got T4 was 1.17, TSH 3.23, and T3 111. She also said Her blood sugar was slightly low but she said that happens when the blood sits in the lab and if my daughter isn't complaining of dizziness or anything not to worry about that. The Dr.'s solution was to increase meds from 50 micrograms to 75...I've been doing a lot of research but it seems as though all these sites refer to these numbers as "normal" as well. The one thing I did notice though was the these meds aren't necessarily going to help with the T3 level so I'm even more perplexed as to why the Dr. would just make that change. She was also tested for iron levels, platlet counts etc. and the Dr. said all of that was fine too. I'm really beginning to think that we have to insist on a referral to a pediatric endocrinologist to get to the bottom of all of this.
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734073 tn?1278896325
Hello! Thought you'd like to know that my daughter is 9 and born without a thyroid gland, so she will always be considered hypothyroid. Hypothyroidism can cause MANY issues if your daughter's thyroid hormone levels are not in proper balance. Specifically her FREE T3 and free t4 which need to be in the mid to high normal range depending on where she feels best.TSH is a pituitary hormone and needs to be low normal. Sometimes a change or an addition to your t4 med is needed, as in our situation. My daughter was always on Synthroid, which is also a synthetic t4 medication like Levo. You must remember that t4 hormone is the storage hormone that must convert to the biologically active t3 within the body, for proper function of the body at the cellular level. My daughters freet3 was very low, and she was having the same issues with exercise, (slow, labored breathing, heavy legged, easily fatigued, no energy, and also heart palps (Premature Ventricle Contractions or PVC's felt as rapid beats for very little exercise -LIKE SHE JUST RAN A MARITHON!) She now takes desiccated thyroid medication (8 months now!) which has t3 in it, and her freet3 and freet4 levels are in the mid upper range. She no longer has heart palps, and her exercise tolerance is much improved. Children's bodies and needs are changing all the time, do not ignore what you are seeing! Especially since your daughter started her period recently! The change/addition of hormones that this can cause can really mess with the thyroid hormone levels, especially if she is not on an optimal dose or the medication that she may now need. Many doctors (especially endochronologist who often focus more on diabetes), down play the issues that hypothyroidism can play. They often imply that just taking 1 magic pill everyday and keeping the tsh and total t4 anywhere in the broad reference range is fine! Problem is, they usually don't look at the freet3 and the reference ranges are too broad. Where you are at in these ranges matters a great deal! Your daughter needs her freet3 and freet4 levels tested! It is the thyroid hormone that is available to the body!  Don't waist your time on a doctor that won't do this! It is also time to read and study about thyroid issues Mom! It can effect so much, if ignored or down played! You are the best advocate for your daughter and you must increase your understanding of the thyroid world, so that your daughter can feel her best! We all will help you as best we can if you will post any questions or lab results! This site has helped me so much with my understanding and has helped us move in a better direction for my daughter's hypothyroidism! So now I try to pay it forward, especially when I see that it is a child with a similar situation as my daughter HAD!
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Avatar universal
Please post whatever thyroid test results and reference ranges you have for your daughter.  I'd like to see what tests have been done previously, then we can discuss further.
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