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Pediatric Endocrinology (Expert Forum)
Thyroid supplementation recommended?
Questions in the Pediatric Endocrinology forum are answered by Dr. Deanna L Aftab Guy, affiliated with Vanderbilt Children's Hospital. Topics covered include adrenal problems, diabetes insipidus, menstrual irregularities, obesity, parathyroid abnormalities, pituitary abnormalities, puberty concerns, rapid growth, rickets and bone disease, short stature, and thyroid.
Thyroid supplementation recommended?
by sadieandlarry, May 01, 2008 04:18PM
Advice please!
My 16 yr old has childhood vitiligo, began at 3 andstable. Very well until 1.5 yrs ago when anxiety/depression started. SSRIs did not help. Then he confided his skin worries (acne/vitiligo). Recently diagnosed with body dysmorphic disorder - depression secondary. So he is just starting on very high doses of SSRI with cognitive behaviour therapy. He is EBV+ (the serology shows reinfection). I am worried that his thyroid function is not optimum and if left untreated will interfere in his recovery (both from the BDD and from the virus). He also has familial hypercholesterolema, which was being treated with Lipitor until he started having these problems - so he has that risk factor as well.
Here are his thyroid test results:
TSH (rr 0.5 -5.0) 2005 6.14; 2006 3.00; 2007 6.30; 2008 7.40 trending up
FT4 (rr 10-22) 2005 14; 2007 12; 2008 11 trending down
FT3 (rr 4.0-7.0) 2005 5.5; 2008 4.5 went down
Total T3 (rr 1.2-3.2) 2008 1.3 very low normal
rT3 (rr 0.12- 0.54) 2008 0.27 normal
Anti TPO (rr10 or until fT4 falls outside range). Dr. says increased uptake in scan is not consistent with hypothyroidism, but I have read it can be increased in early Hashimotos. Dr. also says it maybe sick euthryoid, but since TSH was elevated in 2005 and rT3 is normal I am not sure.
My 16 yr old has childhood vitiligo, began at 3 andstable. Very well until 1.5 yrs ago when anxiety/depression started. SSRIs did not help. Then he confided his skin worries (acne/vitiligo). Recently diagnosed with body dysmorphic disorder - depression secondary. So he is just starting on very high doses of SSRI with cognitive behaviour therapy. He is EBV+ (the serology shows reinfection). I am worried that his thyroid function is not optimum and if left untreated will interfere in his recovery (both from the BDD and from the virus). He also has familial hypercholesterolema, which was being treated with Lipitor until he started having these problems - so he has that risk factor as well.
Here are his thyroid test results:
TSH (rr 0.5 -5.0) 2005 6.14; 2006 3.00; 2007 6.30; 2008 7.40 trending up
FT4 (rr 10-22) 2005 14; 2007 12; 2008 11 trending down
FT3 (rr 4.0-7.0) 2005 5.5; 2008 4.5 went down
Total T3 (rr 1.2-3.2) 2008 1.3 very low normal
rT3 (rr 0.12- 0.54) 2008 0.27 normal
Anti TPO (rr10 or until fT4 falls outside range). Dr. says increased uptake in scan is not consistent with hypothyroidism, but I have read it can be increased in early Hashimotos. Dr. also says it maybe sick euthryoid, but since TSH was elevated in 2005 and rT3 is normal I am not sure.
Member Comments (1)
by Deanna L Aftab Guy, MD, May 01, 2008 07:40PM
, May 01, 2008 07:40PMTo: sadieandlarry
will post answer on next message
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