TSH level in 5 year old

[Monie1111]

My daughter turned 5, September 6, 6007.  She has gained about 23 pounds since November 2006.  Ten of those pounds were gained since August 2007. She now ways 68 pounds. Her TSH was checked last week and it was 5.33.  Her Dr.  called children's hospital in Denver and said that 6 was normal.  What do I do now?  I watch what she eats and she goes to gymnastics twice a week.  She is tired and has no energy most of the time.  Her preschool teacher has noticed it too.  My instincts tell me to keep investigating this.  What should I do??

[Deanna L Aftab Guy, MD]

The TSH alone does not mean anything without a free T4 level. The TSH reflects the hormone that the brain makes and the free T4 reflects the thyroid gland's response to the TSH. If the tsh is elevated and the free T4 is low this is considered hypothyroidism, a 5.3 is really normal in some labs and a little elevated in some. I would consider repeating the level and including a tsh and free T4 to compare. Then discuss all the other important reasons she may have had rapid weight gain. Is she drinking juice-if so stop it completely and have her eat her fruit instead, this includes juice boxes. Eliminate whole milk and make it low fat, no more chocolate milk which has corn syrup added. Try to limit simple carbs like high sugar foods in certain snacks and increase her water intake with small water bottles in her lunch or with dinner, snacks are good but keep them healthy like graham crackers, peanut butter, lean cheeses and turkey or ham or yogurt(lowfat or low sugar).
Increase her activity, if she is at gymnastics 2 times a week that is great! Try something different the other days, be it ride her bike or play outside at least 30 minutes, give this a whole month to see how she does. The goal is weight maintainence NOT loss, this is doable and since she is growing this will lower her bmi and keep her towards a healthy range. Work closely with your pediatrician and perhaps consider at some point a visit with a dietician who is comfortable with children, this can offer good suggestions for the whole family. There may be some genetic influence that is worth being aggressive with her diet and activity level.

[Monie1111]

Thanks for your help.  I have my daughter scheduled to see the GoodLIFE clinic to check into her weight gain and she is also seeing a GI at the Children's Hospital.  She has chronic diahrea, bloating, sore bottom  etc.  Lactase enzymes don't seem to help.  Maybe celiac or lactose intolerance?