9 year old diagnosed with Hashimoto's

[momintexas933]

Our 9 year old had strep throat twice in Jan/Feb. of this year. Our pediatrician had her bloodwork drawn on Jan. 14 as our daughter also had some unexplained lightheadedness and the Dr. wanted to check CBC, CMP, ESR and thyroid. Upon receiving the bloodwork back, all looked normal except for her TSH which was 6.60 (FT4 was 0.73). We did not go back to do the more indepth thyroid test until Feb. 24 and the results were: TPAb - negative, TP AB In - 76.0, Thyroglobulin Antibody - 205 (high), TSH - 5.33 (high), and FT4 - 1.04. She had strep at the time of the Jan. blood draw and had just finished another round (like many kids down here!) just before the Feb. blood draw. Would it be best to do another draw now that she's healthy or does strep even interfere with these levels? We followed our pediatrician and endocrinologist's advice and started her on levothyroxine but she was getting too much they concluded. They reduced her dosage from 150 mcg to 50 mcg after the endocrinologist saw her in person. They said the other dose was too high. My "mom" instinct tells me to retest her blood work but guess it would be quite messed up now after 2 1/2 weeks of overdosing. So, so frustrating and would like to know if others have been through this. Also if natural replacement is a better option and should we be overly concerned about other auto immune diseases popping up? She seems SO young to have this problem. Thanks SO much in advance!

[sabod]

Our daughter was diagnosed with Hashimoto's when she was around 10.  It seems from our experience that there is some trial and error involved in initial dosing. As our daughter has grown, she has had to adjust her dose.  We started on a small amount of thyroxine and then had her blood tested two months later.  Based on those results and her symptoms (her thyroid gets enlarged and she gets muscle aches when the dose is too low) the dose was adjusted and her blood drawn again two months later.  She now has her blood work done every 6 months and at age 14 the dose still needs constant checking to make sure it is keeping pace with her growth.  If the dose is too high she can get nervous and 'highly strung'.  I have heard many people swear by natural replacement (only on line, nobody I know personally), but our physician doesn't recommend it.  I have not wanted to start messing about with our daughter's health unnecessarily as the thyroxine seems to keep her symptoms under control - I figure she can explore that herself as an adult if she would like.  On some of the message boards, people seem to suffer from supply issues with the natural thyroid too, which worries me.  Keep your chin up and love up your little girl.  This is a frustrating thing for our daughters to deal with and to accept.  My daughter has finally progressed, just this year from sitting on my knee for her blood draw, to going in without me.  She remembers to take her medicine every morning (we have one of those weekly dosing boxes) and now we are working on her calling the pharmacy to refill her prescription.  I want this to be seamless for her by the time she heads off to college.  Good luck

[Mark Lupo, M.D.]

I am not sure what TP AB In -76 means...if this is TPO antibody then it's positive but the other TPAb comment was "negative".  TgAb was positive.
This may have been a transient thyroiditis after the strep throat which would likely recover on its own.  In adults (I don't see kids), we often will try to taper off the medication if this is thought to be a transient problem, but monitor levels closely (every 4-6 weeks).

[Nisshoku]

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