First and most important is to leave that doctor and find a good thyroid doctor. Your daughter's symptoms, along with high TSH and very low in the range Free T4 clearly point to hypothyroidism. I have the name of a doctor recommended by a fellow member in the Madison area. Would that be close enough for you to consider?
Thanks for your response. Thats what i thought about the tests too. The unfortunate part, is that we really like this doc. My son's been seeing him for a few years now, and he's always done really well there. We go to the American family children's hospital in madison. We chose him for our daughter because our son has done so well there. I have a lot of respect for this doctor, but i think he missed the mark on this one.
The doctor was basically following the guidelines of the AACE and the ATA: If TSH is high, test for Free T4. If Free T4 is within the range, then it is called subclinical hypothyroidism and treatment is up to the doctor. Too often they ignore the low level of Free T4 and don't medicate, even though the guidelines say that the doctor has the best information about the patient's history and symptoms, etc. and can decide to treat.
A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not just test results, and especially not TSH results. You can get some good insight from this link written by a well known thyroid doctor.
If you give a copy of the link to the doctor, it may be that the doctor might change his mind and agree to treat. If not, then it might be worth while to go ahead and make an appointment elsewhere, since that might take a while.
I really appreciate your input. I have felt like no one's really listened to me over the past year. It's frustrating when there is obviously something wrong with your child, and noone can give definitive answers.
My son has always had "textbook" hypothyroidism (if there is such a thing), so maybe that's why we have never had any real issues with his physician. I can always tell when his meds need an adjustment based on his symptoms, and he has been on levothyroxine since 3 months of age. I can only assume that my daughter will be much less predictable.
Tonight i felt her neck to see if there was anything outstanding, and putting pressure on her sent her through the roof. Her thyroid area is extremely sensitive and painful. My son never had pain in his neck. Is this also a good indicator?
Also, I've never had endocrine suggest subclinical hypothyroidism. Is there a possibility that she could 'outgrow'it, or does it simply mean early stage?
"Hypothyroidism can reduce the production of stomach acid by its effect on the hormone, gastrin. When too little gastrin is produced, this reduces the amount of stomach acid (HC1). Bloating, G.E.R.D., heartburn, intestinal inflammation, decreased food digestion and more can result from the lack of normal HC1 levels." - The 6 Main Systems and Organs Affected by Thyroid Disease by Dr. Frank Lanzisera.
"Some people with Hashimoto's, especially those with a larger goiter, may feel discomfort in the neck area. Scarves or neckties may feel uncomfortable. The neck may feel swollen or uncomfortably enlarged, even sore. Sometimes the neck and/or throat is sore or tender. Less commonly, swallowing or even breathing can become difficult if a goiter is blocking the windpipe or esophagus." - About Health - Hashimoto's vs. Hypothyroidism: What's the Difference?
Endo received my daughter's most recent labs last Friday. As of yet, I have not gotten a return phone call. If I do not hear from them by the end of today, or if they still decide not to medicate, I am ready to move on. Can you let me know which physician you are recommending in the Madison area so that I may contact my insurance company??
Thanks in advance
I just sent you a PM with doctor info. To access, click on your name and then from your personal page, click on messages.