High TSH, Norman Free T4

[jdeal]

We took my 6 year old daughter to the ER last week.  She has been having high heart rate (120-140 bpm) and complaining that her heart is beating "hard".  The doctor suggested that it was most likely either heart or thyroid.  After chest exray, ekg, blood work, etc. (all normal according to the doctor) he basically dismissed thyroid and suggested we see a cardiologist.  I have a history of thyroid disease in my family and the TSH came back high.  This is nagging at me and I was wondering if anyone had some input.  Her blood test results are below.  Thank you.

WBC 7.9
RBC 4.38
HGB 12.2
HCT 34.9
MCV 79.7
MCH 27.9
MCHC 35.0
PLT COUNT 308
RDW 12.5
MPV 8.8
% NRBC 0.0
% NEUT 29.3
% IMMATURE GRAN < 2.0
% LYMPH 61.5
% MONO 6.2
% EOS 2.8
% BASO 0.1
# NEUT 2300
# LYMPH 4840
# MONO 490
# EOS 220
# BASO 10
GLU 97
BUN 13
CREAT 0.3
SODIUM 145
POTASSIUM 3.9
CHLORIDE 108
CO2 25.0
ANION GAP 12
CALCULATED OSMO 288
CA 9.0
TSH 10.60
FREE T4, SERUM 1.37

I appreciate anyone who can shed some light on these results.

[Auntlello1]

Just make sure you find a good thyroid doctor! At her age she shouldn't have to deal with it not functioning properly! I was diagnosed at age 13 with Hashimoto's Thyroiditis, but who knows how long I had had it before I was diagnosed. It can really take a toll on your health, so I would want to find out EXACTLY what is going on with it as soon as possible. Like goolarra stated, FT3 can have a huge impact on coronary health, so maybe by fixing one you can avoid any more complications with the other. Google Free T3 and coronary health. You would be amazed at what they are figuring out.

Best Wishes to you and your daughter!

Heather

[jdeal]

SassySharon..she is about the same.  Still has a high pulse rate.  We see the cardiologist on Monday.  Maybe we will get some answers.

[SassySharon]

How is your daughter doing today?

[goolarra]

Your daughter's TSH is somewhat on the high side.  Several years ago, AACE recommended that TSH range be changed to 0.3-3.0.  However, children's TSH tends to run higher than adults', so the range your lab used might have been age-adjusted.  

Free T4 looks quite good.  It's right about mid-range, which is the rule of thumb for FT4.

The missing element as far as thyroid is concerned is free T3.  FT3 is the most bologically active form of the thyroid hormones, the only form that cells can use.  There are thyroid conditions in which excess T3 is produced.  T3 is often the culprit when it comes to thyroid-related heart symptoms.  I agree with other posters that I'd find a good doctor to do a more complete thyroid workup.  A repeat of FT4 and TSH with FT3 added in would give you some initial direction as to where to go next.

I was just about your daughter's age when I had my first symptoms of a congenital heart defect that caused me to have tachycardia and my heart to beat "hard".  However, that was a long time ago, and it wasn't until fairly recently that I was diagnosed with Wolff-Parkinson-White syndrome.  See a cardiologist, too.  I remember all too well being the scared 6 or 7-year-old with the wildly beating heart.  When I was little, I was told that nothing was wrong with me, so I spent many years thinking I was just a little crazy.  It was when my thyoid started to malfunction and I was put on thyroid meds that my WPW, under control all my life without meds, really went wild.  It might be a combination of the two in your daughter's case as well.  

[jdeal]

First off, thank you for all your good wishes and prayers.

ericaMA, the doctor called the other bloodwork normal.  There were a few things out of range and that was why I was getting on here trying to find answers.  I don't think I was very clear on that.  Thank you.

[danie17075rm]

My heart breaks for you daughter.  It's not fair for such a young child to have to go through this.  I can barely handle it and I have a 5 year old son.  I cannot imagine having him go through the same thing.  I just wanted to say I will keep her in my prayers.  I hope you find answers.  

God Bless

[ericaMA]

Perhaps see a thyroid specialist. I hope she is doing better.  You're right the thyroid number is wayyy too high.  I'm also concerned about" % NEUT 29.3 (37.0-65.0) .  Not sure what that means but why did they tell you everything is normal when this is low?
Best wishes.

[FTB4]

I don't think ER Md's specialize in anything other than trauma, I would get her to a good Endocrinologist who specializes in Pediatrics and thyroid, chances are that if there is a family history of thyroid issues that this might be the cause of the increased heart rate, by all means see a Cardiologist also, do not take any chances, but start your search for a good Endo, Maybe you could post here with your location and some one could give the name of one, TSH is only a Pituitary Hormone and she should have a total thyroid workup, which they do not do in the ER.  And some members that are more familiar with pediatric thyroid symptoms may respond also. Best Regrds  FTB4

[jdeal]

Sorry, first time posting.  I didn't realize I needed that info.  Below are the test results with ranges.  Thank you.

WBC 7.9 (5.0-14.5)
RBC 4.38 (4.00-4.90)
HGB 12.2 (11.5-14.5)
HCT 34.9 (35.0-42.0)
MCV 79.7 (77-95)
MCH 27.9 (25-33)
MCHC 35.0 (31-37)
PLT COUNT 308 (150-450)
RDW 12.5 (12-16)
MPV 8.8 (6.2-12.8)
% NRBC 0.0 (0-0)
% NEUT 29.3 (37.0-65.0)
% IMMATURE GRAN < 2.0 (0-2)
% LYMPH 61.5 (28.0-48.0)
% MONO 6.2 (3.0-6.0)
% EOS 2.8 (0.0-12.0)
% BASO 0.1 (0.0-3.0)
# NEUT 2300 (1500-7500)
# LYMPH 4840 (1500-5000)
# MONO 490 (300-600)
# EOS 220 (30-800)
# BASO 10 (0-140)
GLU 97 (60-115)
BUN 13 (6-20)
CREAT 0.3 (0.0-0.6)
SODIUM 145 (135-145)
POTASSIUM 3.9 (3.5-5.0)
CHLORIDE 108 (95-110)
CO2 25.0 (18.0-27.0)
ANION GAP 12 (3-16)
CALCULATED OSMO 288 (265-300)
CA 9.0 (8.6-11.0)
TSH 10.60 (0.4-6.0)
FREE T4, SERUM 1.37 (0.7-2.1)

[SassySharon]

First, I want to say that I hope your daughter will be feeling better very soon!  It is horrible to have a child feeling ill and to have such a high heart rate has to be making you ill too!

I am not able to give you the answers you need, but many here will be able to.  Depending on the time zones they may already be in bed.  But you should have some responses soon.  There are many really good people here that are very wise on these issues.  But before they can help, you will need to post the reference ranges for these results.  Hopefully, you have them and can post before the morning.

Good Luck with your daughter and I would go ahead with the cardio appt.

Please keep us posted!      -sass-