High TSH Levels in 4 yr old

[brekkaw]

My 4 yr old son had a high TSH level when he was tested the other levels were normal. The part that really makes me angry is that I found this out by accident they told me that his results were normal. He has rapidly gained weight over the last 6 months. He is 85 lbs at 4 yrs old! He is very active and eats healthy food, but is still gaining. He has always had skin issues and his hair grows slowly. What is the next step I should take? I feel so out of control watching him gain more and more weight. Yesterday he told me he hates his body because kids tell him he is fat. It breaks my heart :(

[magpieannie]

The most important thing at the present time is to get him diagnosed for sure, so you will need a pediatric endo. Go in prepared with a list of symptoms and maybe a daily journal where you record moods and sleep patterns and eating behavior with foods eaten. Try taking his temp. each morning under his arm before he gets out of bed. Record this also in the journal and see if there is a trend with low metabolic basal temperature. It should run close to 97.8. If it is in the 95 or 96 range consistently then this is another sign that he is hypothyroid. Pediatric Endocrinologist are VERY conservative and there are probably none in exsistence that would ever give a t3 med in addition to a t4 med. They are SYNTHROID ONLY doctors and rarely ever check the freet3. So to get this done you will need to be pushy. Try getting the pediatrician to run this and then bring it in with you (the free t3 lab result) to the endo. apt.This is probably an easier way to get this done if you can swing it. Gimel is correct in saying that this is the most important level to track. Sometimes the endo. 's will do Total T3, however, this is outdated and bound with protein in the blood. You want to see the amount of the thyroid hormone that is FREE(availabe in the blood for uptake into the cells.) It's the t3 that the body must have to function properly. It is important to know that Synthroid is a t4 only synthetic medication that must convert in the body to T3 and the T3 is then uptaken into the cells. Most people convert t4 efficiently into the t3, however, some ( like my daughter ) do not. Conversion happens in the actual Thyroid  (my daughter has none) and in the intestines (this is where diet makes a difference) and in the liver (we live in a toxic world so our livers are bogged down already--we are non toxic in our home especially if it pertains to what my daughter eats (organic) or uses (non-toxic)) and fatty tissue of the body. When dealing with thyroid issues it is not enough to only give thyroid hormone replacement and then think all is going to be just perfect. You have to look at the complete picture and do your best to correct lifestyle exposures so he can be well. The endocrine system is very interconnected and having low thyroid can really throw things off with the whole body.The first step is cleaning up his diet and continue with light fun exercise as long as he is tolerating it well. Then get him into an endo. ASAP and begin thyroid hormone replacement. It will more than likely be Synthroid (t4). My daughter took this for 8 years. You also can begin giving him a good suppliment (Flintstones not okay) at night and proboiotics to increase the good flora in his gut. My daughter is not a celiac-however I have limited her exposure to gluten and most processed flour products. Many with thyroid issues feel this helps but no scientific evidence. We also eat organic as much as possible. Is your son constipated at all and does he eliminate daily? Many with hypothyroidism suffer with this as everything is slowed down and can just sit in the gut causing issues with fungal overgrowth. My daughter eats an organic apple daily and takes magnesium which helps. She took an oral prescription antifungal (Nystatin) for 6 months which also helped her. Getting off the unhealthy carbs. and limiting sugary snacks is a must!!! We only eat cereal on occasion and then it is always gluten free. Focus on real food! He is young so the sooner you make these changs the easier it will be later and he won't know what he's missing after awhile. I hope I've been of some help to you. Make that endo. apt. and begin reading and researching all you can so that you will have a good understanding of the job of the thyroid gland and what it can effect and how it works . Good luck and God Bless!

[gimel]

Considering his age, a pediatric Endo sounds like a good idea; however, so many of them have the "Imacculate TSH Belief" that you could end up with one that treats patients based only on lab tests, instead of being attentive to symptoms.  I expect that approach is not going to work for your son, longer term.

Whenever I am trying to evaluate a prospective doctor I have had success with calling the office and saying that I was looking for a good thyroid doctor but that before making an appointment I had a couple of questions.  Usually that gets a nurse to respond.  Once I even got a doctor on the line.  Tthe questions to be asked are,  " Is the doctor willing to treat a patient clinically, by testing and adjusting free T3 and free T4, with  meds as necessary to relieve symptoms, without being constrained by resultant TSH?"  The second question is "  Will the doctor prescribe meds other than T4 types?"  If the answer to either question is no, then you might as well keep looking for a good thyroid doctor.  

[brekkaw]

Thanks you guys, those were all the reference ranges they had on there. He is hungry all the time esp if he eats carbs, high fat, high protein he is pretty filled up. He is off the charts for his height too (taller) which is something I am very thankful for. He does carry most of the weight in his stomach, it is very pooched out. I have to get his pants hemmed for him so the fit him right in the mid section it all seems to be super concentrated in his tummy, then his butt and thighs. So should I go right to a ped endocrinologist or go back to his pediatrician who didn't even care to mention his TSH was high? This last year his weight has really exploded he has already gained 30 lbs in 9 months! Shouldn't that be a red flag to them? Esp since I have been super diligent with bike riding, activities and extra food. Also at the end of the day I can just tell he is super worn out he gets real sluggish he keeps going though.

[gimel]

Your son has several indicators pointing to hypothyroidism,  namely his symptoms, his FT4 being very low in the range, and his TSH being over the currently recommended range.  It  would be very informative if he had also been tested for FT3, which is the most active thyroid hormone and also the most important, as I explained above.  He needs to be put on thyroid medication to increase the levels of his thyroid hormones.  He also needs that FT3 test to help guide his medication dosage.  Most of all he needs a good thyroid doctor that will treat him clinically (for symptoms), with whatever medication is necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important.  If your doctor is not willing to treat your son clinically, then you are going to have to find a good thyroid doctor that will do so.  Best to you and your son.  He is lucky to have a parent that doesn't just accept what the doctor says, but is willing to do whatever is necessary to find out what is wrong and to help the boy feel better.  

[magpieannie]

Do you have the reference ranges for the other test results that you posted too? How is his height? Is he getting taller and where does he fall on the growth charts at the doctor? Where does he carry his weight? Does his belly pooch out? His TSH is elivated  at 4.9. The new recommended range for this is 3.0 or under. Ranges are slightly different for kids, but not much. At 4.9 my daughter would be very hypothyroid and under medicated.How is your childs mood? Is he hungry all the time? Sorry to be so nosy, but these are things that I have seen in my daughter when she was hypothyroid and putting on the weight in the past.

[brekkaw]

Oh I also forgot to post the ranges TSH (normal is 0.27-4.68) Normal Free T4 (.78-2.19)

[brekkaw]

cholesterol is 185 sorry...

[brekkaw]

So here are high results tTG antibody < 3, IgA serum 69, ESR 15, CRP <0.5, WBC 10.8,   Hb 12.3, PLT 432, TSH 4.9, Normal free T4 0.93, Insulin <2, Cholesterol. Thanks for all the help! I just weighed him and he has gained another 5 lbs over a little under 2 months! I have been diligent with the bike riding and activities! We ride bikes to and from school every day (2 x on the 2 days he isn't in school) then when he isn't in school I take him on walks and bike rides as well. I am so frustrated and upset the weight is just continuing to go up....

[magpieannie]

My daughter is 10 and born without her thyroid gland. When there is not enough available thyroid hormone within the body reaching the cells then many things can be affected and weight gain is common due to a slowing down of everything in the body. Diet is huge for people with hypothyroidism. Avoid unhealthy carbohydrate filled processed food. Things that many kids eat are the wrong food for your child. Cereal, fruit drinks and cookies are not a good idea. Fast food and junk food need to be on the rare occassion. Focus more on high protein, real food that is low glysemic. My daughter is so much better now that we have made these changes in her diet. She use to steadily gain weight and had blood sugar issues with uncontrolled hunger. I was so worried just as you. Over the last few years we have reversed this in her with diet and lifestyle changes and proper balance of her thyroid hormone levels. Make sure that your son has the FREE t3 and FREE t4 tested  as well as the TSH. Always get copies of labs and post results here with the reference ranges and we'll be glad to take a look and give our opinions.  

[maryanne592]

i would ask for all the blood work done with his T3 T4 and all of the other panals..Tell them that you want all of the blood work done.....That goes along with Thyriod...

[gimel]

TSH is a pituitary hormone that is affected by so many variables that it is totally inadequate as a diagnostic for thyroid problems.  At best it is an indicator, to be considered along with more important indicators such as symptoms, and also the levels of the actual, biologically  active thyroid hormones, free T3 and free T4.  FT3 is actually the most important because it is the most active and it largely regulates metabolism and many other body functions.

Just because the other test results were "normal" does not mean that all is okay.  The ranges for the actual thyroid hormones are far too broad.  Many members with FT3 and FT4 results in the lower half of their ranges have reported having hypo symptoms that were not relieved until FT3 and FT4 were adjusted into the upper part of their ranges.  

If you will post the other test results that were supposedly "normal", along with reference ranges from the lab report, then members can see what tests have been done, and comment further.