Thyroid Disorders Community
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1049076 tn?1256013017

hypothyroid for toddler

Hey everyone,

I am new here and was wondering if someone can give me some information. Let me give you some background.  I have a 2 1/2 year old boy.  He is going through some health issues that no one seems to know what it is.  He is failure to thrive, not growing or gaining well (I read this is common in hypo for this age).  He has coarse hair, and is cold a lot (for example we were at a store and his teeth were chattering).  He was put in the hospital for RSV when he was 9 months old and they discovered he had a swallow dysfunction (I read this too is a symptom) and the doctor wrote that he had abnormally large fontanels ( another symptom I found),  he is developmentally delayed (i.e. he didn't walk til almost 2, doesn't speak many words, I was told he had low muscle tone).  He has been having high blood sugars but they spike high then come down really quickly (the blood sugars are in the high 200's with some 300's and a couple over 400 but he also has low blood sugars in the 40's.  He had a seizure not long ago we expect may have been a low blood sugar but have no proof.

He had a thyroid test when he was in for the RSV at 9 months and the free t4 was 0.69 (range 0.65-2.0) and the TSH was 3.61 (range 0.6-7.1).  Is this normal?

He was admitted to the hospital last week for observation and they did a lot of blood work on him.  They followed him for type 1 diabetes and they did a check on growth hormone and redid the thyroid test.  I'm not sure what all the values are but the endo called us saturday and said the free t4 was only 1 point above the low end of normal.  He said he would like to follow him and maybe start him on growth hormone in about a year.  They did a oral glucose tolerance test and it came back abnormal but not diagnostic of diabetes.  He has so many symptoms of hypothyroid and I read the values changed which would have made his levels abnormal at 9 months old.  Is this correct because the pediatric endo isn't using these values.  I don't think it is wise to wait another year.  

I read that hypothyroid can cause low blood sugars.  He had a sugar in the 40's at home and was lethargic.  I also wonder if the hypo could possibly keep diabetes in check so to speak because it tends to lower sugar.  What if we fix they thyroid and his sugars stay high.  I would appreciate any help here.  If you know of any suggestions on what to tell the doctor I would really appreciate it.

17 Responses
499534 tn?1328707778
I think it is time to get a second opinion. I agree that it sounds like the thyroid is involved here.
When my levels are off I get hypoglycemia as well.
The endo should be looking at the Free T3 and Free T4 more than the TSH. TSH is a pituitary function test. The Free's are the actual active thyroid hormone in the body.
Free T4 converts to Free t3 which is the most active thyroid hormone in the body.
Being 1 point above the low normal range of Free T4 says that something is wrong!
(IN my opinion of course)
Keep a close eye on his diabetes as well.  Did you know that most endo's specialize in diabetes and not thyroid disease? They learn it in school, but don't specialize in thyroid in a lot of cases.
Keep reading and learning all you can......keep seeking. Don't give up!  :)
Avatar universal
I agree with what Laura said, and I just wanted to throw in my opinion about the usefulness of TSH.  As Laura mentioned, TSH is a pituitary hormone that is affected by many variables.  Although used by most doctors as a diagnostic to determine thyroid state and meds, at best it should be used as an indicator, to be considered along with the more important indicators, which are symptoms and levels of the actual biologically active thyroid hormones, which are FT3 and FT4.   FT3 is the most important because it is four times as potent as FT4.  Doctors don't normally test for FT3 because they assume that T4 is converting adequately to T3, so that testing is not necessary.  Inview of its importance, why not tests and be sure?

In addition, just having a FT4 test result barely within the lower range limit is usually inadequate because the ranges are far too broad.  The ranges for FT3 and FT4 have never been adjusted (like was done for TSH 6 years ago), to exclude suspect hypo and hyper patients.  As a result, many patients with FT3 and FT4 levels in the low end of their ranges report continuing hypo symptoms.  Many hypo patients report that they feel best when their FT3 and FT4 levels are in the upper half of their ranges.  

I think you will find this article to be worthwhile reading.

If your doctor is willing to discuss this type information with you and treat your son by testing and adjusting FT3 and FT4 with meds, as required to alleviate symptoms, that is the best approach.  If not, or if the doctor believes TSH is the "gold standard" in testing and treating hypothyroidism, then you will have to start looking for a good thyroid doctor.
Avatar universal
I suspect thyroid as well. If you live in the US, here's a site with recommended thyroid doctors state-by-state: http://www.thyroid-info.com/topdrs/

I do not know if TSH and FT4 levels are different in children, but I DO know that I have Hashimoto's (hypothyroid) disease and his levels are worse than mine. My TSH was only 2.74 and my FT4 dropped to 0.8. I DEMANDED the antibody tests for Hashimoto's (TGAb and Anti-TPO). That is how we discovered my Hashi, and that my first two endos, WHOM I FIRED, were IDIOTS when they laughed at my TSH.

New studies indicate that ANY TSH above 2.0 is indicates hypothyroid if the patient exhibits hypo symptoms. Your son has hypo symptoms. Once again, I do not know the ranges for toddlers, but doctors should be pursuing more thyroid examination, IMHO.

Rarely, some children are born with missing thyroid lobes or entire thyroids missing. Has he had an ultrasound?

Take action! Get mad when doctors don't produce results or when they laugh and shake their heads! Demand he be tested and treated! You are your child's biggest advocate! He deserves a healthy life! Fight, fight, fight!

:) Tamra
1049076 tn?1256013017
Thanks for the help.  I feel like I am fighting an uphill battle.  He has a MRI for the seizure and I called the endo to see if he wanted to have them look at the thyroid.  I was put on hold for 45 minutes and finally I had to hang up to go pick up the kids from school.  This whole thing has been a nightmare.  He tested positive for the type 1 antibodies and then they retested for them and the said they were only 5 which is normal according to them but they wrote on his discharge sheet that his diagnosis was positive antibodies.  I'm not sure what all they did on the thyroid.  They "accidently" discharged him before following all the doctor's orders so I had to fight to get those done.  They were able to call the lab and supposedly pulled it out of some of his test tubes of blood.  I hope they did antibodies but I don't know.  I have the MRI on Thursday so I will pick up his records then.  I don't think I could possibly be anymore frustrated.  

Avatar universal
He has positive antibodies? I am not sure what type 1 antibodies mean. Make sure you ask for the TGab and Anti-TPO. Those are thyroid antibody tests.

Poor baby! My little one hated being poked at that age.

Poor mommy! I'd rather be the sick one than watch my kiddo suffer.

If he has Hashimoto's, remember that auto-immune diseases can run in the family. It would be a good idea to get the family checked.

Take care...
:) Tamra
734073 tn?1278899925
Hello, Thought you'd like to know that my daughter was born without a thyroid gland. She is now nine and doing well. Your son's symptoms most definetely sound like ones of untreated hypothyroidism.Your doctor should also do a radioactive iodine uptake scan as well as an ultrasound to see the gland. You must insist on the freet3 and freet4 blood test as well as the antibodies. Time really is of the essence here. Proper brain and body development depend on the proper amount of thyroid hormone available in his body. If your doctor won't do these test, then find one who will! Trust your instincts and move ahead on this quickly. God Bless!
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