medication

[sachin5]

My daughter aged 11 years  diagnosed with hypothyroidsim on 04/11/2008. Thyroid profile reveals her TSH level elevated to 62.9 micro I.U./ml and T4 4.12 mcg/dl. TMA test was positive with a value of 680. Doctor prescribed her to take Thyronorm-50 (Synthetic hormone-thyroxine) on daily basis. As told, dosage will be adjusted , if required,after another test after 8 weeks of medication...she started taking a thyronorm 50 from 19/11/2008. She was again tested on 22/12/2008 after nearly 5 weeks of medication. Latest Lab Result is as under:
T3 : 1.93 ng/ml (earlier it was 0.588 before medication) , Free T4: 1.81 ng/dl and TSH: 0.164 micro I.U/ml (earlier it was 62.9 micro I.U./ml) . Doctor suggested her to reduce dose of medication to thronorm 25 (from 50). I would like to know that , whether she can stop taking medicine as only after 34 days of medication her TSH level reduced from 62.9 to 0.16.

[laura1967]

Thank you for explaining the TMA test...I have never seen it on lab sheet.  :)

[estrelinha]

TMA is thyroid microssomal antibodies is the same as TPO antibodies (this last ones are more specific), their presence suggests that there is autoimmune thyroid disease. Do not quit meds against medical advice as Laura told you. There is a pediatric endocrinology expert forum in Medhelp, the doctor there is a pediatric endocrinologist she can give you very good advice.

[laura1967]

TMA??  IS that what it says on lab report??  Please look again....does it say TPO Ab....anti TPO....TgAb....TSI....or antithyroglobulin Ab?  

[sachin5]

TMA test was also done and observed positive with a value of 680

[laura1967]

So her thyroid is inflammed....hopefully a temporary situation, but you should insist that they run the tests for thyroid autoimmune disease: Graves and Hashimoto's.

[sachin5]

yes. Her USG -neck (thyroid) was carried out initially on 4th nov 2008.

+ Rt. Lobe- Enlarged (3.8 * 1.2* 1.6 cm) size with low echogenicity. No focal lesion.
+ Lt. Lobe- Enlarged (3.7*1.3*1.6 cm) size with low echogenicity. No focal lesion.
+ Isthmus- mildly enlarged (5 mm) with low echogenicity. No focal lesion.

Generalised thyroid Enlargement with low echogenicity . (?? Inflammatory changes)

[laura1967]

Has her doctor ordered an ultrasound of her thyroid yet? She should have one done if there is noticable swelling.
Sounds like she should follow dr advice and lower dosage and retest in 6-8 weeks.
Hopefully this is just a temporary situation.
Do not quit meds against medical advice....follow drs recommendations. I would also ask for a referral to a pediatric endocrinologist.

[sachin5]

To: stella5349


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stella5349
Female
WI
Member since Jan 2008
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i am eagerly awaiting your response please.

can u please .respond. She has reduced her dose to thyronorm 25 since last week.can she stop taking medicine or else we can wait for another 34 days and do the lab for TSH.if again TSH is coming low then can we stop meds?

she had a swell on her neck and this prompted us to take her to doctor. they suggested to carry out T3,T4 and TSH test. We have carried out the same.

[sachin5]

can u please .respond. She has reduced her dose to thyronorm 25 since last week.can she stop taking medicine or else we can wait for another 34 days and do the lab for TSH.if again TSH is coming low then can we stop meds?

she had a swell on her neck and this prompted us to take her to doctor. they suggested to carry out T3,T4 and TSH test. We have carried out the same.

[sachin5]

she had a swell on her neck and this prompted us to take her to doctor. they suggested to carry out T3,T4 and TSH test. We have carried out the same.

[stella5349]

Young children ( especially girls at this age) are extremely flexible in their hormone testing. She at 11 and is starting to develop rapidly. At this time in her life hormone replacement therapy should be a very last decision.

On the other hand her TSH was very high at 62.- something -- so that is something to take into consideration.

Usually a T4 meds takes 6 weeks to see any real true reading with tests. She made a dramatic level adjustment in a month.

Hormone replacement meds also can subside normal functions of glands and this could make a permanent alter of function for her as she ages. The gland could become dependant on this med to make things work normally.

Taking this situation with children are a tough call. before I give my thoughts which may be controversial to your doctors treatment - I'd like to ask why did you take her in for blood work to begin with? How did this all come about?