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Avatar universal

15 year old girl with low tsh, low t4

My daughter has facial swelling and weight gain on upper body; thick neck, square shoulders, thick waist...and thin well-toned beautiful legs.  I took her to her pediatrician because she has anxiety is sweating through shirts while in school, generally cold and wears jackets, poor concentration...went from being top of her class and starting school early to barely passing, forgets things, falls asleep in movie theaters.  A few days before seeing the doctor she also had "white outs" in her vision followed by double vision.  The doctor thought to test her thyroid and her T4 was a 0.6 (range 0.8 - 1.6) and her TSH was on the very low side of the normal range.  She said that because her TSH is within "normal range"  she wasn't concerned and that my daughter is probably not eating well.  Trust me, I have seen what other families eat and most teenagers eat garbage, but that is not the case with us.  My daughter has always been frustrated with what the other kids get to eat at their homes and when her friends visit us they think we are major health nuts.  My frustration is that I see my daughter spiraling downward and am having difficulty getting the doctor to listen.  Asked her to refer my daughter to an endocrinologist, but she wouldn't.  She didn't even want to give me a copy of her test results until I used the excuse that we were moving.  It was at that time that I discovered that her TSH was so low!!!!    We have an appointment with a new doctor, but would greatly appreciate any advice...
4 Responses
563773 tn?1374246539

Low T4 and TSH are found in pituitary dysfunction and adrenal fatigue. It is the Pituitary gland that produces TSH(Thyroid stimulating hormone). Without enough release of the TSH hormone, the thyroid can not release enough T3 and T4. The hypothalamus is a part of the brain that produces TSH Releasing Hormone (TRH is the blood test to check the hypothalamus function) and the hypothalamus tells the pituitary gland to release TSH to the thyroid and then the thyroid produces T3 and T4.

So it means that the fault lies with either pituitary or hypothalamus,bot of which lie in the brain.MRI brain can confirm the diagnosis.

Adrenal fatigue also causes low TSH ,T3 and T4.So it has to be differentiated from pituitary dysfunction.

Pls consult an endocrinologist as soon as possible and get MRI brain done.

Hope it helps.Take care and pls do keep me posted on how your daughter is doing.

Avatar universal
Thank you so much for responding with such thourough information.  I have been busy researching as much as possible and have a doctors appointment for my daughter on Thursday with a gyn...go figure!!!  (He has helped a few other girls with thyroid problems who were not helped by their pediatricians.)  I have called every endocrinologist in the area and the only one that would see her was the pediatric one, which would of course be perfect, but they had to have a referral from our pediatrician, and she wouldn't do it.  Our insurance allows us to go to anyone without a referral, but I couldn't get aound the red tape in both offices.  I have heard great things from the community about this gyn so hopefully we will get help now.  I want to ensure that a complete set of tests are run and had not heard of the TRH so I am especially greatful to you for that information as well the possibility of the MRI.  
Avatar universal
What was the TSH?  I was diagnosed with graves disease (overactive thyroid) 6 years ago.  Had the radioactive iodine pill to kill my thyroid off and then suffered from hypothyroidism until they were able to get my levels straight with meds.  Some doctors think the tsh is normal at 4.  I completely disagree.  But they have changed it now where normal is alot lower.  I try to keep mine around 1-1.5 just because i feel better around that mark.  I have experienced every possible symptom you can get from thryoid issues.  The weight gain can be due to low levels along with being tired, forgetting things due to being sluggish and not being able to think clearly, i had hair loss, facial swelling, swelling around eyes, i stay very cold when my levels are too low.  I also dont get very hungry and my heart rate stays low.  But KINDD is right it can be due to other things.  Im glad you have a doctors appointment set up.  Maybe you will get some answers soon.  Check and see if they test her for cushings syndrome also.  It can cause weight gain in the areas that you stated and some of the other symptoms.  
Avatar universal
Thank you for your response.  Your symptoms sound similar to my daughters, so I'm sure you can understand my concern.  I was pushing the pediatrician to test further right away because she wanted to wait six months.  She only told me that the T4 was a little below normal range at 0.6 (normal range 0.8-1.6)  and that the TSH was within normal range so she wasn't concerned because she had referred to a book!!!  I know that my daughter isn't feeling well.  When she finally released the lab report was the first time that I discovered that the TSH was a 1.1 (normal range 0.7-5.7).  Her body temperature is 97.6.  
I have been battling doctors the last couple of years as well and have discovered that my testosterone was practically non-existent at a time in my cycle when it should have been at its highest level. 22.5 (65.0-119.0 reference range for ovulating women)  I am an ovulating 45 year old with osteopenia, kidney stones, weight gain, and major fatigue. My body temperature was a steady 97.1 and my blood pressure was always extremely low (105/50 - 115/65) despite being overweight.   I was told by several doctors that I didn't need to supplement because it would just give me male-patten baldness and facial hair. They added that the only positive is that it would increase my labido...which I didn't care about because I never had much of one. Instead they wanted to prescribe drugs to treat my symptoms which I refused...I believe  in getting to the root of the problem.  Finally, I found someone to prescribe the natural compound testosterone (and progesterone which was within range but extremely low) and feel better than I have in decades.  Less facial hair than before and smooth soft skin as well!!!  I also believe that I have adrenal fatigue...

Doctors don't know us as well as we know ourselves...we must educate ourselves and insist that they spend a few moments listening.  I greatly appreciate your information because it helps me go in better informed.  So far I believe that her low thyroid could be because of adrenal fatigue or estrogen dominance or low pituitary function...or possibly a combination.   Why didn't her pediatrician question this???   Again thank you and KINDD.  
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