Daughters results thoughts please

[vintageslant]

Could someone please advise on my daughters thyroid test results. She is freezing cold all the time on her extremities is 3 years old and takes 30mcg of ERFA. Doctors are recommending a 5mcg decrease?

TSH 0.06 mU/L reference range is 0.27-4.2

Free T4 13.7 reference range is 12-22

Free T3 6.87 reference range is 3.1-6.8

Many thanks

Jen

[galathea]

30 mg is half a tablet. How are they proposing to drop by 5 mg? Also test results show t3 all at top of but not over range.... Any reason they want to induce hypothyroidism?

[Jen0209 in reply to galathea]

She's not even under an endo yet we have not long since moved from France. They haven't suggested how to reduce it they aren't familiar with NDT just said I have to prior to her next blood test in a months time. To be honest she's still so cold on her extremities I would be scared of reducing. Anything I can say to them? It doesn't much sound like they know what they are doing does it

[Clutter in reply to Jen0209]

Jen, if you gave your daughter WP before the blood draw that will give a false high FT3 result.

If you left the recommended 24 hours between blood draw and last dose she is very slightly overmedicated. I should think it is nigh on impossible to cut a 30mcg tablet into 6 x 5mg doses. You can buy 1/4 grain (15mg) tablets which can be quartered into 3.75mg doses.

[vintageslant in reply to Clutter]

Hi Clutter I did not leave the 24 hrs in between doses and blood draw. She had her thyroid meds (ERFA) at 9am and the blood was taken about 16.00. I am really reluctant to down her dose at all as she is still so freezing cold on her extremities. Do you know a reason for this and based on those times do you think the dosage she is on is right?

[Clutter in reply to vintageslant]

Vintageslant, I think it is possible the T3 was peaking in her serum and I wouldn't reduce dose unless FT3 is over range on next test. Give your daughter the NDT after blood draws in future and an early morning fasting test (water only) will show TSH higher and FT3 lower.

[Glynisrose]

NEVER reduce or change meds based on blood tests alone! Either ask for physical tests or refuse point blank to lower meds. Use the broken record method of repeating if you have to just DO NOT allow your doctor to dictate to you, it is your responsibility to take your meds not theirs.

[Hidden]

I know it is not revelant to what you are asking, but may I ask, was she premature (see my post below)?

And at what age did you discover she was hypo?

[helvella Administrator Thyroid UK]

Are those specific paediatric ranges? Do you know that there are specific paediatric ranges? Do her doctors know?

This is a link to the paediatric ranges at ONE UK lab:

pathology.bsuh.nhs.uk/Patho...

Each lab will have their own ranges - this link is purely to show you that such things can and do exist, and that labs do know about them! Don't use these numbers - fidn them out for the lab that did the tests. (Even then, there are question marks over paediatric ranges - they are much more difficult to establish than adult ranges. And we have enough of an issue with adult rnages!)