8yr old with goitre, questions to ask!

[Pommykiwi]

Am wanting some advice on questions to ask later this month at a hospital appt with our 8yr old daughter.

2 weeks ago I took her to the GP with what turns out to be a goitre. An ultrasound scan was performed the next day showing a multinodular goitre. Bloods were taken. All thyroid and general bloods came back 'normal' except her CRP which was elevated well out of normal range. Biopsies were taken, FNA and results came in yesterday....Benign but showing signs of infection/inflammation.

She is a fit healthy active 8yr old, with no symptoms.

I'd really like to attend this paediatric appt armed with questions, however the endocrine system and thyroid are all new to me. I am reading up but don't really know where to start! Being 8yrs old I really want to make sure her hospital Drs are on to this, so what I want is a list of questions, so I can sound like I know what I mean!!!!

[Jmay88]

I would go to stopthethyroidmaddness.com to ensure that they tested your daughter's thyroid levels correctly. Did the check her Free t3 and Free T4? If so, look to see if they are in the right part of the ranges for these two hormones. The free t4 should be near the middle of the range and the free T3 should be at the upper end of its range. (If they did not test her two free levels, they don't know what they are doing and get these levels tested elsewhere). This way you can understand whether your daughter might indeed really be hypothyroid. My sister and I are hypothyroid, and we both have nodules on our thyroid. My grandmother who lived in Switerland had a goiter long ago that was removed. Switzerland is a land locked country...no sea water around it...less iodine. Maybe your daughter needs iodine. I'm no expert here, so please check with a doctor regarding the possible need for iodine. With the history of hypothyroidism in our family, all females have it, I ensure that I give my two, young daughters vitamins that have iodine and foods/pink Himalayan sea salt that also have iodine (eggs are a good source). I have hashimoto's thyroiditis, so I cannot do any iodine at all. If she does need thyroid medication, I would recommend not going with the synthetic t4 only meds! There are other good options and one is called (NDT) Natural Dessicated Thyroid, which has both the t3 and t4 hormones. My sister and I are doing fairly well on Naturethroid and WP Thyroid, respectively. Sounds like the infection needs to be addressed, which I know nothing about. Best to you and your daughter and good luck!

[Pommykiwi in reply to Jmay88]

Thanks for this! I'd need to check on the iodine but I do cook with salt that is iondonised. I will make notes from your only tested her TSH which was 3.2 and Free T4 which was 17.

[Astridnova in reply to Pommykiwi]

If they have not checked her iodine they are also not up to the mark.

[Pommykiwi in reply to Astridnova]

Thank you, will add iodine to my list!

[Jmay88 in reply to Pommykiwi]

Hmmm I'm in the US, California, and our Free t4 range is .70-1.53.

[Pommykiwi in reply to Jmay88]

Crikey that's some variation! Surely the human body is the same??!!!

[eeng]

A TSH of 3.2 would be slightly elevated for an adult, but is hardly elevated at all for a child

ncbi.nlm.nih.gov/pmc/articl...

I would not be surprised if the doctors just decide to watch how things develop, calling your daughter back every year or so for checks, while advising you to go back to your GP if anything develops in the way of symptoms. Certainly if she currently has no symptoms you don't want to be pushed into a thyroid removal operation unless the goitre becomes suspicious in some way.

If there are signs of infection then your daughter may be prescribed something to address that.

[Pommykiwi in reply to eeng]

Thank you that is informative and reassuring

[Hidden in reply to eeng]

I think I remember Diogenes commenting once that he likes to see a child's tsh much lower than that. ie, the childrens ranges may be wrong.

[milkwoman]

An elevated CRP is an indication of inflammation in the body. Were any rheumatological factors tested? Poor thing...8 years old is way too young to be dealing with such things...

[Pommykiwi in reply to milkwoman]

Oh agree, fine needle biopsies etc....bad enough on an adult! No nothing has been mentioned about rheumatological factors, I am compiling a list of points, questions, will be sure to add, thank you!

[milkwoman in reply to Pommykiwi]

I realized I should clarify that I am talking about ALL things rheumatological (auto-antibodies and the like) and not just the test called "rheumatoid factor". If your daughter isn't showing symptoms, the doctors could easily dismiss this line of testing.

Your daughter is very brave! Having something medically wrong is scary for an adult (I'm 49, diagnosed two years ago with hypothyroidism, lupus and Sjogrens) never mind a child.

God bless and hugs to you both.

[Pommykiwi in reply to milkwoman]

Thanks for clarifying.

[fatcattn]

I suggest the books, "Iodine, Why You Need It, Why You Can't Live Without It", & "Overcoming Thyroid Disorders" both by Dr. David Brownstein before doing any procedures. The website, "Stop The Thyroid Madness" is a good resource as someone else mentioned. "The Iodine Crisis" is another good book.

Typical iodized salt is to chemically processed to be useful and is stripped of all helpful minerals. Look into Himalayan and Celtic Sea Salts.

I have a multinodular goiter and I have chosen to treat it with an Iodine protocol. The books were recommended to me and are very helpful.

[Pommykiwi in reply to fatcattn]

Interesting about the salts, I will look into

[Pommykiwi]

Thanks all for the replies, I did bombard the dr with many questions! For now they are doing nothing but watching, with repeat ultrasound scans and bloods in 3 mths to monitor, as she is euthyroid. She had further bloods done last week, thryroid function and lots more....still waiting on a copy coming to me! The paediatrician is suggesting some sort of autoimmune process is going on and as she is well is reluctant to treat the goitre in anyway. But concerned thyroid function might become compromised he wants to monitor closely. Fingers crossed all remains well.

[Pommykiwi]

Results are in, today I have been informed our daughter has Hashimotos Thyroiditis, her bloods came back

Thyroid autoantibodies 1631IU/ml

Anti Thyrodglobulin 375 IU/ml

Tg 1.5ug/L

TgAb 318 IU/ml

To be reviewed by hospital in 3 mths as currently euthyroid.