Tsh levels in infants

[abz11]

Hi i am new to this site and looking for advice on tsh levels ,as my 5 year old girl had two tests last year the first her tsh was 8.5 then a month later was 6.7, this year because she was growing well they didnt test her, in the last few months she has been quite poorly so requested her bloods to be tested and told her tsh was acceptable it was 8.2 seems a bit high to me am i worrying for no reason?

[Greentrees1]

I'm not sure about the range for children . The Bupa lab I use uses a range of 0.4-4.00 for adults. As she has a high TSH and Doctors often dismiss anything that's in normal range (most people here question the validity of so-called normal range), I would think she should have a full thyroid check including antibodies. Also check vitD, B12, folate and Ferritin.

Others on her will be more knowledgeable than me, but I know from sad experience that you often have to push doctors and trust your instincts as your child's best advocate.

[helvella Administrator]

Thyroid Functions Test ranges absolutely do vary by age. For ONE example:

pathology.bsuh.nhs.uk/patho...

But you cannot use those figures - you must get the paediatric ranges from the actual lab that performed the test(s). Some labs (like the one I linked to) make these available online. Try searching for "laboratory handbook" and add your location. Or ring them up.

By the way, I have only limited faith in paediatric ranges. How many healthy children and infants have their TSH measured?

[abz11 in reply to helvella]

Thank you will have a look at my local lab ranges, the paediatrician that my girl is under just says the tsh is raised but she's within the right height and weight range for her age, and tries to give her more stronger laxatives to deal with the constipation issues which make her sick, she's alright on the movicol daily plus this year had to have her hair cut short as was coming out in handfuls when brushing it.

[helvella Administrator in reply to abz11]

In my opinion, which is that of someone with no medical training whatsoever, it is absolutely essential to have both Free T4 and Free T3 also measured. Most especially in someone who might very well have had thyroid issues as they develop and grow, there is no basis whatsoever for ASSUMING that TSH reflects actual thyroid hormone levels.

Also, given how quickly things can change in children, annual tests are woefully inadequate. I'd have been hoping for monthly. Every month. Growing well so didn't test? The only reason I can think of not to offer to test is to save money.

Laxatives do not seem to me to be the appropriate strategy - even if needed temporarily.

[abz11 in reply to helvella]

My daughters paediatrician has grouped her in the category that she is child that holds it and wasn't worth doing a blood test as out of every 300 children tested only 1 would come back with a problem, she only has movicol daily as refuse to give her any of the stronger ones pointless when just making her sick, one of the doctors at the surgery where she goes I spoke to on the phone last week he feels a tsh of 8.2 is not acceptable so writing to her paediatrician for it to be looked into, but like you said most probably comes down to cost, and he's already decided she's growing within the right range and she holds it (she's never had an accident or soiled which kids that hold it usually do) don't think he's going to take it any further

[Kerry1971 in reply to abz11]

When I was diagnosed with a severe under active thyroid TSH 177.7 I weighed 7 stone. I was very depressed and had bowel problems. You need to get your daughter full bloods done. I was undiagnosed for so long and suffered such severe constipation that my bowel got so stretch I had repeated bowel obstruction due to my bowel twisting and folding I had to have major surgery to remove 1/3 of my large bowel last year. I have been diagnosed with slow transit constipation (the nerves and muscles in my bowel don't work properly) I'm much better since my surgery but am now gluten, dairy and soya free. Before my surgery I was in hospital 15 times in 2 years for at least a week at a time with bowel obstruction. The pain is worse than labour. Best of luck for her x

[abz11 in reply to Kerry1971]

Thank you for response, its been awfull seeing my little girl suffer bad constipation, a couple of times its got that bad she couldnt physically stand up as she was so constipated, plus a few years back caused quite a few water infections aswell, hopefully now we have had another high tsh result they might look into it , rather than keep saying she a child that holds it.

[sisa1975]

Hello, we have our son's TSH tested every year since his 4th birthday by a private pediatric Endocrinologist and I have kept record of his test results and reference ranges since then (he is 9 years old now). I have just looked in our records and the TSH reference range given to us when he was 5 years old is 0.64 - 6.27. This might however be specific to just our area.

Our son's first ever TSH result was a lot lower than you daughter's hence we didn't qualify for a referral to a pediatric Endocrinologist under the NHS but due to his symptoms we decided to go down the private path with him. He now has a full thyroid check done every year including an ultrasound scan. Your daughter's results certainly do not look favourable, I would ask for a referral to an Endocrinologist for her.

[abz11]

Thank you for your advice, not once has her paediatrician ever requested a blood test, I have had to push for them through her doctors, because her height and weight is where it should be for her age her paediatrician didn't feel a need to test her blood, after feeling unwell and missing quite a few days of school, asked the doctors to refer her for bloods which come back last week at tsh of 8.2.

[mistydog]

Also depending what time of day the test was might give a lower reading. Always have the test done first thing in the morning on an empty stomach. As near to 4am as possible!

[Greentrees1]

I went to an endocrinologist a couple of weeks ago as I have been diagnosed with Hashimotos, yet TSH is only just over 4, but antibodies are around 3000. My 14 year old has a TSH of 3.7 so we were told told all is fine as normal range (i only recently asked for the actual result as I trusted the GP's advice at the time). But when I mentioned it to my endocrinologist he advised that although that might be fine, he recommends a full thyroid check including antibodies for anyone with a TSH over 2! He was very clear that I should get her properly evaluated as thyroid issues run in families.

[Coastwalker]

Hi abz11,

On the hormonerestoration.com website, hidden somewhere, it says - words to the effect - a child's hormone levels (FT4/3) should be far higher in the range than an adults, (up to the age of 25,) I have this printed off myself.

[Hypo32]

I have a child the same age with ongoing constipation problems (he ended up with a severe faecal impaction aged 2 1/2). he has had endoscopy and colonoscopy and everything has been inconclusive. He has been on laxatives for years but still frequently tears and bleeds. His TSH was 8.2. Consultant said it was slightly high but that kids usually are and is T3 and T4 were OK - that is what needs to be tested. He also did antibodies at my request (my brother, grandmother and I all have Thyroid problems with positive antibodies) and they were OK. He seems to think my son will grow out of it. He is small for his age but he is now growing at a steady rate following 25th centile (despite being born on the 91st).

I am keen to follow this thread - does anyone know how I do that?

[abz11 in reply to Hypo32]

I have been back today as they re tested her last week her tsh has improved it was 6.9 and t3 ,t4 and tpo were all in the normal range, made to feel like I'd wasted 10 minutes of his precious time, got told to keep giving her laxatives she will most probably grow out of the constipation by the time she's a teenager, and nothing to worry about having 4 previous raised tsh levels as everything else is in normal range .