Advice for 17 year old daughter

[ClareWade]

My daughter had some tests carried out 2 years ago which showed she had a very high prolactin level - after having a normal MRI scan it was decided there was no sign of anything wrong with her pituitary gland, she was also told she had a borderline under active thyroid function which we have had checked every 4 months since. Two months ago her levels became low enough to start treatment. My concern is that there is something a Miss with her pituitary gland which is causing this but our GP says not. What causes a 17 year old to have this thyroid problem? And should it not be investigated as to why she has this? Does anyone have any advice for me?

[Clutter]

ClareWade,

What were your daughter's TSH, FT4 and, if tested, FT3 when she was diagnosed? If she was diagnosed with low FT4 and high TSH it indicates she has primary hypothyroidism which is due to thyroid failure. Low-normal TSH with low FT4 indicates secondary hypothyroidism which is caused by pituitary dyfunction.

Ask her GP whether thyroid peroxidase antibodies (TPOab) have been tested and what the result and range is. Positive TPOab indicates autoimmune thyroiditis (Hashimoto's) which causes 90% of hypothyroidism.

The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 1.0 or lower with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in thyroiduk.org.uk/tuk/about_...

For maximum absorption Levothyroxine should be taken with water 1 hour before, or 2 hours after, food and drink, 2 hours away from other medication and supplements, and 4 hours away from calcium, iron, vitamin D supplements and oestrogen.

Your daughter should have a follow up thyroid test 6-8 weeks after starting Levothyroxine as dose may need increasing. Arrange an early morning and fasting (water only) blood draw when TSH is highest, and sh should take Levothyroxine after her blood draw.

thyroiduk.org.uk/tuk/about_...

[ClareWade in reply to Clutter]

Thanks for that I have no idea what her results were, they just rang and said she had to go in to see the GP and he said that she was still borderline but it was getting lower so he thought it was time to start to treat it. She has just had her follow up blood test done on Friday so I'll ask what all the results are then. I'm probably coming across really stupid for not asking - it's just my daughter was upset at the time. Thank you again for your reply - you've told me so much more than my GP.😬

[Clutter in reply to ClareWade]

ClareWade,

You're not coming across stupid. It's a pity GPs no longer have time to discuss patient's conditions with them. Your daughter should get into the habit of asking for a printout of her results and ranges (the figures in brackets after results) as understanding her results will help her ensure she is optimally medicated.

[ClareWade in reply to Clutter]

I will make sure she gets a print out with she gets this next lot of results. Many thanks. 😀

[SeasideSusie Remembering]

ClareWade I'm not saying there isn't, and you must pursue it further if you wish as you need to be reassured, but there doesn't necessarily have to be anything amiss. Hypothyroidism happens to children, my step-granddaughter was 14 when diagnosed.

Why do any of us have this? It could be autoimmune, sometimes another illness triggers it (it's said that glandular fever can be a trigger), and for those of us old enough child birth can.

I think your daughter is lucky that she has been monitored and started treatment now, so many have waited many many years for a diagnosis and suffered so much ill health during that time. It seems your daughter has been spared that.

[Learner1]

You might look into a pituitary adenoma, especially if she has any vision or mood problems or headaches.

About 17% of people have them, most go undetected, and the vast majority are benign. High prolactin and hypothyroid are 2 symptoms.

I know 2 women who have them. They can really mess up endocrine function, causing large weight gain or loss, making of breast milk, and psychiatric symptoms.

If they're monitored and managed most people can have very normal lives.

[ClareWade in reply to Learner1]

That's the thing they thought she had something wrong with her pituitary gland originally as her prolactin levels were really high but the MRI scan was normal. Then this problem with her Thyroid started - my concerns are that something was missed or not visible on the scan. It just seems to much of a coincidence to me. But I could be looking too much in to it. I will mention my concerns again to our GP. Thanks

[Learner1 in reply to ClareWade]

The tumors are typically very small. Could they have missed it?

Be persistant about asking questions.

[Hidden]

Make sure she gets her eyes checked regularly, that's how my uncle's pituitary adenoma was finally picked up., it affected his growth hormone and caused bone deposits in his joints so he had had arthritis for years.

[ClareWade in reply to Hidden]

What problems did your uncle have with his eyes it's just my daughter has had vision problems - was urgently referred by our Optician as they saw bleeding behind her left eye but (three weeks later at her urgent hospital appointment) there was no sign of any bleeding so they said it was just one of those things and to make sure she has yearly appointments from now on. Thanks

[Hidden in reply to ClareWade]

They could see the tumour. He'd had arthritis for years which they just put down to age and work related. He had regular appointments with opticians and felt his eyes were getting worse but again originally thought age related - he was 70. But the optician was concerned and referred him to hospital. He had a pituitary macro adenoma and had it removed via the nose. He is 78 now and on regular cortisone. Russell Watson, the singer, had the same thing.

[Hidden in reply to Hidden]

I would push for regular checks

[ClareWade]

Thank you all for your replies - it's greatly appreciated 😀