Hi, My 11 year old daughter is suffering from extreme fatigue, very pale skin, no stamina to sustain a normal active lifestyle, she is very sad and losing confidence, her blood tests show a slight vitamin d deficiency and TSH - 3.2, T4 - 12, her doctor has said no action required, do these levels indicate a thyroid problem?
Any advice is appreciated as I don't know who else to turn to.
Did your daughter have the earliest appointment possible and did she fast?
In some countries a TSH of 3+ would be treated. I shall give you a couple of links and sometime we do have to take things into our own hands as in the UK, the guidelines state that the TSH has to reach 10 before being prescribed. How long must people, especially a young person, deal with disabling symptoms but given other prescriptions instead.
thyroiduk.org.uk/tuk/about_...
thyroiduk.org.uk/tuk/testin...
thyroiduk.org.uk/tuk/about_...
If you wish you can get private blood test for FT4 and FT3 and doctor should have checked thyroid antibodies. If we have antibodies the thyroid gland is under attack.
thyroiduk.org.uk/tuk/testin...
Always get a print-out of the results for your own records and also state the ranges of the results - the reason for this is that labs differ in the machines they use and can have different ranges.
Thanks for replying, her blood test was in the afternoon, they didn't tell me to get an early appointment, does this make much of a difference?
I shall read through the links to get more information.
Yes, there is a circadian rhythm to the daily production of TSH by the pituitary. See the graphs on this research paper :
Free Triiodothyronine Has a Distinct Circadian Rhythm That Is Delayed but Parallels Thyrotropin Levels
reboundhealth.com/cms/image...
As you can see from the graphs, TSH falls to a minimum in the afternoon. To get the maximum during working hours blood needs to be taken as early in the morning as possible, and definitely by 9am at the latest.
It is also considered to be a good idea to have the test done fasting except for water which can be drunk freely. So delay breakfast until after blood is taken for the test.
There are still no guarantees that this will give a high TSH. The minimum and maximum for a particular individual might not be very far apart, or they may be quite different. Nobody can tell beforehand.
Another thing that can affect TSH is if your daughter has thyroid antibodies i.e. autoimmune thyroid disease or Hashimoto's Thyroiditis (two names for the same thing - UK doctors use the first name). If your daughter does have Hashi's then TSH might be quite low or quite high, seemingly almost at random, depending on antibody activity. Unfortunately, doctors don't test antibodies very often, nor do they often test all the relevant kinds there are.
It is very hard to get treated for underactive thyroid in the UK. We have to suffer for a long time in many cases before getting a diagnosis and treatment.
The best you can do for now is to make sure your daughter's nutrients are optimal. Hypothyroidism lowers stomach acid causing all sorts of problems including indigestion and heartburn, and also reduced absorption of nutrients, so anaemia is common.
The most important nutrients for thyroid health are iron/ferritin, vitamin B12, vitamin D, folate. If you can get your doctor to test these, then ask for the results and reference ranges and post them on here in a new post and ask for feedback. The alternative is to get private testing done, but I wouldn't suggest doing that unless you had to. If it interests you though we can tell you how to get private testing done without involving a doctor. Just ask.
Thank you, I will go back to the doctor with all the correct information and see if I can get the right tests.
I doubt many doctors would be aware that the earlier the blood test the better for patient. Also once on replacement hormones, allow a 24 hour gap between last dose and test and take afterwards. Also thyroid hormones have to be taken first thing with a full glass of water and wait about an hour before eating. Or at bedtime, as long as she's last eaten about 2.5 or 3 hours previously. (Protein usually takes a long time to digest as our digestion is slow until on optimum meds).
Out of interest did they test her sugar?
Hi they tested her HbA1c which was normal. I have been back to the doctor the refused any more tests and said that she was suffering with post viral fatigue. I have another appointment with a different doc next week.
Sorry to hear about your daughter Sheffieldmum . I just wondered if they have checked her iron levels ? From what I understand the levels can be low/drop around puberty. ....and that may explain her symptoms. Just a thought.
Sorry, I must have missed this post, they checked ferritin and haemoglobin, both quite low but in range.
My Mum's Blood Test Results.
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