Bean's test results

[Beanieskeeper]

Hi, I have figured out how to post a picture, if anyone has any advice? My son is 8 years old xx

[Beanieskeeper]

I also have his other results

Serum ferritin 26 ug/L (25-350)

Serum vitamin B12. 437 ng/L (180-1000)

Serum folate >23.3ug/L (>4.00)

Haemoglobin estimation 128 g/L (115-155)

MCV 81.7 fL (77-95)

Platelet count 280 10*9/L (140-400)

Total white cell count 8.4 10*9/L (5.0-17.0)

Neutrophil count 4.90 10*9/L (1.5-8.0)

Lymphocyte count 2.53 10*9/L (1.5-7.0)

Monocyte count. 0.53 10*9/L (0.1-0.8)

Eosinophil count 0.36 10*9/L (0.1-0.8)

Basophil count 0.06 10*9/L (0.00-0.2)

Red blood cell count 4.77 10*12/L (4.0-5.2)

Haematocrit 0.390 1/1 (0.35-0.45)

Mean corpusc. Haemoglobin (MCH) 26.9 pg (27-32) LOW

Many thanks xx

[bluebug]

Go to your GP asap and asked to be referred to a paediatrician. Make an on the day appointment if the GP hasn't rang you back to make an appointment to discuss the test results.

State in the appointment that it is clear your child as hypothyroidism and you want a specialist to see him now before he becomes sicker.

Point out you have noticed his ferritin, iron stores, are on the low side of the reference range and the MCH is below it indicating possible problems with his heamoglobin. State it is common in adult hypothyroid patients to have iron problems due to not being treated in time and in a child anything that effects their metabolism will impact their growth and development. Then point to the other test results that are out of range.

In practice the paediatrician won't specialise in thyroid conditions but will know more about treating it in children than a GP.

Btw the optimal ranges for children and supplement dosing for children are different for adults so I doubt you will find many posters who can advise. So when you get your referral you need to ask about his iron level.

You will probably be advised to change his diet which means making meals that older people on this forum ate as kids. For example at school as a kid we had liver once a week plus beef stew in winter. I was also made to eat liver at home roughly once every two weeks, though oddly enough I preferred black pudding. You can actually hide liver in other red meat dishes.

Vitamin B12 mostly comes from dairy products but due to the calcium in them you don't want to eat them at the same time as red and white meat. Likewise you don't want grains such as bread when eating red or white meat as like calcium this also interferes with iron absorption.

Finally if he doesn't​ play outside you need him to in the summer months. That way you can ensure he makes sufficient vitamin D.

[lolajone in reply to bluebug]

Hi blue bug very interested in your comment "Btw the optimal ranges for children and supplement dosing for children are different for adults ". Do you have any links or references you could direct me to to re optimal ranges etc.? My son has current TSH of 13.1,paediatrician won't reveal any guidance and I couldn't find any on Google!

[Beanieskeeper in reply to lolajone]

Hi lolajone, I was always told that anything under 5 was 'normal' but you may feel better if anything over 2 is treated. I have been hypo since 12/13 yrs old. How old is your son? As he may be old enough for you to go on how he feels which is a better guide xx

[lolajone in reply to Beanieskeeper]

Hi sorry didn't mean to hijack but the thought of some guidelines for children was too great to resist. I am having to do battle with NHS it feels. He is 13 and feels rubbish and I can appreciate how he feels having had both graves and now hashi's myself . He is on a starter dose of 25. We have an appointment next week and I was looking for more information. This paediatrician thinks TSH 5.9 is fine!

[Beanieskeeper in reply to lolajone]

Don't apologise, we are all here for help, I can't even get my incompetent GP surgery to send the flipping referral letter, the guys here have been really helpful but as bluebug said it's different for children. The paediatrician needs a slap, at 5.9 I would be feeling like I was walking through treacle, I personally don't feel well unless my tsh is almost completely suppressed (under 0.2) and more reasearch is showing that tsh at those levels are safe. The paed should go on his symptoms more than test results, if you contact the thyroid uk people they have a booklet about preparing for your appointment, the very nice lady just sent it to me, if you pm me your email I can forward it onto you if you like?

It's awful you have to fight to get treatment for your child, I'm completely losing faith in the NHS and thinking about taking Bean to a private endo. Hope your appointment goes well xx

[bluebug in reply to lolajone]

Sorry I don't know.

I do know that reference ranges for various measures depend on the age of the child - if you know any adult reference ranges you can clearly see it in the results that have been posted.

Also the fact that medicines are done by body weight until they get to teenage years unless the teenager is small. This means you can't​ for example give adult iron supplement doses to a child.

Actually with iron you may actually be able to find details on supplementation for children on the emc. The reason for this is one of the most common forms of poisoning is children finding an adults iron supplements and thinking they are sweets hence they put the amount on emc.

[Hidden in reply to bluebug]

I agree with saying all the things above but I would sit down and write him a good old fashioned letter because most GPs dont have time to listen or time to think face to face and fob you off They do in my experiance read the whole of a letter and if they have to write a reply they have to think about it/ Be polite and even humble, point out that you have had advise from thyroid OK, clearly state what you concerns are for you childs future wellbeing and your understanding that the blood results are out of range and how you think the doctor should proceed. I have given up visiting doctors I just write them nice letters instead and boy does it seem to get things moving. They are just dismissive in a consultation but give them a good rational reason to do what you want on paper I find that they as academic people do give you a rational reply. Email does not work so well.

[Katepots]

His TSH is high really should be under 2. I'd say he was hypoththyroid.

Ferritin is very low he needs supplementing, talk to your Dr

He needs to have his thyroid antibodies checked too to test for Hashimotos Thyroditis, Auto Immune and very common. He would then need to at least be gluten free but I won't go in to that until you know.

You need to be referred to an endocrinologist, dont mess about with the Dr as they know nothing about thyroid conditions.

Well done for spotting so early, this could have gone on for years!

He needs the creatinine levels investigated, insist on that.

The low MCH test shows he may have iron deficiency anaemia.

Your sons B12 result isn't too bad but could ideally be raised. Under 500 can start to cause neurological changes. (In Japan they start to supplement at 500) over 600 would be much better.

Good luck.

[Beanieskeeper]

Wow thank you so much, I thought I was being an overprotective mother and over reacting as GP has seen these results and is referring him to paeds but she didn't seem overly concerned and when I finally got the full results yesterday I was very concerned. He plays outside all the time rain wind snow or sun, but the last 6/9 months he's been difficult to get off the sofa and when he does move he complains his ankles and now his arm hurt. He is also starting to fall behind at school and is extremely emotional, crying at the slightest thing. GP still hadn't sent the referral a week and a half later, so I'm beginning to lose faith. Not surprised about the B12, my grandmother, mother and myself have pernicious anemia and I recognise some of his symptoms from when I need my injection x

[Katepots in reply to Beanieskeeper]

No you were just being a really good insightful mum! Yes he will be feeling shocking and literally dragging himself around with all that's going on poor lad

He will be very brain fogged so concentration is very hard. Speech too is hard and to organise your thoughts.

That follows re the pa

Do you follow the PA society website?

Sure he'll be back to running around in no time once deficiencies and thyroid meds sorted.

Definitely get his thyroid antibodies checked.

Good luck.

[Beanieskeeper in reply to Katepots]

Yes he does have real trouble getting his words out recently, it's all starting to fall into place now. I'm thinking about taking him to a private endo as I have no faith in the NHS these days!. Thank you so much for your help xx

[Katepots in reply to Beanieskeeper]

Good plan you'll get MUCH better help and proper supplementation as long as endo is good. Email

[e-mail] (If you're in uk!)

for a list of recommended ones.

Get the endo to tell the Dr what supplementation he needs, exactly what meds then you'll get them on the NHS

A good way round as much less expensive then.

[Beanieskeeper in reply to Katepots]

Brilliant, thanks very much. At least I now feel like I'm doing something for him rather than just having to sit and watch him get worse while waiting for the NHS to grind it's wheels x

[Hidden in reply to Beanieskeeper]

Dear Beanieskeeper,

If you find good private endo let me know my child is hypo with tsh of three but he is really ill. I cannot maintain a standing position at tsh of2 with out added hormones anddont knowhow the hell I am going to get him treated.

[Katepots in reply to Beanieskeeper]

Really good info vitamins and minerals in this summit that starts today.

It's free daily although you can buy info if you want.x

Section on children's health.

thatvitaminsummit.com/live/

[Hidden]

Creatinine is related to kidney function and low thyroid function can affect kidneys. Hope you get little guy sorted soon. X

[Beanieskeeper in reply to Hidden]

Thank you, he had post streptococcal glomeral nephritis 2 years ago so I always worry about his kidneys, I will get him checked out properly as soon as I can. He is a walking disaster this kid, he's only 8 and this is the 5th separate thing he needs to be seen for! It's no wonder I'm going grey 😂

[Hidden in reply to Beanieskeeper]

I feel your pain, I really do. My son is suffering with various issues too. Just wish I could go through it for him as I'm sure you do too. Seems to just be one thing after another doesn't it! Lots of luck, hope you get a thorough and understanding doctor. Xx

[Beanieskeeper in reply to Hidden]

Thank you, im also hypo so I know what he is going through and I really want to get this sorted for him, poor little man has been through enough x

[humanbean]

For future reference, this website is worth bookmarking :

labtestsonline.org.uk/

It tells you about all sorts of tests that doctors might do e.g. creatinine :

labtestsonline.org.uk/under...

MCH is mentioned on this page :

labtestsonline.org.uk/under...

I imagine your son may have had hypothyroidism for a while. One of the problems it causes is low stomach acid. With insufficient stomach acid the body can't extract nutrients from food very well and so low iron and ferritin is common, this leads on to low haemoglobin and low numbers of red blood cells, low transferrin saturation... This link is worth keeping too :

irondisorders.org/Websites/...

Low stomach acid could be the cause of the low(ish) B12.

If your son ever gets indigestion or heartburn or bloating or wind or feels sick or gets gut pain after eating he may have low stomach acid. The last thing he needs in those circumstances is acid-suppressors or indigestion tablets. If or when it becomes an issue ask for advice on what to do about it.

I wouldn't be surprised if your son has low vitamin D as well. That causes all sorts of muscle and joint pain. If you can't get a doctor to test for you, it can be done privately with a finger-prick test (although the lab doing the test is an NHS lab) :

vitamindtest.org.uk/index.html

For more info on private testing which doesn't involve doctors :

thyroiduk.org.uk/tuk/testin...

One of the issues your son has may be low Free T3. Doctors don't believe this is important, but patients have found it is the best indicator of how severe hypothyroidism is. Doctors use TSH as an indicator, but TSH (high or low) doesn't make people feel anything. It is low Free T3 that makes people feel ill.

Always make sure that blood tests for thyroid are done first thing in the morning, by 9am at the latest, fasted overnight, but drink plenty of water. If/when your son starts on levothyroxine take levo 24 hours before blood testing and then no further doses until after blood testing. Breakfast should be eaten after blood testing is done, and any missed doses of Levo should be taken after blood test.

Doctors will tell you that time of day and fasting makes no difference to blood test results. They are wrong.

[Beanieskeeper in reply to humanbean]

Ok, so I now have about a million questions, will have a read of all those links thank you so much, but I am also hypo, have been since I was 13/14, on 225mg levo a day and try to keep my tsh below 0.2 or I feel horrible. But even completely suppressed I feel off. My GP's lab will only test for tsh on established thyroid patients, so my t3 could be wrong? I have never been told to fast before bloods and always take my Levo after breakfast so it sounds like I'm doing it all wrong! If Bean is hypo guess I better learn how to manage this properly for both of us!

[humanbean in reply to Beanieskeeper]

Levo should always be taken on an empty stomach, an hour before eating, or two hours after eating. And that includes avoiding coffee and tea and other drinks except for water during that hour or two hours.

Also, if you take any supplements they have to be taken well away from taking Levo. For most supplements the gap needs to be two hours.

But for iron, vitamin D, calcium, oestrogen, and magnesium it has to be four hours.

If you are not a late night snack eater or cocoa drinker, then taking Levo at bedtime helps a lot of people. (Wouldn't suit me - I like my bedtime hot drink.)

For anyone who reliably wakes up during the night or gets up during the night for a pee, taking Levo then works well too - no need to delay breakfast and/or coffee then.

[Beanieskeeper in reply to humanbean]

Yep, really been doing this all wrong! I'm mainline coffee most of the day and take my Levo after breakfast, will try taking it before bed, have to cut off the coffee supply at 3 or I sleep even more badly than I do already! Again thank you so much, have a lot of reading and research to do.

[humanbean in reply to Beanieskeeper]

Hope it helps.