Need help

[Monkeys631]

Hello

My 13 year old has just got some concerning blood work back. Wondering if anyone can give me some insight here.

TPO is 10,280

TSH is .14

Other antibody test result was 2000

Her symptoms mostly reflect hypothyroid

[lelin]

You need to give more information. I can't image, what do you mean with that scarce information?

[Raventhorpe]

Hi looks like your daughter might be hypothyroid but we need more information before we can advise.

[shaws Administrator]

Welcome to our forum, and it would appear your daughter has high thyroid antibody levels. This would indicate he has an Autoimmune Thyroid Disease called Hashimoto's and it is the commonest form of hypothyroidism. The antibodies attack the thyroid gland and wax and wane and can be reduced by going gluten-free. I shall give you some links and advice.

Blood tests have to be at the very earliest possible, fasting (she can drink water) and allow a gap of 24 hours between her dose of levo and the test and take it afterwards. This helps the TSH to be at its highest as doctors are apt to adjust doses upon the result of a TSH.

Her doctor should have prescribed 50mcg of levothyroxine. If doctor hasn't or thinks because her TSH isn't yet high enough, email [e-mail] for a copy of Dr Toft's Pulse Online article and highlight the part where he says antibodies should be treated by thyrid hormone replacement to 'nip things in the bud'.

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

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

Also ask GP to test B12, Vit D, iron, ferritin and folate at the next test. Everything has to be optimum.

Always get a print-out of the results with the ranges for your own records and you can post if there's a query.

[Monkeys631]

Thank you! Vitamin D is 40 they added B12 waiting for that result and a few others. Her blood work was morning after fasting. The TSH being .14 would suggest hyperthyroid wouldn't it? She was referred to a pediatric endocrinologist. They looked at all possible diabetic labs values too but that all fell into normal ranges. Now they are testing for celiac disease. It seems odd because her symptoms are fatigue, weight gain, short stature. She does have a very large thyroid. I was concerned when the children's endocrinologist stated that her antibody levels were some of the highest she has ever seen.

[greygoose in reply to Monkeys631]

Her TSH is 0.14? Please don't forget the zeros, it makes it so much clearer. At a brief glance, that could be 14! And it would be great if you could add the ranges when giving results, because the results of most things, on their own, are meaningless.

A TSH result, on it's own, doesn't mean anything much. One needs to se the FT4 and, preferably, the FT3. Something doctors just don't understand! However, those high antibodies - TG antibodies, would that be? Or is it something else? There are lots of different antibodies, this is why people are asking for more information. High antibodies mean an autoimmune disease. But, we need to know which antibodies they are, to know which disease.

[Monkeys631 in reply to greygoose]

TG is 2000

TPO is 10,288 (in first post)

Total T4: 6 (5.0 - 10.8 ug/dL)

Free T4: 1.2 (0.7 - 2.5 ng/dL)

Free T3: 2.8 (2.5 - 6.5 pg/mL)

Her doctor is actually running a lot of additional tests they just have not been resulted. The doctor is absolutely going to treat her they just want all autoimmune diseases investigated before they start adding medications. They will also ultra sound her thyroid. As I stated it's the extremely high antibodies that concerned me. I have not seen that high of results on any forum I have read. That in combination with the doctors statement led me to ask if anyone had personal insight or experience with results like this.

[Monkeys631 in reply to Monkeys631]

Oh and yes tsh is 0.14

[greygoose in reply to Monkeys631]

Well, if he's going to treat her, anyway, there's no problem.

It doesn't matter how high the antibodies are, it's still the same disease. It doesn't change anything. She has Hashi's, which will eventually destroy her thyroid gland. Antibodies fluctuate.

However, those low Frees, with the low TSH, it also rather looks like she also has Central Hypo. Central Hypo is where the problem lies with the pituitary or the hypothalamus. Not enough TSH is being secreted. Therefore, you must make sure that she is never dosed by the TSH, as a lot of doctors tend to do, but by her FT3. Her TSH will always be low, if she has Central Hypo. But, that's nothing to do with the antibodies.

[Monkeys631 in reply to greygoose]

Thank you. They have not given her the diagnosis of hashi's yet. I assume because they are still running tests. They just seemed concerned about antibody level so I was asking.

[greygoose in reply to Monkeys631]

They don't need to run any other tests to know she's got Hashi's, the high antibodies tell them that. But, they should be running more tests to test her pituitary.

[melville999 in reply to Monkeys631]

your daughters doctor sounds very interested.i cant comment on blood results and don't read enough forum results that I could tell you.a lot of autoimmune diseases are missed in adults early on so there may be lots of folk who have very very high levels early on of the antibodies but no one actually checked them cos they weren't recognised as ill.thankfully perhaps this is being sorted out a bit quicker in a young person.Are there any factors in life that could have triggered this possible autoimmune illness?(looking back).I developed quite high antibodies at a point of being badly bullied at work.I hope you and your daughter are able to tap into as much support as is possible meantime.take care

[melville999]

don't cut out gluten until you have coeliac ruled out.otherwise you will get a false negative result

[Monkeys631]

Thank you all. As of now the plan is to get the thyroid ultrasounds this week and repeat labs In 3 weeks. They currently are saying if the free t3 and t4 are "normal" then there is nothing to treat yet. I personally disagree. They did say it's hashimotto so she will eventually be treated. Now if ultrasound reveals something or in 3 weeks her lab work is different they would treat now.