Daughters first thyroid bloods - Overactive?

[MissFG]

For the past two years my now 18 year old daughter has been low in ferritin B12 and VitD and has had periods of tiredness and low energy.

Our GP’s are good but due to my hashimotos I’ve been watching and making sure they check her bloods when she has periods of tiredness. This time I also asked for FT3 and FT4 in case there was an underlying thyroid issue. My daughters main concern was her not being able to put on weight but we thought it could be her metabolism and slim frame.

Bloods came back and we saw our GP this morning. These are what I noticed were low and in 4 weeks their requesting all bloods again and thyroid antibodies, FT3 due to abnormal FT4 and strong family history of thyroid disease. I will make sure I help her supplement with Spatone, B12 and vitamin D in the meantime to get them up. If bloods abnormal again our GP will refer to an Endo.

Any advice please as she looks overactive? She’s only 18 so I want to make sure she doesn’t get as sick as I was and I think we’ve caught it early.

TSH 1.94 (0.38-2.5)

FT4 20.4 (10-18.7)

Ferritin 29 (22-322)

VitD 49.5 (50-?)

B12 597 (211-911)

[jimh111]

The thyroid results look good, fT4 is a touch high but 5% of the population will fall outside the reference interval. It makes sense to run another test with fT3 and antibodies. Make sure the GP specifies very clearly that fT3 must be done, the hospital labs tend to override GP requests for fT3 so they need to be brought in line. I suspect she is fine, they often have periods of tiredness at that age, hypo is usually a constant battle against fatigue.

[MissFG in reply to jimh111]

Already covered GP put comments on bloods ready to order in 4 weeks and I’m to ring her to remind her to contact the lab direct as due to my daughter not being on thyroxine they didn’t do FT3 this time as we requested.

She has ongoing long periods of tiredness tbh she’s corrected me saying she’s always tired and has been for several years. She has been taking some supplements so I think her levels would be lower taking this into consideration.

[jimh111 in reply to MissFG]

That's good. I'd wait and see the results because there are so many possibilities at the moment thryoid and non-thyroid.

[MissFG in reply to jimh111]

Yes thanks I’m praying it’s non thyroid as everything has been investigated and I wouldn’t wish this on anyone!

[Hennerton]

What is her diet like? Does she get enough iron naturally from food?

[MissFG in reply to Hennerton]

She eats very well compared to most of her friends at that age. I buy and eat healthy so encourage her to also

[HughH]

"strong family history of thyroid disease"

Your family history of thyroid disease points to a genetic condition known as Impaired Sensitivity to Thyroid Hormone, sometimes called Thyroid Hormone Resistance. It causes hypothyroid symptoms and requires very high Free T3 levels (often above the top of the normal range) in the body to overcome the resistance.

It causes low stomach acid, resulting in poor absorption of minerals (including iron) and Vitamin B12.

[MissFG in reply to HughH]

Strong family history of hashimotos

[HughH in reply to MissFG]

Your family history and your and your daughter's symptoms are a strong indicator of a genetic condition: Impaired Sensitivity to Thyroid Hormone (more often known as Thyroid Hormone Resistance). It causes hypothyroid symptoms and requires very high T3 levels (often above the top of the normal range) in the body to overcome the resistance.

I have sent information as a personal message.

[ShootingStars]

Hi MissFG. She is vitamin D deficient; below bottom range. Deficient or low D can cause low energy, tiredness, as well as other symptoms, like depression. Her ferritin is also too low. If both of these were identified 2 years ago, why hasn’t she been treated? She would can get practically immediate relief (within days) if supplementing the right amounts of D. Iron can take a little longer to respond. It only takes a few months to build adequate levels and a bit more time to raise levels to optimal.

Her over range FT4 and inability to gain weight are suspicious, but you need to test both thyroid hormones to find the answer. She could have Hashimoto’s and be going through a temporary hormone surge, as can happen early on on the disease. Both TG/ab and TPO/ab should be tested. TPO can be positive in Graves, not just Hashi’s. If her FT3 and FT4 are high, she’s positive TPO, then TSI and TRAb are tested to diagnose Graves.

[MissFG in reply to ShootingStars]

She has been treated repeatedly which is why I keep pushing for her bloods to be tested and keep an eye on her.

Labs won’t test FT3 without the patient being on thyroxine. But our GP is going to ring personally and has put notes on the next set of tests to ensure this is also checked. Now her FT4 is over she’s also happy to check antibodies.

If these flag up anything then she’ll be referred to an Endo.