13 year old daughter's thyroid results - please help!

[HashiHolly]

Hi there - I'd been concerned about my 13 year old daughter's health this year and given our family history of thyroid issues (thyroid cancer, thyoid nodules and high antibodies) I asked that her thyroid be fully tested. These are all the tests that were performed and I was told there's no significant abnormality? Am I wrong to be concerned about her antibodies and her relatively low T4? Would really appreciate any advice - Holly

S TSH_Roche 1.22 mU/L (0.5-5.0)

S FT4_Abbott 11.8 pmol/L (10.0-18.0)

S TgAb 61 U/mL (<115)

S TPOAb 28 IU/mL (<35)

[SeasideSusie Remembering]

HashiHolly

Am I wrong to be concerned about her antibodies and her relatively low T4?

No, not at all, especially given the family history. Keep an eye on her levels. If you want to do private testing then Blue Horizon will test under 16s.

[HashiHolly in reply to SeasideSusie]

Thanks SeasideSusie! Given I'm in Australia which tests would you recommend for a more accurate picture? I'm wondering whether to take her to an Endocinologist or a more holistic doctor that has a greater understanding of thyroid issues and nutrition. Also, how often would you retest?

[SeasideSusie Remembering in reply to HashiHolly]

Basically what you've already done:

TSH

FT4

FT3

TPO antibodies

TG antibodies

Her low TSH doesn't correspond with her low FT4 at the moment, she will need an over range TSH with a low FT4 for a diagnosis of Primary Hypothyroidism.

If TSH remains low and FT4 goes to the bottom or under range, this could suggest Central Hypothyroidism where the problem lies with the pituitary or the hypothalamus rather than the thyroid. The signalling feedback loop is broken - the signal - TSH - is not getting sent when FT4 gets low. If FT3 is also bottom/under range this is further suggestion it could be Central Hypothyroidism.

Don't forget that antibodies fluctuate which can cause fluctuations in test results and symptoms. Here in the UK it's the TPO antibodies that doctors tend to use to diagnose Hashi's. Her TPO level is very near the top, once it goes over then that's it - a positive result for Hashi's. If there's ever a time when she feels less well, that may be the time to nip in and do the test, trying to catch the antibodies at their highest.

[HashiHolly in reply to SeasideSusie]

Thank you so much! She was also being tested for Coeliac as she's positive for the gene. Her diet was awful for the six week gluten test so am hoping her antibodies will fall now that she's gone back to being gluten free which she prefers. If you have a moment - given your clear explanation above - are you able to explain what a low TSH, good T4 and a low T3 indicates? This seems to be me and I haven't been able to find anything I can understand!

[Wetsuiter in reply to HashiHolly]

is that perhaps poor conversion? good t4 but its not doing what it needs to do to convert to t3?

[shaws Administrator in reply to HashiHolly]

There are two thyroid hormones, i.e. T4 and T3 - also known as levothyroxine and liothyronine.

TSH means 'thyroid stimulating hormone' and it is from the pituitary gland which tries to flag up more thyroid hormones that our body needs to function optimally.

T4 is an inactive hormone and has to convert to T3. Your daughter's T4 is very low so I'd assume her T3 is also. They've tested her FT4 but not FT3!

T3 is the Active hormone and is needed in the millions of T3 receptor cells and brain and heart contain the most.

As Wetsuiter has suggested,maybe your daughter isn't converting sufficient T4 into T3. If someone has Thyroid Hormone Resistance it means that T3 alone might be required if they cannot convert T4 into T3. I doubt many doctors are aware of Thyroid Hormone Resistance.

p.s. I'm not medically qualified and have hypothyroidism.

[gabkad in reply to shaws]

Shaws, the natural hormones produced are thyroxine and triiodothyronine.

[shaws Administrator in reply to gabkad]

Thank you. I was referring to the replacements but probably should have made it clearer.

[sbadd]

Can i ask what your daughters symptoms are?

Im also in Australia and my 13 year old daughter early last year kept complaining of tiredness and upset stomach along with chest pain all the time, turns out she was deficient in iron and b12, she also tested positive to a pernicious anemia test, i too have underactive thyroid but hers was ok just wondered if doc has tested these aswell ?