Hi Everyone, Im so grateful to all of you here on Thyroid UK for all the help. I have found so much information here to improve my own hypothyroid symptoms but now im really concerned about my nephew's worsening hypo symptoms even though his medication (Letrox) was raised from 50mg to 100mg a few weeks ago. He feels tired all the time and he has no interest in school. He is such a smart boy but his is getting bad grades since he has Hashimoto. He feels exhausted all day. He has big dark circles under his eyes along with very pale skintone.
Unfortunately his blood was drawn at 14:49 pm not in the morning. And the other bad thing is that endocrinologists dont care about other factors than TSH here in Hungary. Saddly they are very ignorent.
So we had to take him to a private practice to ask for vitamin D, B12, iron, ferritin.
Iron 10,5 Ref: 8,8-29,9
Ferritin 30 Ref. 20-300
Transferrin 2,3 Ref: 2-3,6
Total iron binding cap. 58,0 Ref: 42,8-85,6
B12 180 Ref: 133-675
Can you please help for this little boy?
Thank you very much in advance!
Eszter
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Ester78
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His ferritin and B12 are low in range and vit D is under range. His T3 is scraping along the bottom of range and his TSH is way over range. T4 is better than T3 but still in lower half of range ... all of which suggests to me
(a) he is still under-medicated
(b) he doesn't convert that well - T3 needs to be MUCH higher and
(c) he needs to improve nutrients - at which point conversion of T4 to T3 may improve.
SeasideSusie is excellent on nutrients and may pop up here to advise more
Is it straight-forward to get T3 medication in Hungary? - he may benefit from a mix of T3 and T4 meds.
Dear Fuchsia_Pink, Thank you so much for your kind reply. Its very helpful. Unfortunately endocrinologists here dont prescribe anything else than Letrox. We dont have any NDT's here.
Dear SlowDragon, Thank you for your reply. He has been taking 100 mcg for 4 weeks now. And he wasnt taking his medication that morning. actually that time he wasnt taking any medication for his illness. He is not a gluten free diet yet. Dostors dont even recommend going on gluten free if you have hashimoto. Actually all he wants to eat is junk. Do you think that would help? Thank you very much for all your advice.
I find these rather concerning (but of course I am looking at it from the point of view of what we say when discussing adults' results, I don't know if it's any different with children):
Serum iron: 55 to 70% of the range, higher end for men - his result is 8.06% through range
Saturation: optimal is 35 to 45%, higher end for men - there isn't a result for this
TIBC (total iron binding capacity) or Transferrin: Low in range indicates lack of capacity for additional iron, High in range indicates body's need for supplemental iron - Transferrin is low in range and TIBC is 35.51% through range
Ferritin: Low level virtually always indicates need for iron supplementation - this is 3.57% through range
I think the doctor should be looking into iron deficiency (due to low serum iron) or possibly iron deficiency anaemia (due to low ferritin). A full blood count is needed including haemoglobin, MCV and MCH.
Symptoms of low ferritin include:
◾Weakness
◾Fatigue
◾Difficulty concentrating
◾Poor work productivity
◾Cold hands and feet
◾Poor short-term memory
◾Difficulty remembering names
◾Dizziness
◾Pounding in the ears
◾Shortness of breath
◾Brittle nails
◾Headaches
◾Restless legs
*
B12 180 Ref: 133-675
This is very low in range and many people with this level, even into the 300s, have been found to need B12 injections.
and if he has any they should be discussed with his doctor and further testing for B12 deficiency and pernicious anaemia should be carried out.
As B12 has been tested then Folate should also be tested as these work together.
*
Vit D: 65.1nmol/L
This is low according to the Vit D Council/Vit D Society who recommend a level of 100-150nmol/L. If this is going to be supplemented then D3's important cofactors also need to be taken - magnesium which helps the body convert D3 into it's usable form and Vit K2-MK7 which is needed to direct the extra uptake of calcium to bones and teeth and away from arteries and soft tissues where it can be deposited and cause problems.
*
Optimal nutrient levels are needed for thyroid hormone to work properly.
His Hashi's has probably played a big part in his dire nutrient levels.
Dear Susie, first of all i would like to thank you for your time and your kindness replying to me. Actually i find his state concerning as well. The sad thing is that doctors here dont seem to care about thyroid related conditions. The only thing they care about is TSH. His endocrinologist said his tiredness is caused by spring tiredness. I was the one pushing my sister to go and have a private blood testing checking out his iron levels, vitamin D, B12..etc
And actually I have learnt everything that i know about this condition from YOU members
I have all blood count of his but i dont know how to post the photo of it as a reply.
Unfortunately you can't post photos in replies, just one picture in the opening post of a thread can be posted.
The sad thing is that doctors here dont seem to care about thyroid related conditions. The only thing they care about is TSH.
Well that confirms that ignorance about thyroid disease and obsession with TSH is universal
His endocrinologist said his tiredness is caused by spring tiredness.
Oh dear
I've never heard of spring tiredness. Seasonal Affective Disorder (SAD) yes, but that is a winter condition when days are long and dark. Spring is a new awakening, nature is being reborn, days are getting longer, we start to see the sun again. Life is springing back. Spring tiredness - poppycock!
Hemoglobin 13 Ref: 12-15,8 - not a range we see in the UK but even so he's only 26.32% through range
Hematokrit 35,3 Ref: 36-48 - below range
MCV 77,2 Ref: 81-100 - below range
MCHC 36,8 Ref: 31-36 - above range
MXD% 11 Ref: <10 - above range. Not heard of this test so looked it up and found
"The MXD blood test, also referred to as the Mixed Cell Count Blood Test, is the collective measurement of the levels of the three types of white blood cells which are less significant than the neutrophils and lymphocytes."
and
A high MXD blood means an immune response to an inflammatory condition in the body.
It's possible that his Hashi's is connected with the high MXD%
MCH test would also be a useful one. Low MCH can indicate iron deficiency/microcytic anaemia and high MCH can indicate folate or B12 deficiency.
Taking all these individually:
Low haemoglobin levels usually indicate some sort of anaemia. His low in range but not below range.
Low haematocrit can indicate anaemia.
Low MCV is when red blood cells are too small and is called microcytic anaemia. Microcytic anemia may be caused by iron deficiency.
High MCHC - this can be raised when MCV is low
So looking at his results overall, his iron panel shows low serum iron and low ferrititin which can indicate iron deficiency anaemia, his low haemoglobin and low MCV can also indicate iron deficiency anaemia, his low B12 can indicate B12 deficiency or pernicious anaemia, if he has low folate there is also folate anaemia.
I think maybe a different doctor who is willing to seriously look into all these dire levels is a must.
Please do not take my reply as medical advice or diagnosing anything, I am not qualified and can only respond with information I have personal experience of or have researched/read. Further research on your/your sister's part is necessary.
When using a search engine make sure the sites you go to are reputable ones.
One good place to start is one that the NHS often refers patients to for explanations of blood tests so that's a good place to start searching for explanations of the results:
Dear Susie, thank you so much for further information and all the effort you take to help me. Im so grateful to you and I really appreciate it. Yes, spring tiredness is ridiculous. I guess its a Hungarian thing. They say it because its thought to have depleted vitamin levels by the time spring starts. Dont worry! Im not taking your advice as a medical diagnosis but its been very very helpful. :)))
The fact that doctors worldwide seem to be very ignorant of diagnosing/treating those who are hypothyroid because before blood tests were introduced we were diagnosed upon our symptoms alone and given a trial of NDT (natural dessicated thyroid hormones).
NDT is made from animals' glands (usually pigs). The patient can begin to feel an improvement with a small increase given about every six weeks and concentrating on symptoms being relieved. All thyroid hormone replacements are taken fasting, usually first thing a.m. with one full glass of water and wait an hour before eating. Or if a child a glass of water, sufficient so that the tablet can be swallowed easily.
p.s. I also state I'm not medically qualified but had to diagnose myself as no doctor or specialist could and I even underwent an operation to remove a 'web in my throat'. I found out two weeks later that I had no such thing as a web but later on, I realised it was probably a swollen thyroid gland as my TSH was 100.
So, even if we pay doctors/consultants, it doesn't mean they know anything at all about clinical symptoms of hypo.
Vast numbers of Hashimoto’s patients find strictly gluten free helps or is essential
He should have coeliac blood test FIRST while still eating gluten
Hashimoto's frequently affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten intolerance. Second most common is lactose intolerance
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find strictly gluten free diet reduces symptoms, sometimes significantly. Either due to gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies
While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first
Assuming test is negative you can immediately go on strictly gluten free diet
(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)
Trying strictly gluten free diet for 3-6 months
If no noticeable improvement, reintroduce gluten and see if symptoms get worse
You have been so helpful. Thank you very much for your kind reply and all your suggestions. Yes, i think it would be a great idea for him trying to go on gluten free. Hungary has just started to have a little more gluten free items.
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Do you think that would help? Thank you very much for all your advice.
They say it because its thought to have depleted vitamin levels by the time spring starts. Dont worry! Im not taking your advice as a medical diagnosis but its been very very helpful. :)))
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