My DD is 13. For about 9 months she has had the following symptoms: dizzy when moving from bed or sitting, low mood, dry hair and skin, extreme mood swings, especially in the evening, constipation, always cold. Based on this we saw GP. DD never sees GP. Not since she was about 5 I think. This was her request as ‘she didn’t feel right’. I expected Anemia or low blood pressure, both came back ok, but her TSH levels were 6.8. Anothe test to see if she had antibodies. Levels were 15.2. No action. Another blood test 3 months on... TSH up to 7.7. Antibodies 16. The G P, based on symptoms was going to prescribe thyroxine trial, but after speaking to endocrinologist he said no. As no antibodies and not above 10 on TSH.
Her symptoms still the same. Had previously had 100 percent attendance at school. This academic year she is down to 80 percent, mostly because of dizziness and total exhaustion. Btw her dad has extreme vitiligo. May or may not be relevant.What do I do? See a private doc? Ask for different tests. Any advice greatly appreciated. She is just not herself.
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Sausagedog1970
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I do wish GPs would stop referring to endos for advice. Have they not yet understood that endos know nothing about thyroid? Your poor daughter is very hypo, and it's cruel to make her go on suffering until her TSH reaches 10. But, most endos seem to be sadists!
Just testing TSH and antibodies is not sufficient. She also needs:
FT4
FT3
Tg antibodies (NHS only tests TPO antibodies, but the other might be high suggesting Hashi's)
vit D
vit B12
folate
ferritin
With that high TSH, she probably has low nutrients, that will make her feel bad, too. And optimising nutrients is something you can do without a doctor - probably best to do it without a doctor, anyway, because they know nothing about nutrients!
So, could you get a private test done, perhaps? Details of private tests here:
Thank you! Her serum free t4 level was 15.2 then was 16 optimal levels are 12-22 pmol/L apparently. I take it these are fine then. I think I will do the test as you suggested. The only other thing that was odd on her bloods was Basophils count which was 0.04 and platelet count 422. Are these interesting or just a bit off?
free t4 level was 15.2 then was 16 optimal levels are 12-22 pmol/L apparently. I take it these are fine then
No, optimal levels are not 12-22. 12 would be much too low, and 22 would be too high for some people. Due to the crazy way ranges are devised, they are far too wide. But, in any case, optimal is the level you personally feel good on, and you can't know that by looking at a range.
Most hypos need their FT4 at least in the upper third of the range - sometimes higher. So, your daughter's result is pretty low. Only 30% through the range. So, her FT4 is not alright at all.
And, as I said, she needs the FT3 testing. T4 is basically a storage hormone. T3 is the active hormone. And, that's what causes symptoms if it's too low. Hers is probably going to be low because her TSH is so high.
I'm afraid I don't know anything about basophils or platelets. And certainly couldn't hazard a guess without knowing the range.
She could have low B12, low vitamin D, gluten intolerance
First step is to get FULL Thyroid and vitamin testing
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially if have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies
Ask GP to test vitamin levels
What’s her diet like?
You will need to get full Thyroid testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
Private tests are available as NHS currently rarely tests Ft3 or BOTH thyroid antibodies or all relevant vitamins
All the wonderful learned people on this site have given you help and advice.
I cannot add to that, but should you decide to go down the private route, I can recommend a very good private doctor who will be able to help . Obviously depending where you are and if you’re prepared to travel if necessary. PM me if this is an option for you.
Hi there - as someone who suffered as a child with similar symptoms which eventually years and years down the line meant a low thyroid condition - I tend to agree with both the medical people - your daughter is only 13 and hormones are raging - hormones that can temporarily - we would hope - change the thyroid status - I doubt very much whether the medics know which one - but they are being cautious and I think they are right. An imbalance in oestrogen/progesterone can cause thyroid issues and she is at an age whereby these hormones are now coming in thick and fast. To put someone on thyroid hormone for life - when if you can wait a little longer to see if it settles - might not be the best answer. As we all know once we go down the route of hormone supplementation it might relieve one or two symptoms but could upset the balance of other pathways reliant on stability of the other and then Pandora's box is opened.
I would suggest trying to get her comfortable with her current symptoms via another route - check she isn't low on vital vitamin and minerals which will also be being used up at a great rate of knots - particularly zinc. The symptoms you are explaining ARE thyroid related in my opinion but....................the reason for the disarray of the thyroid could be coming from somewhere else which might settle. If it doesn't settle then obviously you will need to look at medication. The Consultant mentioned in the link below is the person I would go to see when this virus issue is over. As you will see he runs a specialised teenage clinic and if he says she should be on it - then I would feel happy - if he said she doesn't need to be on it - I would also feel happy as he is top of this field. He would at least keep an eye on her situation and monitor her which is what is needed.
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