My 11 year old daughter has Hypothyroidism symptoms (I have Hashimotos Hypothyroidism) and her blood test results have come back as:
T4 = 11.8 (range 12.6 - 21.0)
TSH = 2.38 (range 0.51 - 4.3)
GP says normal, but T4 is below normal. Is it ok because TSH is in the middle?
Perhaps not OK but I'd be reluctant to start a young person on thyroid for life just in case it's a short term thing. Maybe get TSH, fT3 and fT4 tested in a month or so and see how she is then. If her fT3 was also low I'd push for treatment as you don't want it to affect her development or schooling.
jimh111, I'd be reluctant to start a young person on thyroid for life just in case it's a short term thing.
As I understand it, levothyroxine doesn't necessarily have to be for life. As long as the individual is closely monitored, the medication can be stopped if there's evidence that their own thyroid is 'fully operational'.
It's much easier to monitor thyroid performance when someone is not on hormone tablets. Once they are taking levothyroxine it is difficult to judge the thyroid as the body adapts by lowering TSH. So, I'm suggesting holding off for a couple of months to see if the thyroid is indeed failing or it was just a blip. Also, fT3 needs to be measured.
I hear where you're coming from. Just wanted to clarify for the benefit of others reading, that being on levothyroxine isn't going to 'kill off' the thyroid, which is what I've seen written elsewhere lots of times.
What reason(s) would the T4 be low for a short period of time? I will ask for a retest in a month or so including T3. I don’t want to leave it too long as her symptoms are affecting her life and could be the reason for her behaviour and issues with learning.
Thyroiditis (inflammation of the thyroid) or illness / stress / depression can affect hormone secretion. I think the odds are in favour of this not being a short-term issue but now is an opportune time to take a second measurement before she is on hormone tablets.
Even if you persuade a GP to request fT3 the labs often refuse to do it. It might be better to do an at home finger prick test for fT3, fT4, TSH. I use thyroiduk.org/help-and-supp... because they are the cheapest and an NHS lab. However, I'm not sure whether they will do tests for minors. Perhaps someone else can advise.
If you need to ask your doctor to run fT3 as well, you will need to ensure they not only request it but note down that it must be done. You may also have to give the lab some grief if they don't run the fT3. I've found labs don't like work so it helps to harass them if they don't do their job!
Thank you. Yes I will push for further tests and then take it from there.
Blue Horizon do tests for minors :
Discount codes for private testing :
thyroiduk.org/help-and-supp...
It would be worth checking the FAQs and Terms & Conditions for each of the companies in the second link. I know Medichecks won't test minors and Blue Horizon will, but for the others I'm not sure.
Foggy73, Do you know whether the reference ranges you quoted above are the same as the adult reference ranges from the lab that did this test?Here's an article that says there should be different ranges for adolescents
January 15, 2020
Adolescent-specific thyroid reference ranges may avoid misdiagnosis
healio.com/news/endocrinolo...
I don’t know, but they are similar to my ranges. My ranges are:T4 (range 12 - 22)
TSH (range 0.3 - 4.2)
The reference intervals differ for infants but not much for school age children. Figures 1 to 4 in this document give a good idea of how they change bmcendocrdisord.biomedcentr... .
As you have Hashimoto’s she needs FULL thyroid and vitamin testing
Request GP retest in 6 weeks including thyroid antibodies
For full Thyroid evaluation she needs TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.
Meanwhile request GP test vitamin D, folate, ferritin and B12 now
Does she have any hypothyroid symptoms?
Have you and your family had coeliac blood test done
Yes she has hypothyroidism symptoms. I have been tested for coeliac and negative.
But are you now on strictly gluten free diet or tried it
Only 5% of Hashimoto’s patients are coeliac, but about further 80% find strictly gluten free diet helps or is essential
No I’m not on a gluten free diet.
Essential to test vitamin D, folate, ferritin and B12 at least annually
Poor gut function with Hashimoto’s can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but a further 80% find gluten free diet helps, sometimes significantly. Either due to direct 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
Before considering trial on gluten free diet get coeliac blood test done FIRST just to rule it out
lloydspharmacy.com/products...
If you test positive for coeliac, will need to remain on gluten rich diet until endoscopy (officially 6 weeks wait)
If result is negative can consider trialing strictly gluten free diet for 3-6 months. Likely to see benefits. Can take many months for brain fog to lift.
If no obvious improvement, reintroduce gluten see if symptoms get worse.
chriskresser.com/the-gluten...
amymyersmd.com/2018/04/3-re...
thyroidpharmacist.com/artic...
drknews.com/changing-your-d...
restartmed.com/hashimotos-g...
Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease
ncbi.nlm.nih.gov/pubmed/296...
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
ncbi.nlm.nih.gov/pubmed/300...
The obtained results suggest that the gluten-free diet may bring clinical benefits to women with autoimmune thyroid disease
nuclmed.gr/wp/wp-content/up...
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
restartmed.com/hashimotos-g...
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
Just sharing my experience and I believe that I've had hypothyroidism since age of 8 as at from that age I began suffering severe constipation and had terrible cold sensitivity and I didn't start my periods till one month before my 16th birthday and that was a very distressing and embarrassing time for me. I wasn't diagnosed till I was 40 and wouldn't like to think of your daughter having to go through the same thing, I understand that you it's scary for you to have your daughter have a life long condition but better to get it treated now and prevent delayed puberty,as I never understood why I felt like a freak compared to other girls my age.
Thank you. I agree as I suffered terribly until my medication was optimal. My daughter has already started her periods and they are very heavy and painful (which is a symptom) and she has other symptoms too, including feeling tired all the time, but has trouble getting to sleep. I have the GP calling me today to discuss her results as I want them repeated with the addition of the ones that SlowDragon has suggested. I don’t want to put her in life long medication at her age, but I don’t want her to suffer and have a negative impact on her and her education longer than needs to if it’s a simple fix.
Unfortunately treating hypothyroidism is not an easy fix despite the fact that doctors are trained to be believe that plus everyone is different si what works for one may not work for another, the endocrine system is a very complex system of different hormones in the body and you'll probably find yourself having to fight for certain things on your daughters behalf, sorry that sounds negative but unfortunately it's how it is now the NHS has been run into the ground by the tories.
That’s ok. I know what you mean as I had to fight years ago to be referred to an Endocrinologist to get T3 as I was still getting symptoms with just T4. I was right to do so because I got prescribed it and felt better. Unfortunately now I have to pay for the T3 tablets as they were removed on the NHS here.
Clearly all the campaigning in parliament hasn't been effective as the government department responsible for the costing of medicines has just stood by and allowed Concordia( the pharmaceutical company who make T3(Canadian I think) and allowed them to charge whatever they want for the drug, however with the high possibility of a third world war on the horizon it pales into insignificance compared to that.
Tsh optimal Below 2.
So her T4 is below normal and her TSH is a little high to be optimal.
I have spoken to the GP and repeat bloods in 6 - 8 weeks time including others that were not included last time. Thank you everyone 😊
What triggers hypothyroidism is children? My daughter had a mild case of Covid in October 2021, could this have triggered it?
I have read about covid triggering autoimmune diseases in other people. It is often Type 1 diabetes, which is another Th1 AI disease like Hashimoto's.
Hi. I imagine that the Dr will take a cautious approach as there are a number of issues in developing children that can be transient and unnecessary levo is definitely to be avoided. It is probably best to retest in a few weeks as the Dr suggests so that the situation can be monitored.
I have the same scenario with myself and my daughter. She started levothyroxine with labs like that. Her dr feels anything above 2.0 with symptoms should be treated. She did have number of symptoms prior to starting medication. You should check her FT3, as well.
It is important to stay on top of her labs because she is in a time of huge growth and hormonal changes.
TSH below level T4 in range
Help with interpreting TSH, Free T4 and Free T3 results please
TSH and T4 both dropped 
TSH T3 and T4 NHS Test results via GP
TSH AND T4 RESULTS - very confused! 
