Help with my teenage daughter's blood results

[Auntbessy]

My daughter has just had various bloods done and the doc is happy with them. However I'm concerned about her T4. She is 13 and the range is 12-22. Hers us 12.1. T3 wasn't tested and her TSH is 1.5 and range is 0.27-4.2. Her vitamin D is also low. My daughter has low energy and mental health issues. What are people's thoughts? I am in this group because I have hashimotos.

[FallingInReverse]

I’ve managed my daughter through similar from that age through now - she’s 18.

Your best first step is to get a full thyroid and vitamin panel for her, including antibodies.

Are you well versed for yourself and can you get same for her?

[Auntbessy in reply to FallingInReverse]

Yes I know what to do and what to look for but she has extreme needle phobia so I cannot do a finger testing kit with her.

[FallingInReverse in reply to Auntbessy]

My daughter did too!!!!!!!!!!!

Isn’t it something!!!

She has had many a meltdown and even a few doctor appointments that had to be stopped without getting what we needed… delaying care for her… and as you know then waiting weeks/ months for the next appointment slot to try again.

Some of the highest stress points I’ve had as a mom ever.

There were some doctors who refused to let her come back to them!l for how hysterical she got.

Good luck… I suggest you read up on phobia treatments on the internet. I do not believe it requires a trained professional… as I put little faith in most “trained professionals” but as a mom it helped me envision what path the professionals suggest. Many if the things on the internet I could weave into my conversations with her, and I did put a plan down on paper and stayed on it no matter how long it took and how unreceptive she was.

In my experience, it didn’t get better until I addressed it head on.l and it was a serious risk to getting any healthcare support for her.

My heart is with you - it is very trying.

[helvella Administrator]

On another thread I posted this:

Be sure they are using paediatric reference intervals (ranges). By age 13 (edited), the differences are smaller, it is nonetheless important to do so.

helvella - Paediatric Reference Intervals

Discussion of the importance of using paediatric reference intervals for interpreting laboratory test results.

Last updated 18/07/2024

helvella.blogspot.com/p/hel...

[Auntbessy in reply to helvella]

These are pediatric ranges through our local hospital.

[Auntbessy in reply to helvella]

I think I'm not clear from everyone's responses whether her T4 level warrants investigation tbh. She did have other things tested. B12 was on the low end of normal (225ng/l). Vitamin D was below range (25nmol). Folate was a bit low but not bad (11.8 ugl). Ferritin low but in range (26ugl).

[helvella Administrator in reply to Auntbessy]

Well, I'd be concerned about that low an FT4 result, and also the other results.

But I really don't know the best, the right, way of approaching the issues.

All that ferritin result being in range means is that the range is too low! Clearly too low. Some labs have fairly recently increased the lower end of their ferritin ranges because they have long been far too low.

B12 needs to rise. And that can only be obtained from food, supplements or - in extreme - injection.

Folate - while within range - should rise a bit. But whether to use folic acid, folinic acid or methylfolate, I do not know.

Vitamin D needs to be addressed.

My real problem is not knowing whether to start tackling all of them - and, if not, what order? This is way out of my experience and I do not feel comfortable making suggestions which could be precisely the wrong approach. For one, it is usual to advise to supplement B12 before folate but the rationale for that has recently been questioned more deeply!

The only thing I am sure about is that she needs these to rise.

[humanbean]

There is a problem...

Your daughter is only 13 and most private testing companies that deal directly with the public will only do business with people aged 18+.

If you were to buy a test and fake the date of birth (which I know some people have done before) you would get tests done, but the reference ranges used in interpretation of results would be ranges for adults not paediatric ranges.

I don't know if this is accurate, and I would suggest checking before spending any money, but I have heard that Blue Horizon Medicals will test people under 18. Phone them up and check before ordering.

bluehorizonbloodtests.co.uk/

Some useful links - but I don't know how much help they will be.

thyroiduk.org/testing/priva...

Another possibility - but more expensive - is that you try to find a private doctor. There is a list available of doctors in the private sector that at least one patient has liked and found helpful. But you would have to ask the Thyroid UK office for the list via email.

thyroiduk.org/contact-us/ge...

I don't know if the above link also includes a list of NHS GPs who might be helpful. You could ask.

[FallingInReverse]

humanbean out of curiosity, are you saying there is no NHS pediatrician who will provide these blood tests to a patient under 18?

[humanbean in reply to FallingInReverse]

No, that isn't what I'm saying.

If you can't get a GP to test more than TSH and who won't test all the nutrient levels and other tests you are interested in via the NHS e.g. thyroid antibodies, cortisol, an iron panel, possibly some others, then the only other options I can think of are doing postal testing with finger-prick samples of blood - but then you have the age problem of getting a private testing company to do the testing for a 13-year-old. And the other option I can think of is to see a doctor privately who obviously could arrange testing for people of any age - but then you have the expense of paying for the doctor and paying for the private testing. And a doctor organising private testing will probably take a cut of the cost. So, in total it would all be very expensive.

[FallingInReverse in reply to humanbean]

Got it! Tx for the explanation!