I'm after a bit of advice re levels if anyone can help. 6 weeks ago my 7 year old had blood tests. Her TSH came back at 5.03, T4 14.6. Now I have no real knowledge of normal levels, but Dr asked for a repeat test. I have today got the results and they are TSH 5.18 and T4 12.3. The receptionist has said Dr said they are normal.
Are they? Tried googling but confused myself. With initial levels (i was only told TSH) I was thinking potentially Hypothyroid, but now I'm not sure, because of T4 levels.
She has some symptoms that fit. She is currently under a pediatrician for recurrent regular headaches. A clear MRI has led them to decide its migraines. I'm not convinced. She has been 'off' for about 14 months now. Nothing serious but recurrent periods of general malaise.
Any advice greatly received.
Thank You.
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vive17
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You will be able to see that there are age-dependent ranges for thyroid blood tests. It is vital that the appropriate ranges for your lab are used. I have included the link as an example.
FT4 ranges in particular can vary hugely from one lab to another. You must do whatever is necessary to get the right ranges. That could be to ring the lab. Or to ring the PALS service at your local hospital.
TSH ranges tend to vary much less from lab to lab. And over 5 looks to me to be wrong. Certainly I would NOT categorise it as "normal" even if your lab's range for 7-year olds goes higher.
I have found out that the range for the hospital is
TSH 0.4-4 T4 10.6-21
So I'm assuming there is an issue then? I have booked an appointment with the GP to discuss it further. What would be the appropriate next steps, if any?
Your doctor is wrong, isn't he. He's probably thinking the range is the same as for adults - 0.5 to 5.0 or whatever. But according to those results the TSH is above range and the T4 is very low in the range.
I don't know anything about hypo in children but I'm hoping to learn because I'm worried about one of my granddaughters. But if these were my granddaughter's results, I'd either want some action, or a second opinion. Can you take her to a pediatrician? They should be more clued up on children, no?
Your doctor is wrong, isn't he. He's probably NOT thinking...
I am really struggling to understand how we have systems that do not include the appropriate reference ranges with results. Surely half the point of computerised records is that information, in this case age, gets passed to lab so that they can provide pertinent initial comments? And the GP can see both the result and that range. Far too simple and obvious...
However, to get back to the case in hand. Yes, GG is spot on. That needs attention - not in six months, not in a month, but as soon as reasonably practicable. It is not an emergency, but thyroid affects a lot and she should not be left in this state beyond the unavoidable minimum time. A paediatric endocrinologist should be the ideal person - but you might not have that possibility. Your existing paediatrician might be just fine.
It is not exactly unusual for headaches, whether migraines or otherwise, to be associated with low thyroid hormone levels. Certainly we have had some adults who report considerable improvement following sensible thyroid hormone medication.
And as we so often have to say: Get vitamin B12, folates, iron/ferritin and vitamin D all checked out (against appropriate ranges!)
Yup, that's just about right, Rod! As a collegue of mine once said : I don't get paid to think!
Yes, it does need immediate attention. I was hypo as a child - possibly from the age of 5 but don't know exactly, and it's miserable! Life was hard, both at school and at home - but especially at school. You get blamed for being fat, and slow, and stupid, you get told you're lazy, and games and gym was a nightmare! If only someone could have recognised that it wasn't all my fault - certainly not the fat bit, because just after the war we didn't have much food, and it was so horrible I didn't eat much of it anyway! If only I could have been treated at that time, my life would have been so different...
My daughter has exactly the symptoms that you had as a child.....and they cant find which is the cause.....doctors thought that has learning problems....till yesterday...we found that she has Hypo.....we hope to see her better with the treatment....
Well, at least they've found it, now, so she has a chance. But, she needs to learn about her disease to progress. Don't just leave it all up to the doctors.
My advice would be to read as much as you can - here and elsewhere - and ask specific questions. Just asking for advice is a bit vague, because we don't know what you know and what you don't.
Has the doctor started her on levo? How much? When has he said to go back for a retest?
Have so little faith in Drs. What worries me is that they said they were normal. Good job I asked the levels. Fortunately (or not) I have plenty of experience with Drs/hospitals, but it really worries me about all those that trust what medical professionals tell them. Guess that's a whole other thread though!
So I have taken my daughter to see the GP and she has completely dismissed us. She said levels are fine and there is no need to do anything. She was also dismissive of any link between the headaches and illness and the levels. She said had we not done the blood test we wouldn't know! Also she tried to infer that it was just because I knew about these things! (My son has type 1 diabetes and coeliac!)
So the question is where do I go from here? We have an appointment with pediatrician on May 18th. Should I wait until then?
Another question is would it have made a difference what time the blood test was taken? The first one was a fasting test and the second was after school. I've read time of day affects the results is that so?
Your GP is an absolute genius. I don't think. The whole point of a blood test is to check, confirm or find something you don't bloomin' well know, isn't it?
Well, these blogs show that time of day can be important.
Frequency of subclinical hypothyroidism in 5- to 15-year-old children with migraine headache.
Fallah R, Mirouliaei M, Bashardoost N, Partovee M.
Source
Department of Pediatrics, Shahid Sadoughi Hospital, Yazd, Iran.
Abstract
BACKGROUND:
Migraine is the most frequent acute recurrent primary headache in childhood. Hypothyroidism may be an exacerbating factor for some primary headaches. The purpose of this study was to determine the frequency of subclinical hypothyroidism in children with migraine headache.
METHODS:
In a cross-sectional analytic study, the thyroid function tests of 5- to 15-year-old migraineurs who were referred to the Pediatric Neurology Clinic of Shahid Sadoughi University of Medical Sciences from January 2010 to February 2011 in Yazd, Iran, were measured based on the second edition of the International Classification of Headache Disorders.
RESULTS:
Forty-eight girls (46.2%) and 56 boys (53.8%) with mean age of 10.46±2.72 years were evaluated. Twenty-five (24%) children had hypothyroidism. The monthly frequency of headache (mean±SD, 14.75±8.9 vs. 20.12±9.49, p=0.04) and the duration of headache (mean±SD, 1.96±1.08 vs. 3.75±2.71 h, p=0.03) were more statistically significant in migraineur children with hypothyroidism, but the mean age, mean of onset age of migraine, sex distribution, and severity of headache were not statistically different in both groups.
CONCLUSION:
Based on the results of this study, subclinical hypothyroidism was as an exacerbating factor for migraine headache. Therefore, it is logical to check the thyroid function tests in migraineur children.
I dare say your GP would say that isn't true in the UK but only happens in Iran - and being an evil empire country suspected of nuclear ambition is definitely isn't true there either! (Sorry - my sarcasm is overcoming me.)
Is there any possibility of getting the paediatrician appointment brought forward? I can't see you doing any better with your GP than you would by hitting your head against a very hard wall.
Haha. I think she forgot that she sent her for blood test because age has been unwell too! Head, wall, bang!!
Thank for those links. The report is interesting. I have found a couple of other articles linking the two. I will print them off for when we go to the hospital.
I will try and get appointment brought forward, but I'm not going to hold out much hope. I think because they have done a brain MRI for her headaches that was clear they have me down as an paranoid parent. I know there's nothing serious wrong with her. But definitely something isn't right.
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