# My Daughters Lab Results



## AriasMami (Jan 31, 2011)

Hello everyone,

I am new here and I have been lurking around the boards for a couple weeks now ever since we had gone to the Pediatric GI specialist for my 4 1/2 year old daughter and we received back that she had a low TSH. We then went to the Pediatric Endocrinology & Diabetes specialist who thought that the limits/ranges were a bit off and thought that nothing would be wrong with them if they retested using their limits. So they retested her on 2/2/11 and I received the results today and they were as follows:

TSH- 0.450 L (.0700-6.400 uIU/mL) 
Note: Test methodology is 3rd generation TSH

T3- 137.1 (80.0-204.0 ng/dL)

Free T4- 1.17 (.80-1.80 ng/dL)

Please give me any input on what you think please.

Also, she added a note that said that she does not believe that she truly has hyperthyroidism , but that we need to follow up on it. which we are on March 15th.


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## Andros (Aug 26, 2009)

AriasMami said:


> Hello everyone,
> 
> I am new here and I have been lurking around the boards for a couple weeks now ever since we had gone to the Pediatric GI specialist for my 4 1/2 year old daughter and we received back that she had a low TSH. We then went to the Pediatric Endocrinology & Diabetes specialist who thought that the limits/ranges were a bit off and thought that nothing would be wrong with them if they retested using their limits. So they retested her on 2/2/11 and I received the results today and they were as follows:
> 
> ...


Welcome and I am sorry your little girl is not feeling well. Could you list her symptoms, please?

Okay; the TSH is very low and unfortunately, they did not do the FREE T3. Darn it all. They did the Total 3 which is free, total and reverse T3 all piled together. (T3, FT3 and rT3)

So, may I suggest a FREE T3 test, rT3 test and TSI (thyroid stimulating immunoglobulin) which if present, is definitive for hyper.

TSI
Normally, there is no TSI in the blood. If TSI is found in the blood, this indicates that the thyroid stimulating immunoglobulin is the cause of the of a person's hyperthyroidism. 
http://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html

Your daughter would benefit from other tests as well that are indigenous to the thyroid.

TSI (thyroid stimulating immunoglobulin),TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/

It probably would be good to do a sonogram also. Normally I would say RAIU but since she is a wee one, I don't think that a good idea unless absolutely necessary.

Here is a link to understanding the various thyroid tests.......
Understanding thyroid lab tests.....http://www.amarillomed.com/howto/#Thyroid

Also, both the FT4 and the T3 are below mid-range. With low TSH and low FT4 and T3, this could suggest pituitary problem as well.
http://www.pituitary.org/faq/faq.aspx

Hope this is all helpful to you!


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## AriasMami (Jan 31, 2011)

Hello everyone,

So we went back to the Endo on the 15th, and we saw her doctor who we were not able to see the first visit because he was out for a family emergency. He does think that she has hyper symptoms and he decided to run another panel of labs and test for antibodies. When we first went in I knew none of the symptoms that were linked with hyper- so I had always chalked it up to being 4. But this time when I went and talk to the other doc. I knew that her hyperactivity that she has is totally a symptom. Also , not being able to sleep all night. She wakes in the middle of the night, she is hot, she gains no weight. She eats a lot and all the time. She is just going a mile a minute all the time and she is rather snappy with her peers at school and will hit. But the weird thing about it is that is just all of a sudden came about. I am still waiting for the results from the 15th. The doctor said that the next steps will be 1) if it is hyperthyroidism then we will do one of three things. I told him I did not want to know the three things because I don't want to worry. 2) if it is not that then we will do a thyroid scan to see if anything is wrong with her thyroid that might be causing low TSH. If that comes back normal then 3) The last step is to do a MRI ( this is the part that made me cry in the car) to check her brain for cyst or tumors . I just hope it is something simple and I can have a normal little girl. But whether or not it is something or not she is mine and I love her. Yall keep me in your prayers.

Kiki


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## lainey (Aug 26, 2010)

This is why I don't like doctors.

You didn't let him tell you the treatment options because you didn't want to be upset, but then he used "MRI" and "tumor" in the same sentence which had the effect of scaring the pants off you.

So I will start with the treatment options for hyperthyroidism, because they really are not so scary.

The first line of treatment for hyperthyroidism is oral medication to bring the thyroid levels in line. This is usually done for a period of time (months) and then withdrawn to see if the patient goes into remission. If the patient goes into remission, there is reasonable follow up to see if there is a recurrance (ie, blood work periodically).

If there is a recurrence, you can try oral anti-thyroid medication again. Or, you can choose 2 options that will permanently eliminate the problem thyroid -- surgery or radioactive iodine. You can function perfectly well without a working thyroid--the patient takes thyroid hormone medication after the procedure (yes, it is forever, but it is a tiny little pill and in the scheme of things, its not a lot of trouble)

Keep in mind, it takes a while to get to the "recurrence" stage.

Also, her behavior and symptoms will likely improve with the medication. She will be healthier and much happier in school and socially, and will feel better. If she is truly hyper, she is 'driven" from inside, for a reason that she does not know why, to have energy, hunger, anger, an urgent need to use the bathroom-- even when she may not want to. Proper treatment will help her to be normal again.

Now, for the MRI and the tumor--and I love how doctors feel the need to suggest _everything_-- what he is talking about is a benign pituitary adenoma--some of these produce TSH, some of these stimulate the thyroid, some interfere with the other functions of the pituitary such as growth--they do occur, and are very rare. If the blood tests are inconclusive, you may want to do this scan just to be sure.

The antibodies tests (hopefully they ran the right ones, because the first set of labs was woefully inadequate from a pediatric endocrinologist) and the Free T3 will tell the story, and then you can move forward.


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## Andros (Aug 26, 2009)

AriasMami said:


> Hello everyone,
> 
> I am new here and I have been lurking around the boards for a couple weeks now ever since we had gone to the Pediatric GI specialist for my 4 1/2 year old daughter and we received back that she had a low TSH. We then went to the Pediatric Endocrinology & Diabetes specialist who thought that the limits/ranges were a bit off and thought that nothing would be wrong with them if they retested using their limits. So they retested her on 2/2/11 and I received the results today and they were as follows:
> 
> ...


Hi there and welcome. I hate it when children don't feel well.

Too bad the doc did not run FREE T3 which is the active hormone available for cellular uptake.

Here is a test that is fool proof; please request that and the FREE T3.

TSI
Normally, there is no TSI in the blood. If TSI is found in the blood, this indicates that the thyroid stimulating immunoglobulin is the cause of the of a person's hyperthyroidism. 
http://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html

Also, here are other antibodies' tests that would benefit.

TSI (thyroid stimulating immunoglobulin),TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/

I hope we can be supportive and helpful to you and your daughter.


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