# Teen and Thyroid issues (? Hashi)



## RNalleycat (Mar 7, 2010)

Hi Everyone,

This is impressive to have a thyroid board. I have some questions about my daughter's thyroid levels, as a nurse...I am very frustrated with her Pediatric Endocrinologist. I will start with a little bit of her medical history.

Diagnosed at age 4 with Asthma
Diagnosed at age 10 with Insulin Resistance, she was also extremely moody and irritable (they said she had oppositional defiant disorder)
Started her periods at the age of 11 and would bleed 2*3 weeks out of the month and they would be extremely heavy. This has normalized quite a bit since she was put on the birth control pill a year and a half ago. She is now 14.

Jan 2009
Heart rate (140's to 160's)
24 hour urine for Catecholamines, extremely high twice and the third time it was normal. 
Insomnia 
Headaches 
Tremors, it was like she was on overdrive. 
CT scan of her adrenals to rule out pheochromocytomia (it was normal)

Oct 2009
Psychitrist did labs...
TSH was 0.016
T4 and T3 where high (don't have exact numbers)

Feb 2010
TSH is 5.95
T3 >100 
T4 0.95
Heart rate now in the 80's and 90's
Sleeps a lot and she is almost too calm
Difficulty concentrating
Gained 60lbs in the last year but only grew 2 in. in height
Her Cholesterol is high
Acne
Muscle/Bone pain

Why did the TSH go from almost nothing to high in six months? Does this happen in Hashimoto's?

Thanks for your insight!


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## Live2Love (Sep 14, 2009)

Hi RNalleycat,
I was just diagnosed in October with Hashimotos, and from what I have found it is normal to switch back and forth from Hypo to Hyper w/ Hashi's. You can look at my posts in this same thread for some feedback from Andros on this. Here are all my lab results since October:

9/4/09 * Before Meds
TSH: 8.60 (0.40*5.00)
Free T4: 0.98 (0.93*1.70)

12/2/09
TSH: 0.17 (0.40*5.00)
T4: 14.2 (4.60*12.0)

1/15/10
TSH: 6.30 (0.40*5.00)
Free T4 1.02 (0.93*1.70)

2/22/10
TSH: 8.51 (0.40*5.00)
Free T4 1.06 (0.93*1.70)
TPO Ab 207 (0.00*34.0)

My suggestion would be to have the TPO test which I was able to convince my doctor to test. I wanted to be sure they made the right diagnosis, and if high levels of antibodies register than there is a large indication that something autoimmune is going on w/ the thyroid. As you can see * the range was 0*34 , and mine are 207. After I received those results back my doctor decided to check another antibody test as well. The TgAb. I think it is important that the doctors look at the entire picture* not just the TSH. I hope this helps some. Andros should be able to pipe in too.


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## Andros (Aug 26, 2009)

RNalleycat said:


> Hi Everyone,
> 
> This is impressive to have a thyroid board. I have some questions about my daughter's thyroid levels, as a nurse...I am very frustrated with her Pediatric Endocrinologist. I will start with a little bit of her medical history.
> 
> ...


Welcome to the board. Oh, I just get so upset when I hear stories like your daughther's! Children are supposed to be enjoying their lives.

Right at the outset, I suspect of course, thyroid disease but also something else which may or may not be comorbid. I don't yet know what but my instincts are flaring. I "am" thinking.

Meanwhile, yes...............there is a thyroid problem and aha, it just hit me; possible pituitary issue? Has this been ruled out?

Here are the thryoid tests I suggest. It is so important to find out if she has antibodies to "anything.!" This is pretty comprehensive. For example, if one has ANA, we know that is "suggestive" and more tests should be run.

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

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

And yes, fluctuation is found in Hashimoto's and Hyperthyroid.

Here is a good source on pediatrics..............
http://www.thyroidmanager.org/Chapter15/15*frame.htm


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## RNalleycat (Mar 7, 2010)

Andros and Live2Love,

Thanks for the information. I plan to go in there "armed" with knowledge and I will not let this go untreated.

Andros * pituitary has NOT been ruled out, I asked for a head MRI last Spring, but the Peds. Endo said it is not her pituitary so she would NOT do an MRI.

Thanks again!

PS: I love the icons on the right!


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## Andros (Aug 26, 2009)

RNalleycat said:


> Andros and Live2Love,
> 
> Thanks for the information. I plan to go in there "armed" with knowledge and I will not let this go untreated.
> 
> ...


We are here for you and I hope we can offer support and help. The worst pain in the world is when your child is ill.


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## RNalleycat (Mar 7, 2010)

Ugh!!!! So I call the Ped's Endo and the "referral" person tells me it will be JULY until they can see our daughter. I start yelling :sick0025: at this lady and tell her I will NOT sit around for 4 more months and watch our daughter have symptoms that she has had to deal with for OVER A YEAR, especially knowing that she could go into Myxedema Coma or Thyroid Storm. It certainly can't be normal for her levels to go from one extreme to the other in 6 months time. She has also started having more irritability. I called her Family Doc and asked them to see if they could get us in sooner. Thanks for letting me vent!


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## Andros (Aug 26, 2009)

RNalleycat said:


> Ugh!!!! So I call the Ped's Endo and the "referral" person tells me it will be JULY until they can see our daughter. I start yelling :sick0025: at this lady and tell her I will NOT sit around for 4 more months and watch our daughter have symptoms that she has had to deal with for OVER A YEAR, especially knowing that she could go into Myxedema Coma or Thyroid Storm. It certainly can't be normal for her levels to go from one extreme to the other in 6 months time. She has also started having more irritability. I called her Family Doc and asked them to see if they could get us in sooner. Thanks for letting me vent!


That is the most ridiculous thing I have ever heard!! Start screaming cancer and law suit. It is a shame we have to act out of the ordinary but if this is what it takes; do it to it.

I am sure many of us wish we were there to help you. Alas, we can only help from afar.

Please do let us know. I am very very upset for you, your daughter and everyone else concerned.


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## RNalleycat (Mar 7, 2010)

Thanks Andros and everyone else. I found another doctor that can see her in a few weeks. I should have an appointment by Monday (had to wait on her PCP to fax stuff over).

Can someone please tell me what Armour is? I have noticed a lot of people on this site take it. I have hypothyroidism myself and do not feel the synthroid is working for me anymore, but my levels are within the norm, so they will not increase my dose. Every day between 10am * 3pm...I just want to fall asleep at my desk, my skin and hair is DRY, I have ZERO energy!

Thanks,
Alice


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## Andros (Aug 26, 2009)

RNalleycat said:


> Thanks Andros and everyone else. I found another doctor that can see her in a few weeks. I should have an appointment by Monday (had to wait on her PCP to fax stuff over).
> 
> Can someone please tell me what Armour is? I have noticed a lot of people on this site take it. I have hypothyroidism myself and do not feel the synthroid is working for me anymore, but my levels are within the norm, so they will not increase my dose. Every day between 10am * 3pm...I just want to fall asleep at my desk, my skin and hair is DRY, I have ZERO energy!
> 
> ...


Hi Alice. Let us know about the appt. for your daughter and how it goes.

Armour is dessicated porcine thyroid and contains T4 and T3. It has been off the market for over a year but is slowly coming back in. You could also consider NatureThroid/WestThroid both by RLC Labs.

Here is info on Armour..........
http://www.armourthyroid.com/


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## RNalleycat (Mar 7, 2010)

We have an appointment for our daughter with a pediatric endocrinologist, it is next Wed. What should I DEMAND be done? She is also back to having two periods a month despite being on birth control...when it rains it pours.

Thanks


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## chopper (Mar 4, 2007)

What did the docs say about the 24 hour catecholamine test? Did they not even mention the words "adrenal tumor" or "Pheochromocytoma"?

The toggling and really low and really high thyroid numbers have the markings of Hashitoxicosis - a case of Graves' mixed with Hashi's but even with Graves' I don't think those catecholamines would be real high like that. I would certainly ask for a retest of the 24 hour catecholamine. I would also want a 24 hour cortisol.

Due to her age, I would also want a blood cortisol, prolactin, FSH, LH, TSI, TPO Ab, TG Ab, TSH, Free T3, Free T4, Total T3, Total T4, Ferritin, TIBC, ACTH. You can look up those tests online if you are not familiar with them.

My gut is telling me she's got the trifecta of antibodies which would suggest hashitoxicosis - TSI, TG and TPO and those antibodies are flaring and then taking a rest, repeating the cycle, repeating the symptoms.

If you have a really cool doc who doesn't mind testing and you really want to move forward, you can ask for a pituitary MRI, a thyroid sonogram for sure, and ultimately an RAI uptake test to see how her thyroid is functioning in addition to the other blood tests mentioned above.

She could have more than one thing going on at a time which is quite common with autoimmune troubles.

I am concerned about that catecholamine test and why it was dismissed. It could very well be an adrenal problem, a thyroid or pituitary problem. Troubles with either seem to have the same sort of symptoms as the others so its difficult to tell unless you test like crazy, ruling each bodypart out as you go along.

************************

Sorry...see she had an adrenal scan and it was clean. That moves us back to Hashitoxicosis. My money's on that - Graves AND Hashi's all at the same time.


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## Andros (Aug 26, 2009)

RNalleycat said:


> We have an appointment for our daughter with a pediatric endocrinologist, it is next Wed. What should I DEMAND be done? She is also back to having two periods a month despite being on birth control...when it rains it pours.
> 
> Thanks


Will that be tomorrow, the 17th. of March? Also, and I meant to ask this before, has your daughter been seen by a gyn.? Perhaps an MRI of the ovaries, fallopian tubes, uterus and etc.??


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## RNalleycat (Mar 7, 2010)

Andros said:


> Will that be tomorrow, the 17th. of March? Also, and I meant to ask this before, has your daughter been seen by a gyn.? Perhaps an MRI of the ovaries, fallopian tubes, uterus and etc.??


Andros,

No, it's next Wed. ... sorry about the confusion. She did see a GYN but she did not do an exam, she ordered a pelvic ultrasound, which was normal except they could not visualize the left ovary at all. The radiology report recommended an MRI, but they blew it off as "nothing". Then they put her on the birth control pill at just under the age of 13. In a year in a half she has been on four different BC pills...it's like when her body gets use to the pill she goes back to bleeding twice a month. I will be bringing this up with the endo next week also.

Thanks for all your help


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## RNalleycat (Mar 7, 2010)

nasdaqphil said:


> What did the docs say about the 24 hour catecholamine test? Did they not even mention the words "adrenal tumor" or "Pheochromocytoma"?
> 
> The toggling and really low and really high thyroid numbers have the markings of Hashitoxicosis - a case of Graves' mixed with Hashi's but even with Graves' I don't think those catecholamines would be real high like that. I would certainly ask for a retest of the 24 hour catecholamine. I would also want a 24 hour cortisol.
> 
> ...


Thanks..I will ask for all these things, plus an abdominal MRI....as I want to make sure she has all her parts...they could not see the left ovary when she had a pelvic ultrasound.
Thanks for all your help!


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## Andros (Aug 26, 2009)

RNalleycat said:


> Andros,
> 
> No, it's next Wed. ... sorry about the confusion. She did see a GYN but she did not do an exam, she ordered a pelvic ultrasound, which was normal except they could not visualize the left ovary at all. The radiology report recommended an MRI, but they blew it off as "nothing". Then they put her on the birth control pill at just under the age of 13. In a year in a half she has been on four different BC pills...it's like when her body gets use to the pill she goes back to bleeding twice a month. I will be bringing this up with the endo next week also.
> 
> Thanks for all your help


Hoh, boy!! Inepitude inepitude! No one out there cares. Scary!

We are here for you and your daughter.


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## RNalleycat (Mar 7, 2010)

Visit with the Peds Endo went very well, she was very thorough and even drew my daughter a picture to help her understand. She had the antibodies drawn today, as well as repeating the TSH and T4. The Endo Doc said her thyroid is slightly enlarged, but wants to get the labs back first. The Dr. said that if they are negative then she wants to repeat in 6 months and that two of her medications can cause the fluctuation, one being her Birth control pill (to help regulate her periods) and her Topamax (for migraines). Another thing the Dr said was that she is certain she has polycystic ovaries (PCOS), due to certain hair grown on her body. Thanks everyone for your kind words and for your wisdom. I will post again when we hear something about the labs.


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## Andros (Aug 26, 2009)

RNalleycat said:


> Visit with the Peds Endo went very well, she was very thorough and even drew my daughter a picture to help her understand. She had the antibodies drawn today, as well as repeating the TSH and T4. The Endo Doc said her thyroid is slightly enlarged, but wants to get the labs back first. The Dr. said that if they are negative then she wants to repeat in 6 months and that two of her medications can cause the fluctuation, one being her Birth control pill (to help regulate her periods) and her Topamax (for migraines). Another thing the Dr said was that she is certain she has polycystic ovaries (PCOS), due to certain hair grown on her body. Thanks everyone for your kind words and for your wisdom. I will post again when we hear something about the labs.


Thank God. This woman clearly knows her stuff and obviously cares about your daughter. That is so so wonderful.

You know that "I" will be anxious to see labs and ranges as will others who have been following your posts.

What a shame such a young girl has to be on so much medicine and not be able to enjoy her life.

The good news is it does sound like help is on the way.


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## RNalleycat (Mar 7, 2010)

Heard from the Doc. today. All labs are negative...YAY. Now her thyroid levels are back in the normal range too. She said she thinks her Orthotricyclin and the Topamax are affecting the levels. Follow up with her in 6 months.

Has anyone heard about Isol for thyroid? Someone told me they take it for low thyroid and I thought about switching to it.

Thanks everyone for your support!


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## Andros (Aug 26, 2009)

RNalleycat said:


> Heard from the Doc. today. All labs are negative...YAY. Now her thyroid levels are back in the normal range too. She said she thinks her Orthotricyclin and the Topamax are affecting the levels. Follow up with her in 6 months.
> 
> Has anyone heard about Isol for thyroid? Someone told me they take it for low thyroid and I thought about switching to it.
> 
> Thanks everyone for your support!


I am glad to hear this good news and how is your daughter feeling? What about the possible PCOS? All clear on that too?

I have never heard of Isol; where did you hear of it?


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## RNalleycat (Mar 7, 2010)

PCOS is a pretty sure thing, she has all the signs of that including the "excess testosterone hair patterns" on her belly and chest. We knew this was a possibility because she has insulin resistance. I was diagnosed with it at 19, along with Endometreosis. She is about the same, but is more frustrated because it didn't really answer why she has been feeling so listless.

As for the Isol, someone who works at a Chiropractor takes it and Selenium instead of synthetic thyroid. So I was curious.

My Endo Dr. is increasing my synthroid to 75mcg 4 days a week and 50 mcg 3 days a week...we talked about Armour, as she LOVES it, but said it is difficult to get right now, so when it becomes more readily available, she will prescribe it for me.

Thanks Andros for all you do!


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## Andros (Aug 26, 2009)

RNalleycat said:


> PCOS is a pretty sure thing, she has all the signs of that including the "excess testosterone hair patterns" on her belly and chest. We knew this was a possibility because she has insulin resistance. I was diagnosed with it at 19, along with Endometreosis. She is about the same, but is more frustrated because it didn't really answer why she has been feeling so listless.
> 
> As for the Isol, someone who works at a Chiropractor takes it and Selenium instead of synthetic thyroid. So I was curious.
> 
> ...


Thank you for the clarification. Armour is coming in. I just got 500 one grain tabs. They are only shipping one grain and half grain.

There should be no reason your pharmacist can't get it for you. I am in Georgia and I got it in 24 hours. If your pharmacist won't co-operate, find one that will.

Here is the info for you and your doctor.

http://www.armourthyroid.com/


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## enter (Apr 30, 2010)

nasdaqphil said:


> What did the docs say about the 24 hour catecholamine test? Did they not even mention the words "adrenal tumor" or "Pheochromocytoma"?


Is there any link between a pheochromocytoma and thyroid conditions? I don't ever remember hearing about this before. Of course, I've read about thyroid tumors and cancer but, as far as I remember, nothing about pheochromocytomas.


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