# 11 Year Old: Lab Results



## NDMomOf3 (Mar 8, 2013)

Hi There. I have an eleven year old daughter who has had some abnormal thyroid labs.

Our adventure started with my daughter having:
Excessive sweating of the hands and feet.
Extra hair growth arms and legs.

June 2011 - Local Appointment
TSH: 5.59 (.34 - 5.6) "so called normal"
FT4: 2.17 (.58-1.64) H
TSI: 83 (<123)
TPO: .4 (0-9)
TgAb: <20 (<20)

Aug 2011 - University Appointment 7 hours away
TSH: 3.53 (.4 - 5.0)
TT4: 15 (5 - 15) H
FT4: .51 (1.1 - 2.0) L - tested different method - equil. direct dialysis
TgAb: negative

From this appointment we were told if we didn't hear from them we could consider the results normal and no follow up was needed. Of course we didn't hear from them. (We didn't recieve the above labs results till just this past Dec when we had to go back out there)

Last summer she started having occurances of sudden diarrhea, and changes in her vision - right eye became lazy (vision so decreased her brain stopped using this eye). I took her back into our local Dr.

Nov 2012
TSH: 2.03 (.34 - 5.6)
FT4: 1.89 (.58 - 1.64) H
FT3: 4.02 (2.5 - 3.90) H

We were refferred back to the University 7 hours away in which they did NOTHING. The current Ped. Endo wants to write it off as "normal" for her.

I'm consulting with another Ped Endo for a second opinion. He is suggesting we do a T3 uptake test and if that's normal he says he would agree with the other Dr. that this is just normal for my daughter.

I'm going to request for my piece of mind to accept this "normal" that they also run the TT4, FT4, TT3, FT3, TSH, TPO, TSI, TBII, TgAB

Is there any other labs you would recommend I have checked?

Additional symptoms:
18% - 19% for height and weight. 
extremely irritable and sensitive (cries about EVERYTHING). 
anxiety
frequent bowel movements (3x/day)
headaches
shortness of breath. 
has always had warm moist hands (except when coming down with a virus). When she is ill she runs high temps (102 - 104).

Thanks for any opinions and advice you might have!!


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## Andros (Aug 26, 2009)

NDMomOf3 said:


> Hi There. I have an eleven year old daughter who has had some abnormal thyroid labs.
> 
> Our adventure started with my daughter having:
> Excessive sweating of the hands and feet.
> ...


I believe your daughter to be hyperthyroid. TSI should not be present at all and there are other antibodies that make the numbers look in normal range when they are not due to binding, blocking and stimulating of the receptor sites.

Going to give you a "lot" to read.

TPO Ab
Mild to moderately elevated levels of thyroid antibodies may be found in a variety of thyroid and autoimmune disorders, such as thyroid cancer, Type 1 diabetes, rheumatoid arthritis, pernicious anemia, and autoimmune collagen vascular diseases. Significantly increased concentrations most frequently indicate thyroid autoimmune diseases such as Hashimoto thyroiditis and Graves disease.
http://labtestsonline.org/understanding/analytes/thyroid-antibodies/tab/test

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.

Negative test results means that the autoantibodies are not present in the blood at the time of testing and may indicate that symptoms are due to a cause other than autoimmune. However, a certain percentage of people who have autoimmune thyroid disease do not have autoantibodies. If it is suspected that the autoantibodies may develop over time, as may happen with some autoimmune disorders, then repeat testing may be done at a later date.
http://labtestsonline.org/understanding/analytes/thyroid-antibodies/tab/test

Trab
http://www.ncbi.nlm.nih.gov/pubmed/17684583

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/

Substances not found in normal serum (scroll down to autoantibodies)
http://www.thyroidmanager.org/chapter/evaluation-of-thyroid-function-in-health-and-disease/

Also, get her in to see a Board Certified Ophthalmologist who has experience w/ thyroid eye disease (TED) and Graves' Eye Disease (GED.)

Most importantly she needs either an ultra-sound of the thyroid or RAIU (radioactive uptake scan), the latter being the better choice.

This is the pediatric and adolescent section; scroll down to hyperthyroidism.
http://www.thyroidmanager.org/chapt...ildhood-and-adolescence/#toc-hyperthyroidism1


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## I DClaire (Jul 31, 2011)

I cannot add one word to what Andros has shared - her insight into all this has proven to be extraordinary! I do want to say I hope you'll find some answers for your young daughter - thyroid disease is rough for anyone but I'm sure it's even harder for little children.


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## NDMomOf3 (Mar 8, 2013)

Thank you both for the replies!

Andros THANK YOU for all the great information. I will continue to read through it all and make notes to take to the Dr.

I have learned so much about the Thyroid in the last few months! Yes thyroid issues are SO frustrating. With her not having "classic" hyper or hypo labs, Our family Dr. nor the Peditrician he referred us to will do or test for ANYTHING without the advice of an Endo. Then being under 18 just complicates things even more. Adult Endos (at least around here) will NOT take on a pediatric case. So that makes the hunt for a good Dr. even more difficult. I have no problems traveling for Dr. appointments. But now we have been bit by the whole "just because they are an Endo does NOT mean they know that much about Thyroid"! And that was an appointment 7 hours away from home (TWICE)!

I have some hope in this newest Dr. he at least will only accept actual lab reports, not dictation for review. I just wish he would request the rest of the tests instead of just the T3 uptake to be run. It's been almost 2 years since her antibodies were tested and as I have learned from this board and another a lot can change in the antibodies. I might have to resort to begging and pleading, but I'm determined to get those tests run again along with that ultrasound. I don't think I get them to do the RAIU, We had briefly talked about this and the local Dr. is unsure how to do this on a peds patient.

I have also learned from researching my daughter's labs that I myself am sub-clinical hypo along with the labs I have hypo symptoms: 
TSH: 3.79 (.34 - 5.6) 
FT4: .90 (.58 - 1.64) 
Vit D: 18 (30-80)

The Vit D was low enough that they took notice and have me taking supplements. But of course they call my thyroid function normal. I'm going back in for follow up blood work in 2 months and will hopefully get them to run the antibodies on me. Maybe if those will show something that might help me help her as well!

Fingers crossed!!


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## annieo (Sep 26, 2012)

NDMomOf3 said:


> Thank you both for the replies!
> 
> Andros THANK YOU for all the great information. I will continue to read through it all and make notes to take to the Dr.
> 
> ...


I just wanted to let you know that my son had a radioactive iodine uptake scan at 2 weeks old. So I am pretty sure it can be done on an 11 year old.

Ann


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## Andros (Aug 26, 2009)

NDMomOf3 said:


> Thank you both for the replies!
> 
> Andros THANK YOU for all the great information. I will continue to read through it all and make notes to take to the Dr.
> 
> ...


You need a good doctor also!! Sigh and double sigh!!!


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## NDMomOf3 (Mar 8, 2013)

Just wanted to post an update in case others out there are looking for answers.

We found a new Dr. who ran a genetic study on our family. My husband and children have a mutation in their albumin gene which is causing the abnormal thyroid tests. This condition is called: familial dysalbuminemic hyperthyroxinemia (FDH).

The Dr. believes that my daughters symptoms are NOT related to the Thyroid, but possibly to Celiac instead.

THANK YOU for taking time to post and share your knowledge!!


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## webster2 (May 19, 2011)

I am so glad you have found an answer. I hope they will begin to feel better soon. And, you too!


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