Guest guest Posted March 15, 2005 Report Share Posted March 15, 2005 Ami, I'm not familiar with pediatric ranges but do know that up until a certain age kids need more thyroid hormone than adults do... Glaringly missing here is the Free T3 results.... high TSH tends to mean that the pituitary senses insufficient thyroid hormone. The doc is testing for Free T4 (storage hormone) but not the Free T3 (active hormone) It could be that part of the problem is the he's not converting sufficient amounts of T4 to T3 for the pituitary to be satisfied. Since he is on a T4 only synthetic, Levothyroxine, it's mandatory to have the Free T3 testing to see if there is adequate conversion... IMHO, of course. Topper () On Tue, 15 Mar 2005 07:59:17 -0600 (Central Standard Time) "Foxes" writes: For those unfamiliar, is my 7 year old son with ADHD, hypothyroidism, atrial septal defect, and chronic lung disease/asthma. His ped cardiologist noticed on Dec 8 that his thyroid was slightly enlarged and ordered labs which showed his TSH was 9.79 and his fT4 1.33. Because his fT4 was still right in the middle of normal range, the cardiologist chose to hold off on treatment and send him to the endo. Labs were redone on 1/20, at which time his TSH had risen to 63.4, with an fT4 of .94. We saw the endo the following week, who prescribed him to 50mcg of levothyroxine, which he started on 1/28. During pre-op labs on 2/16, his TSH came back as 16.4 and his fT4 as 1.13 (2 weeks, 5 days on levo). Labs were drawn on March 2 by the pediatric asthma/allergy specialist. He was drawing to check his immunoglobulins & such, to get an overall picture of 's immune system, because of him having these couple of things that weren't healing. The report I got last week stated that most of those labs came back normal. In the process of doing those labs, Dr. Mahr (ped asth/aller spec) also drew for his TSH and fT4. When I called last week to get those, they were a bit odd, I thought. His TSH was 9.08. His fT4 was 1.84. The nurse said his T4 was a bit elevated now, but his TSH is still elevated, also. SO, when "normal range" for fT4 (in adults) seems to be 1.0 to 1.5, and he's at 1.84, I'm not sure what the deal is there. One would think it meant that he's leaning more towards becoming hyper now, but in that case, shouldn't his TSH be even lower yet? I'd called and left a message with Dr. Pehling's (endo) snotty nurse last week. He called me back himself this morning, and we discussed the results, along with how has been feeling physically, and agreed we'll wait a bit longer and recheck him in another 4 - 6 weeks, unless he physically is showing signs that we need to check sooner. In the meantime, the size of his thyroid has gone down a bit, and he has more energy. He's still constipated, so his doctor put him on miralax to help with that. I'm wondering, though, if anyone has any helpful thoughts on what might be causing his TSH and fT4 to both be elevated, and what a course of action might be, I'd appreciate it. He did say that it can take some time to get things balanced right and find dosages. Which I told him I understood from being on these groups, and hearing the stories of so many of you and how you've had to try multiple dosages, switch to or from synthetic or dessicated because one or the other worked better for you, etc. So he was glad to hear I expect this to not be a simple process. In the meantime, as I said, has been showing improvement. Thanks for your input, and thanks SOOOOOOOOOO much for everyone's support!!!!!!! Ami & Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 15, 2005 Report Share Posted March 15, 2005 Well, I value your guys' opinions and thoughts, which is why I ask. I will contact his endo to ask about doing a T3 test. Do we want free t3 or total? I'm assuming free. If that was low, would he then need to take something to replace the t3? or does the cytomel (sp?) help to convert the t4? or what does it do? Also, do you think it would make any kind of difference if I split his pill and he took 1/2 in the morning and 1/2 in the evening since they are scored? Ami -- Re: 's most recent labs Ami, I'm not familiar with pediatric ranges but do know that up until a certain age kids need more thyroid hormone than adults do... Glaringly missing here is the Free T3 results.... high TSH tends to mean that the pituitary senses insufficient thyroid hormone. The doc is testing for Free T4 (storage hormone) but not the Free T3 (active hormone) It could be that part of the problem is the he's not converting sufficient amounts of T4 to T3 for the pituitary to be satisfied. Since he is on a T4 only synthetic, Levothyroxine, it's mandatory to have the Free T3 testing to see if there is adequate conversion... IMHO, of course. Topper () No virus found in this outgoing message. Checked by AVG Anti-Virus. Version: 7.0.308 / Virus Database: 266.7.2 - Release Date: 3/11/2005 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 15, 2005 Report Share Posted March 15, 2005 No, I don't believe that it would make any difference to split his T4, as that hormone is storing up to be converted. Cytomel IS T3, directly, and yes he does need the Free T3 done, above ALL else. Get ready, the fight may be on with your endo. If he hasn't done it yet, in all this time, then he may not understand how vitally important it is. You can get it done yourself through HealthCheckUSA, if push comes to shove. This has become THE most important part of his particular situation, at this point, obvious by the higher T4, and the pituitary not recognizing this as enough to stop hassling the thyroid, yet it is the part that has not been done. I would get that Free T3 ASAP. One other remote possibility could be that the hypothalamus is not reporting back to the pituitary soon enough, i.e., wrong signals? This is remote, but should probably be checked out. Topper, sorry, I can't erase the ads from this email, and am very impatient, when that happens. Re: 's most recent labs Ami, I'm not familiar with pediatric ranges but do know that up until a certain age kids need more thyroid hormone than adults do... Glaringly missing here is the Free T3 results.... high TSH tends to mean that the pituitary senses insufficient thyroid hormone. The doc is testing for Free T4 (storage hormone) but not the Free T3 (active hormone) It could be that part of the problem is the he's not converting sufficient amounts of T4 to T3 for the pituitary to be satisfied. Since he is on a T4 only synthetic, Levothyroxine, it's mandatory to have the Free T3 testing to see if there is adequate conversion... IMHO, of course. Topper () No virus found in this outgoing message.Checked by AVG Anti-Virus.Version: 7.0.308 / Virus Database: 266.7.2 - Release Date: 3/11/2005 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 15, 2005 Report Share Posted March 15, 2005 No worries, ... you answered Ami's post the same as I was about to... and the extra ads didn't come through.... ...great minds think alike!?!? hehehehee Topper () On Tue, 15 Mar 2005 15:12:31 -0600 " " writes: No, I don't believe that it would make any difference to split his T4, as that hormone is storing up to be converted. Cytomel IS T3, directly, and yes he does need the Free T3 done, above ALL else. Get ready, the fight may be on with your endo. If he hasn't done it yet, in all this time, then he may not understand how vitally important it is. You can get it done yourself through HealthCheckUSA, if push comes to shove. This has become THE most important part of his particular situation, at this point, obvious by the higher T4, and the pituitary not recognizing this as enough to stop hassling the thyroid, yet it is the part that has not been done. I would get that Free T3 ASAP. One other remote possibility could be that the hypothalamus is not reporting back to the pituitary soon enough, i.e., wrong signals? This is remote, but should probably be checked out. Topper, sorry, I can't erase the ads from this email, and am very impatient, when that happens. Quote Link to comment Share on other sites More sharing options...
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