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Thyroid Disorders Message Board
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Old 04-25-2008, 02:50 PM   #1
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Smile My Daughter's Labs

Since I have hashi's, I had my daughter's thyroid labs run because I want her to have a baseline to refer back to as she gets older (she's almost 18).

The results:
TSH = 0.95 (0.36-5.80)
FT4 = 0.6 (0.9-1.5) *L
TPO Ab = < 10 (0-35)
TgAb = < 20 (0-40)

I'm a little concerned that her FT4 is in the toilet, I'm assuming there should be a retest to confirm. Also her antibodies, while not out of range, are not 0 either. No T3 was done.

Also, I asked the doc to check her for anemia, and all she ran was a CBC? Her Hgb came out low at 12.8 (13.0-16.0), so I'm not sure what to think.

My daughter is skinny and always super energized, but she doesn't sleep well and complains of fatigue.

Doc says she's fine, but I think these numbers are worth watching carefully - any thoughts or advice?

Thanks

 
Old 04-25-2008, 05:13 PM   #2
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Re: My Daughter's Labs

Letterer,

I would say your daughter is anemic and her doctor was wrong to dismiss her thyroid results. Her FT4 is low and her TSH is low normal. This is suggestive of Secondary Hypothyroidism. May docs fail to catch this inappropriate relationshiop between these two numbers but clearly she is deficient in FT4. We don't know her T3 levels and she may be feeling ok at the moment but, in theory, without a T4 supply to feed and keep T3 levels up, one would eventually start having symptoms and feeling bad. i think it's worth investigating further - maybe there was an error in the FT4 test but maybe not...


Of note, I have the same pattern as your daughter although my FT4 was never below range...I was low normal TSH and FT4 but suffering terribly until appropriately diagnosed and started on Armour (still working to optimal). I went through periods of insomnia and feeling wired, no appetite, weight loss and exhaustion right before "hitting the brick wall" ~ doc says those symptoms related to my adrenal glands...although I also had the typical constipation, freezing, hair-loss, hypo stuff.

 
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Old 04-25-2008, 05:52 PM   #3
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Re: My Daughter's Labs

Well, she also has issues with being cold, terrible concentration, she was dx'd with ADHD last summer. She's also on BCP's for irregular cycles and painful periods.

I'm thinking when I get her retested I'll need to get the TSH, FT4, FT3 plus Ferritin and Iron, Vit D and B12.

Is there any rule of thumb on how long to wait before retesting?

Thanks

 
Old 04-25-2008, 06:26 PM   #4
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Re: My Daughter's Labs

If she's not on thryoid meds there is no issue on timing around retesting - she can be retested anytime.

Good luck!

 
Old 04-25-2008, 08:25 PM   #5
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Re: My Daughter's Labs

You need a retest with TSH (3rd Gen/sensitive), FT3, FT4, ACTH, Cortisol, B12, Ferritin, Vit D.

I am suspecting Adrenal insufficiency or secondary hypoT as a result of an ineffective pituitary gland. She needs to be looked over now, before things start breaking due to undue stress on her system. If she were to get pregnant at that active T4 level. There would be nothing for her or the developing fetus. Please do not let this rest. Get her on here with us and we can help her. Hey, I am not advocating get married and pregnant now. I am just saying that something is off and will impact her in the future.

Has she had mono? Been ill with a virus or bacterial infection for a long time. The other thing to check is for Graves Disease. Graves can burn out a thyroid. Those antibodies are TSI and TRAb.

Good luck and keep us informed.
MG
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Old 04-26-2008, 05:24 AM   #6
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Re: My Daughter's Labs

The reference value in hematology for hemoglobin in females is 12-16. We have NEVER had a patient referred to us with a hemoglobin of 12.8, this is actually quite acceptable. Can you double check your lab values? Even in the mid to high 11's it is usually just a watch and wait approach. Good luck.

 
Old 04-26-2008, 08:50 AM   #7
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Re: My Daughter's Labs

Hi Sparkie -
I double checked, her result is 12.8, ref range is 13.0-16.0 g/dL. It was flagged low. She's barely in range on the RBC and at the low end on Hct as well. That's why I was wondering how this all plays into the picture.

MG - Thanks for the checklist, I'll print it out. I was wondering about secondary etc. as well, but I didn't know if I should be concerned yet off just one lab result. No mono, but she had about 8 strep infections in one year when she was 5, had tonsils and adenoids removed at 6. She was a "carrier", her adenoids were full of pockets of strep when they removed them.

Thanks for the pregger commentary, arghh! Naw, she's a good kid, we have time to get her health straightened out before THAT comes into the picture.

An interesting side note - on her lab results, there's a note saying "the FT4 range for adults age 18-50 has been modified based on recommendations of the NACB and AACE effective 10-12-06". Yet this lab still uses a TSH range of 0.36-5.80!

 
Old 04-26-2008, 10:01 AM   #8
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Re: My Daughter's Labs

TSH range does varies by analytical technique. The sTSH = sensitive TSH or TSH 3rd Generation are accurate to the 0.3-3.0 range. However each lab will have its own deviation shift due to instrument calibration and such. As a result the 0.3 - 3.0 range could shift 0.35 - 3.5 etc.

A general TSH should have the range of 0.35-4.0 to 4.0-4.5. Either way they are off. It is odd that they are keeping up with the FTs but not the TSH. I wonder how hard it would be for the NIH to set up a page with all lab tests and the current N A C B accepted ranges? Humm? It would be a way to ensure we all got current care. They could go one step further and send out a bulk e-mail to MDs and labs as well. They do have to get certification through the government to operate and practice after all. *snort*

MG
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