Can someone help me understand my daughter's test results?
I have a soon to be three year old daughter. We have been very concerned with how fast she is gaining weight. To give you an idea, here are her stats - 40" tall, 57 pounds. She was 30 pounds at one year and 45 pounds at two years. She eats a fairly healthy diet with occasional treats, minimal juice and milk. She gets exercise daily. We have been closely monitoring her diet for about a year now as when we expressed our concerns to our doctor a year ago she told us that she did not want her gaining anymore weight, rather maintaining and growing taller. We ran bloodwork on her then as well. At that time her TSH was 3.50. I do not know her cortisol numbers however the doctor said both were within normal range.
After giving it about six months (during which she was still gaining), we decided to take her to a pediatric endocrindologist. I have been concerned that she may be hypothyroid due to the following symptoms: weight gain, constipation, dry skin with worsening keratosis pilaris, mood swings/irritability & low body temp (97.1 is her norm). She also has a 4mm difference in her pupil size which I'm not sure has anything to do with it but thought I'd mention it.
Anyhow, I got her test results in the mail on Saturday and I'm a little concerned with the numbers. I did speak to the endo last week at which time she told me her prolactin levels were borderline. She has recommended retesting in a few weeks to see what they are then but also told me it's not unusual for them to be elevated in overweight people. On the letter she sent with her test results she recommended nutrition counseling if the next set of prolactin levels come back normal. Here are some of her results:
Lab normal ranges are included. So, her TSH is higher than what it was last year. Our family practice doctor said last year that they wouldn't even consider treating thyroid until TSH was over 10 - this after I questioned her about the lab range going to 5.9 since I had read it was changed to 3. She looked at me like I was crazy for thinking that and said she had never heard of that.
I don't know where to go from here. I don't want her to have to get worse before she gets help but I also don't know if these numbers truly warrant treatment.
Thank you so much for reading and I hope someone will respond with their own experience or knowledge of what these numbers mean. Its so hard not to just scream at these doctors every time they mention going to a nutritionalist. The amount/type of food she is eating should not be leading to this much weight gain. She is tall and I will give them the fact that she is genetically predisposed to being on the larger size. But 42 pounds is the 100th percentile and she is 15lbs above that? Like I said, I just don't know where to go from here.
Re: Can someone help me understand my daughter's test results?
I'm no numbers expert (and pediatrics is even more specialized), but you can ask them if they can run a free t3 if you want more thyroid info, but in terms of small children, thyroid symptoms aren't necessarily weight gain (more like lack of growth types of things) from what I remember (my friend's kid who's a giant in height now, stopped growing). The tsh can fluctuate, and it can also go up from pituitary problems.
Maybe there's something else going on, don't just focus on thyroid, when there's a whole big picture thing. There's something up, it may or may not be caused by the thyroid.
I would even consider seeing a geneticist if you can't figure out from a really great pediatric endo.(see another one if you don't like this one)---this could even be some sort of genetic syndrome. There can be soooo many things, that are really hard to diagnose---don't get caught up on one thing. If they treated her at this number for thyroid, with her free t4 being decent, it could make her hyperthyroid, which can also cause apetite increase. Keep searching for a really great doctor.
And she shouldn't be treated on tsh, but the free t4 and free t3, and I wouldn't use a doctor that had the philosophy of waiting until tsh reaches 10 as a policy. You have to keep track of this here, it might take time.