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Old 02-16-2012, 07:38 AM   #1
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Can anyone help with my daughter's lab results

Hello,

I finally got recent labs for my daughter. We are so unhappy with her endocrinologist. I think they have no idea what they are doing. She has been treated now for a year with Synthroid only. She has gained 30 pounds since starting on the Synthroid. She sees a nutritionist, watches her diet and even exercises but keeps gaining weight. She always looks bloated and has trouble focusing in school. I feel like there is more here and they are just not doing anything about it.

When she was first tested these were her results:
TSH-11 Range .6-4.84

I don't have any other labs. The next set of labs were after 2 months on Synthroid:

TSH 4.420 Range .6-4.84
Thyroide Peroxidase (TPO) Ab 446 Range 0-21
Antithyroglobulin Ab 104 Range 0-40
Free T4 1.4 Range 0.65-1.9
Thyroxine T4 10.2 Range 4.5-12.0

Her latest Labs are:
TSH 5.15 Range .50-4.30
Free T4 1.1 Range .9-1.4

They increased her Synthroid from 100-112 mcg. They told me the weight gain is normal, but I am upset. Is my child going to keep gaining weight before they figure this out? I asked them about giving her also a T3 med and they shot me down saying they don't prescribe T3. Please any advice I would be very grateful. Thanks!

 
Old 02-16-2012, 08:34 AM   #2
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Re: Can anyone help with my daughter's lab results

I'm sorry your daughter is going through this. (hugs). How old/young is she if I may ask?

she's still undertreated, the increase is good and needed, but I wonder whether it will be enough. When is another bloodtest scheduled? It's common practice to have the bloodtest rechecked 6-8 weeks after a dosage increase. It takes at least 6 weeks to balance out in the body and waiting longer is lost time.

The symptoms you describe can be thyroidrelated indeed, but that's not to say it's normal. (unless one is undertreated of course). it speaks for itself that as long as one ain't optimal treated, symptoms remain.

do you have the possibility to switch doctors?

hang in there

 
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Old 02-16-2012, 08:43 AM   #3
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Re: Can anyone help with my daughter's lab results

Hi there, thanks for the input. No we can't switch doctors becasue they are the only pediatric endocrinologist in our area. But we found a Holistic doctor that we want to try but he doesn't take insurance so we would have to pay these horendous fees to see him. I don't mind doing it if in fact I get confirmation that her current doctors aren't treating her right. She is 11.

 
Old 02-16-2012, 10:13 AM   #4
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Re: Can anyone help with my daughter's lab results

Have you had her insulin levels checked? Is any of her other bloodwork abnormal?
Most reputable thyroid books that I have read advise against adding T3 because it can reach toxic levels, since her body is already making T3 it is unnecessary and possibly dangerous.

 
Old 02-16-2012, 10:31 AM   #5
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Re: Can anyone help with my daughter's lab results

Hi, yes her A1C is in normal range and so are her fasting blood sugar levels. All of her other bloodwork is fine except that her Vitamin D levels are low and something called her C-Peptide is high?

 
Old 02-16-2012, 11:04 AM   #6
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Re: Can anyone help with my daughter's lab results

Although the weight gain is likely driving you crazy, as it's a lot, maybe you should first focus on getting those thyroid levels right---as lisa stated, she was under-medicated, and with either this dose increase, or perhaps the next, maybe that will improve her "numbers' and then she can worry about the weightr issue.

I think the current doctor is doing the right thing for now in terms of the t4 treatment, as you haven't had free t3 tested, there's no reason yet to believe her body won't have the ability to convert the synthyroid/t4 med naturally over to what her body needs. If you have the free t3 tested in a few months, once she's found a good dose of t4, then you can investigate if she needs anything else.

Once she's at a good dose, hopefully the exercise and good nutrition will get some assistance with a better metabolism, and the weight will start coming off. If it doesn't, then you can look into other autoimmune disorders---because she obviously has hashis, and may have others too---she's also likely starting puberty, and some of these other issues may come out at that time.

Hang in, and keep us posted, hopefully she's on her way to getting the right dose soon.

 
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Old 02-16-2012, 11:09 AM   #7
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Re: Can anyone help with my daughter's lab results

So sorry to hear of your daughter's struggles - it's painful for a mother to be aware of them.

T3 is a lifesaver for those of us with conversion problems.

The old school of thought was that our bodies were capable of converting the T4 storage hormone (in Synthroid) into T3, the active hormone.

Since 20% of conversion happens in the thyroid, those of us with improperly functioning thyroids often have problems with conversion.

The only way to know for sure if your daughter is having problems with conversion would be for her to have a FreeT3 test.

"Thyroid for Dummies" is quite specific about the need to have both the FreeT4 and FreeT3 levels checked.

Your daughter's most recent FreeT4 level indicates the need for the dose increase she received.

Please know that, until our levels are optimized, we can have symptoms (or issues such as weight gain).

I'd be inclined to push the endo for the FreeT3 test to see if she even needs T3 supplementation. We can show you how to interpret the results.
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Old 02-16-2012, 11:29 AM   #8
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Re: Can anyone help with my daughter's lab results

Quote:
Originally Posted by Junip1977 View Post
Hi, yes her A1C is in normal range and so are her fasting blood sugar levels. All of her other bloodwork is fine except that her Vitamin D levels are low and something called her C-Peptide is high?
I think that may be quite telling. Have you discussed the C-Peptide result with your Dr? A quick internet search on high levels of c peptide indicate that insulin resistance could still be a possibility. How high was her fasting insulin level? A level over 10 for an adult indicates some degree of insulin resistance, despite the lab ranges going up to 26. Not sure for a child, I would imagine the range would be less?
Cushings syndrome is rare in children but it does happen. Have you had her cortisol levels checked? People with Cushing's have a very particular appearance, with very round faces and abdomen but skinny limbs.
If you don't mind, can you list her labs so that we can dissect them further? (keeping in mind that none of us have medical degrees, I'm assuming)

Last edited by jaymee456; 02-16-2012 at 11:31 AM.

 
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Old 02-16-2012, 12:27 PM   #9
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Re: Can anyone help with my daughter's lab results

Yes it is definitely a struggle. I see her cry everyday because of her weight and it kills me. I hate when people assume she is heavy because she eats like crap. It is so untrue, especially in her case. I will definitely ask the doctor to have her Free T3 checked next time, and if he says no, I have the lab sheet so I will checkit off myself...already did that to check her cortisol levels which were fine by the way.

Not sure which lab results you would like me post, I posted earlier in the thread all the thyroid related ones. Her fasting gluscose was 89 on a range of 65-99. Her Cortisol was 7.3 on a range of 3.0-25.0, Her A1C was 5.3on a range of anything lower than 5.7 is normal. Other than that, all the other labes are just the typical CBC count, etc and they all came back within normal ranges.

Thanks for everyone's input, you all are very sweet for trying to help!! :-)

Last edited by Administrator; 03-15-2012 at 11:58 AM.

 
Old 02-16-2012, 01:19 PM   #10
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Re: Can anyone help with my daughter's lab results

(hugs) must be hard for you as a mother seeing her struggle like that.
I think her weightgain can be perfectly explained by her undertreated thyroidproblem. truly it's one of the most standard symptoms.
At this point I would not worry too much about it (easier said then done) but first try to get her levels optimalized and then losing weight will become easier. She'll be less emotional too. (as you might know and/or noticed thyroid does play on the emotions, so if she's having rough moments, cry moments or whatever, all that is not uncommon).
once her levels are better, she will feel better.

hugs for the both of you and take care.

 
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Old 02-16-2012, 01:23 PM   #11
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Re: Can anyone help with my daughter's lab results

Quote:
Originally Posted by Junip1977 View Post
I will definitely ask the doctor to have her Free T3 checked next time, and if he says no, I have the lab sheet so I will checkit off myself.
Just in case you don't know this, FreeT3 is often listed as "tri-iodothyronine, free, serum" on lab slips.

I agree that it's best to optimize her levels before addressing anything else - especially since the rest of her bloodwork seems fine.

I remember my doctor questioning my declaration that certain symptoms were being caused by my thyroid. Lo and behold, ALL of my symptoms dissipated once my levels were optimized. (I am fortunate that I have no other health issues that could make things confusing.)

You're doing the right thing, mama.
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Old 02-16-2012, 01:28 PM   #12
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Re: Can anyone help with my daughter's lab results

Thanks Lisa! :-)

 
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