TSH high, else is perfect. What can it be?

amother

Periwinkle

Fri, Oct 09 2015, 11:06 am

After full thyroid panel blood test the TSH is high but the other numbers are perfect. Weird. The pediatrician says to wait 6 months and repeat blood work. He doesn't think it's important to see a pediatric endo. I'm surprised. I do want to get a pediatric endo (second) opinion.
Has anyone here had such or similar experience with a young child?

amother

Jetblack

Fri, Oct 09 2015, 4:15 pm

I have two kids who were diagnosed with hypothyroidism as young children (3-4 years of age). They started getting more tired, had issues with constipation, and my daughter kept complaining that she wasn't feeling well. When comprehensive blood work was done, TSH was high, but everything else was normal. They were diagnosed by pediatric endocrinologist and put on meds right away. Just keep in mind that it's normal for very young babies to have elevated TSH levels. I would definitely ask for a consult with an endocrinologist if it's an older baby or child, since side effects from untreated hypothyroidism could be pretty severe. Let me know if you have more questions, I'll PM you.

PinkFridge

Sun, Oct 11 2015, 9:08 am

bnm wrote:

constipation can be an issue related to thyroid? why has no one told me that one yet?

It can be a symptom of hypothyroidism. Just like rapid digestion/diarrhea can be a symptom of hyperthyroidism.

I don't know what pediatric TSH levels are and, if like adult levels, the official levels are not the best ones for your doctor to use. On the one hand, waiting and testing again isn't unreasonable. OTOH, why did you have a thyroid panel to begin with? What symptoms were presenting? What exactly are the other numbers - are they midrange or at the bottom?

If your child's suffering, maybe you should see a pediatric endocrinologist. And it might take a while to get in, so maybe you should look into recommendations already.

bnm

Sun, Oct 11 2015, 11:55 am

The kid is chronically constipated and was due for his full round of bloodwork- the gastro does it every 6 months to a year. TSH I think came back just over borderline. The pediatrician and gastro said its nothing. I'm going to request a retest. I don't have the numbers in front of me anymore.

PinkFridge

Sun, Oct 11 2015, 12:03 pm

bnm wrote:

(Breathe in, breathe out, Fridge)
Do you just have a TSH? What are the ranges given for normal? I don't know what pediatric ranges are but you can google the TSH wars and see what the kerfuffle is for adults. What happens is, doctors will do a TSH, if it's at all in the normal range they don't go further. The problem is that the ranges given aren't optimal. It's known that people can be hypo even with a TSH lower than 5. (Or even 3, as some labs are a bit more forward and have lowered the ranges.) But if it doesn't come flagged the doctors won't do further testing.

I'm not saying that your son is definitely hypo, it might not be thyroid at all, but unless the proper tests are done and properly interpreted, you can't rule it out.

bnm

Sun, Oct 11 2015, 12:35 pm

it came flagged as red with limits being 4. something and it was just a bit above that, hadn't reached 5. I'm going to ask it to be redone and if its still at that point I'm going to take him to an endocrinologist.

amother

Periwinkle

Sun, Oct 11 2015, 5:52 pm

amother wrote:

Op here.
Thanks for your reply. How did you go about finding a Dr?

PinkFridge

Mon, Oct 12 2015, 7:55 am

amother wrote:

The TSH was over 5.

And what were the T3 and T4, and what are the ranges the lab gives for normal for the Ts?

I'm googling pediatric TSH range. For some reason I'm not getting lots of results but did see one site that put the upper limit at 6.4. I have no idea what really good doctors say. I know that the good doctors for adults recognize that if presenting with symptoms a patient can be hypo even with a TSH of 2. So I would assume that there may be some moves in that directions in pediatrics too.

amother

Periwinkle

Mon, Oct 12 2015, 8:23 am

PinkFridge wrote:

I'll check the other numbers soon when I have a chance but I do remember that the TSH normal range was in the low 4's.

amother

Jetblack

Mon, Oct 12 2015, 9:16 pm

Ranges might be different from lab to lab, but not significantly.
Here are the last labs from my kids:

4 year old
TSH 0.70 - 5.90 mIU/L 1.95

8 year old
TSH 0.70 - 5.40 mIU/L 2.80

The first set of numbers is normal range., the bolded number is their result. Our endocrinologist likes the numbers to be in the middle or a little on the lower side. However, as you can see the normal range is in the mid to higher 5s depending on age.

I live next to one of the best children's hospitals in the country, so I just went to endocrinologist there. I would look for a children's hospital nearby to find a good specialist.

PinkFridge

Tue, Oct 13 2015, 7:51 am

amother wrote:

The numbers aren't bad, though I wonder how the 8 y.o.'s fits with past results.
And more, do you have numbers for T4 and T3? A doctor can't medicate totally to get an optimal TSH, s/he needs to look at how much thyroid hormone is actually circulating.

And I'm concerned about an endo who wants the TSH in the upper range. Maybe there's something I don't know about pediatrics. (A lot I don't know Wink

but ykwim.)

amother

Periwinkle

Tue, Oct 13 2015, 10:40 am

Op here.
These are the numbers

FT3 = 4.1 (3.4-5.1)

FT4 = 1.2 (0.9-1.6)

T4 = 9.5 (5.6-14.9)

TSH = 5.17 (0.50-4.30)

It's a 2 1/2 year old child.

The pediatrician rolled his eyes at me for insisting to get the full thyroid panel test. You know the 'nah don't worry testing the T3 and TSH are enough' song?

Anyway... I'm on the hunt for a pediatric endo.
I need to clear things up

amother

Periwinkle

Tue, Oct 13 2015, 10:42 am

amother wrote:

Op here. Would you mind sharing which Dr you see? Or is that asking too much..

PinkFridge

Tue, Oct 13 2015, 11:24 am

amother wrote:

T3 and TSH? Not T4 and TSH? Generally it is enough. It's good to get T3 tested occasionally. Most people will not need T3 replacement - the thyroid converts T4 to T3. But sometimes people do need T3 so it's good to be aware of it. At least he doesn't go by TSH alone.