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Thyroid Diseases

Does My Daughter Have Hypothyroid Disease?

02/22/2008

Question:

Last week my 11 year old daughter underwent full blood work up including her thryoid. Her TSH came back very high. 4 days later our doctor sent her for a full repeat thryoid blood work. Hypothyroid disease runs in my family, on my mom`s side. My daughter has had many of the symptoms since she was a baby. I finally got her 2nd lab results back Monday except for one. I don`t understand why her Thyroglobulin AB is not back yet. Her T4 looks a little high and now her TSH is fine. I still don`t understand if she has an underactive thyroid or not? Her 1st TSH test was so bad, how could it be fine 6 days later? The thyrglobulin AB result that we are still waiting for is the thyroid antibodies that will determine for sure if she has thyroid disease or not. We are still waiting for my daughter`s thyroid antibodies resutls.

What I do not understand is her 1st TSH test was very high. Her 2nd TSH result was normal. Both blood tests were done only 4 days apart. How or why could the exact same test, 4 days apart be so drastically different? Our family doctor exptects her antibodies results to come back positive, in which case, he will refer us to a pediatric endocrinologist for further testing. What kind of further testing would a pediatric endocrinologist do? Thank you, Mom.

Answer:

The discrepancy in TSH levels within 4 days could be attributed to either technical problems with performing the test or the differences in timing of blood draws rather than a true changes in thyroid status. However, one can not make any conclusion based on your question considering many unknowns, such as, 1) thyroid hormone levels on her first blood draw, 2) magnitude of TSH abnormality in her first blood draw, 3) timing and fasting status of blood draws on two occasions, and 4) type of thyroid hormone (total or free component) reported to be high on her second blood draw.

I have to agree with her primary physician that she would need to see an endocrinologist, who could put the clinical picture and both lab results together and come up with the answer for your questions.

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Response by:

Marzieh  Salehi, MD Marzieh Salehi, MD
Assistant Professor of Endocrinology
College of Medicine
University of Cincinnati