daughter's thyroid lab results? Concerned

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Megan Eliz
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Date Joined Apr 2013
Total Posts : 59
   Posted 2/6/2018 1:08 PM (GMT -6)   
My DD age 10 is being treated for chronic Lyme and two co infections.  I have some concerns about her thyroid results from December 2017 and was looking for opinions from others with experience. I know Lyme can mess with the thyroid.

I trust her LLM doctor and he says its nothing to be too concerned about . She does not seem to have any thyroid related symptoms.  Not sure if ranges are different for children   Done at Quest labs. This is the latest results. 

I have other blood work from the past year.  She has tested positive for the thyroglobulin antibodies on other tests.  Highest positive was 10 on the tests before this one in July 2017

THYROGLOBULIN ANTIBODIES 6 H     < or = 1 IU/mL
THYROID PEROXIDASE ANTIBODIES 1 <9 IU/ml
TSH 2.71        0.50-4.30 mIU/L
T4, FREE 1.0    0.9-1.4 ng/dL
T3, FREE 3.8     3.3-4.8 pg/mL 
T3 REVERSE, LC/MS/MS 10      8-25 ng/dL
T3 UPTAKE 32     22-35 % 
T4 (THYROXINE), TOTAL 5.9    4.5-12.0 mcg/dL 
FREE T4 INDEX (T7) 1.9          1.4-3.8
VITAMIN D,25-OH,TOTAL,IA 24  L    30-100 ng/mL

Iron, B12 were in range

Girlie
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   Posted 2/6/2018 1:26 PM (GMT -6)   
At a glance her TSH, FT4 and FT3 looks good.

Looks like she does need some vit D supplementation, though.

Hopefully Astroman - who is thyroid lab savvy will comment.
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Symp started April/2013; Buhner's Lyme May 15-July24/14; Igenex pos. July 3/14
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Megan Eliz
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Date Joined Apr 2013
Total Posts : 59
   Posted 2/6/2018 2:15 PM (GMT -6)   
I should have stated that it is the thyroglobulin antibodies that I am most concerned about. I was wondering if any one knew if her number (6) is high or just above the range and if I should start adding a supplement for her thyroid.

Also she is on Vitamin d3 supplement.

Traveler
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   Posted 2/6/2018 2:27 PM (GMT -6)   
Seems you are correct in being concerned about that. I found this article, from a Pediatrician and I believe you will find it helpful for referencing all the lab values: www.peirsoncenter.com/articles/pediatric-thyroid-reference-ranges

Specifically on the thyroglobulin antibodies: "TgAb (Thyroglobulin antibodies) - < 4.0 IU/mL"
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astroman
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   Posted 2/6/2018 4:10 PM (GMT -6)   
Megan Eliz said...
  She has tested positive for the thyroglobulin antibodies on other tests.  Highest positive was 10 on the tests before this one in July 2017

THYROGLOBULIN ANTIBODIES 6 H     < or = 1 IU/mL
THYROID PEROXIDASE ANTIBODIES 1 <9 IU/ml
TSH 2.71        0.50-4.30 mIU/L
T4, FREE 1.0    0.9-1.4 ng/dL
T3, FREE 3.8     3.3-4.8 pg/mL 
T3 REVERSE, LC/MS/MS 10      8-25 ng/dL
T3 UPTAKE 32     22-35 % 
T4 (THYROXINE), TOTAL 5.9    4.5-12.0 mcg/dL 
FREE T4 INDEX (T7) 1.9          1.4-3.8
VITAMIN D,25-OH,TOTAL,IA 24  L    30-100 ng/mL

Iron, B12 were in range


thyroglobulin antibodies - have history and current high levels; might be start of hashimoto, but its not very high at all, keep an eye on it. Dairy free and glutan free are sugested in hashimoto, then re-test antibodies after three months.

T4, FREE 1.0 0.9-1.4 ng/dL - very close


Per Travelers link- "Given the negative feedback loop that occurs between TSH and T4, endocrinologists have been using TSH levels only to assess the health of the very complicated thyroid hormone process for their patients. This has resulted in many patients who still experience symptoms of hypothyroidism but are told by their doctor that they don't have hypothyroidism." - Good thing they recognise this fact

Megan Eliz
Regular Member


Date Joined Apr 2013
Total Posts : 59
   Posted 2/6/2018 4:16 PM (GMT -6)   
Thank you every one. Sometimes I feel I am overreacting and overanxious with her health since she has a history of illness and we only figured out it was Lyme and co infections in late 2016. I tend to overanalyze everything too.

I know her Lyme doctor (Dr J from CT) is an excellent doctor. One of the best and I know he goes over all her blood work.

I thought since her thyroglobulin antibodies was not that far above the cut off maybe it was a wait and see thing but I was not sure if having any number for antibodies meant she had Hashimoto. And I know Lyme can mess with all parts of the body.

Post Edited (Megan Eliz) : 2/6/2018 3:22:47 PM (GMT-7)


Megan Eliz
Regular Member


Date Joined Apr 2013
Total Posts : 59
   Posted 2/6/2018 4:34 PM (GMT -6)   
astroman said...
Megan Eliz said...
  She has tested positive for the thyroglobulin antibodies on other tests.  Highest positive was 10 on the tests before this one in July 2017

THYROGLOBULIN ANTIBODIES 6 H     < or = 1 IU/mL
THYROID PEROXIDASE ANTIBODIES 1 <9 IU/ml
TSH 2.71        0.50-4.30 mIU/L
T4, FREE 1.0    0.9-1.4 ng/dL
T3, FREE 3.8     3.3-4.8 pg/mL 
T3 REVERSE, LC/MS/MS 10      8-25 ng/dL
T3 UPTAKE 32     22-35 % 
T4 (THYROXINE), TOTAL 5.9    4.5-12.0 mcg/dL 
FREE T4 INDEX (T7) 1.9          1.4-3.8
VITAMIN D,25-OH,TOTAL,IA 24  L    30-100 ng/mL

Iron, B12 were in range


thyroglobulin antibodies - have history and current high levels; might be start of hashimoto, but its not very high at all, keep an eye on it. Dairy free and glutan free are sugested in hashimoto, then re-test antibodies after three months.

T4, FREE 1.0 0.9-1.4 ng/dL - very close


Per Travelers link- "Given the negative feedback loop that occurs between TSH and T4, endocrinologists have been using TSH levels only to assess the health of the very complicated thyroid hormone process for their patients. This has resulted in many patients who still experience symptoms of hypothyroidism but are told by their doctor that they don't have hypothyroidism." - Good thing they recognise this fact


you wrote very close. Did you mean close to under range or close to Hashimoto?

astroman
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Date Joined Mar 2014
Total Posts : 4879
   Posted 2/6/2018 9:11 PM (GMT -6)   
(I have no idea why my reply turned out bold)

Yes she has Hashimoto hypothyroid at the time of this test. But- just barely, and why a Dr would not suggest thyroid hormone supplement yet.

A smart Dr would suggest a re-test in less than three months.

The turning point to Hashimoto is gradual. Like water temperature going from cold to hot, there is all that area between the two.

T4, FREE 1.0 0.9-1.4 ng/dL (the very end of the low limit is .9; she is at 1)

She is on the edge of being hypo with the low but in normal range of Free T4 hormone at 1.
Probably is more hypo some days, less hypo other days, it changes a little day to day.

Technically, she has a slight case of Hashimoto right now - high antibody levels are what separate hashimoto hypothyroid from regular hypothyroid.

This right here is Hashimoto: THYROGLOBULIN ANTIBODIES 6 H < or = 1 IU/mL;
Thats why it has an "H" for high.

Its not very high, but its over the limit of the range performed on the specific test instrumentation/machine used at that lab. Different brands of test machines have different ranges for antibodies.

If her levels gets worse, more hypo, the pattern you will most likely see Is: The antibody will go higher making the free T4 fuel hormone go lower, which turns up the tsh signal higher as well.

**Since its not that bad, it might just clear up on its own as lyme gets better. But makes sense to monitor by retesting the antibody and free T4 occasionally.**

Post Edited (astroman) : 2/6/2018 8:15:17 PM (GMT-7)


Megan Eliz
Regular Member


Date Joined Apr 2013
Total Posts : 59
   Posted 2/6/2018 10:22 PM (GMT -6)   
thank you. Can you just take a quick look at her other tests. She gets blood work every 3 to 4 months with her Lyme doctor (Dr. J in CT). The blood work I posted was from December 2017

July 2017

Free T4 1.1 0.9-1.4 ng/dL
Free t3 3.7 3.3-4.8 ng/dL
t3 reverse 10 8-25 ng/dL
TSH 2.95 0.50-4.30 (ages 1-19)

Thryroglobulin antibodies 10 H (range is less than 1)

October 2016 (this was her first set of labs with Dr. J before any lyme treatment) These were the only thyroid tests that were run.

T3 uptake 36H 22-35%
T4 total 6.5 4.5-12.0 mcg/dL
Free t4 index 2.3 1.4-3.8
Thryroglobulin antibodies 5 H (range is less than 1)


I know numbers can vary but is there a pattern I am missing that or is it really just a wait and see?

She goes back in March and will most likely be retested for

astroman
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Date Joined Mar 2014
Total Posts : 4879
   Posted 2/6/2018 10:32 PM (GMT -6)   
The pattern is her T4 level is getting lower. At least its doing this gradually and real slow.

That high antibody is "roller coastering" - not uncommon in the beginning of antibody activity.

When different ranges are used, you can still compare if you think of it as a percentage.

Try to use the same labs that test "Free T3 and Free T4". Not uptake, index ect
Had initial lyme symptoms late 80's, then again and with bullseye early 90's. Ended ABX for Lyme in 2015. Rebuilding / fine tuning / fixing muscles since then; member "10 Percenters Lyme Club". What an adventure this has been. Hashimotos adds to the enjoyment.
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