Quick Q re thyroid blood tests- any experts about?

[SirVixofVixHall]

DD (12) was recently diagnosed with Hashimoto's, we're still at the stage of getting her levels back to normal. She has bloods due tomorrow am but they clash with a school test. I'd read that one should have bloods as early in the morning as possible, she wouldn't be able to go and get them done until midday, unless she misses the test. Does it make a difference?

bumping in hope

TSH is higher first thing, fasting. But you probably shouldn't miss the test unless you can get another one soon. Just be aware that TSH would have been higher earlier. Make sure you get to see the results to see where her TSH and FT4 are in the range. Normal range isn't the same as optimal. For an adult with hypothyroidism the aim is around 1 for TSH and upper quarter of range for FT4. It's how she feels that counts most though.

Thank you. She had the bloods done at about 9.30 am and went into school late. Last tested four weeks ago when her TSH was 50 , she had her thyroxine upped again then and so I'm hoping it will be looking better. She is still exhausted and foggy. It is early days. She has a goitre, it is definitely smaller.

Wow. Poor girl. Hopefully they'll test her regularly to get her optimally medicated. Definately best to tedt the same time each test so you can compare results.

Ok, thanks, that is a helpful thing I hadn't thought of. Her TSH was over 100 six weeks ago ,with very low T4, she has been so unwell. Hopefully we'll get the results today.

Have posted a different thread re her results, but anyway, here they are
TSH 2.45
T4 15.6
T3 6.9
Ferritin 27
B12 442
The vitamin D result isn't back yet.

Her ferritin is pretty low, but in 'normal range'. You can get gentle iron for that. It's low enough to cause fatigue. If she starts her periods, her ferritin will drop further so its good you know her current level.
Her TSH is a lot better. That must be reassuring. I don't know about teens, but for adults on thyroid replacement the aim is around 1 for TSH and upper quarter of range for FT4. FT3 looks good. I wish I could get mine that high! FT4 and FT3 have different roles so you want both high in range. I hope she's beginning to feel better, that's the most important thing.

Yes I agree her ferritin is too low. Mine is lower, 22, and I feel half-dead all the time. (I am also hypothyroid). She's on the Solgar gentle iron, her periods started yesterday. What would be ideal for T4? Good to know her T3 looks good. She's still so tired and foggy-brained though. I just want her to feel well again.

It would be good to get her vit D results. My DDs was 31 and it's really effecting her with tireness and brain fog.

Im no expert, but i believe you need top quarter of the range for FT4 so around 20+. I imagine they'll up her dose, which might just do it for her, especially if ferritin improves and vit D is optimim of around 100.

Has she had any itching since this all started? My DDs results were low with FT4 at 14 but her TSH is low. She's got this awful itching though which might be a reaction to vit D supplements but I wondered if your DD has it as I've heard you can get it with hypothyroidism?

Yes, itching, covered in hives, particularly at bedtime. I had hives too a few years ago but they have subsided now.

I think she does need a slight dose increase, but the paediatrician said they'd aim to get her TSH to "under 10", so whether they will agree to her slightly upping the levothyroxine I don't know. Maybe she needs 100/75 alternate days?

The under 10 suggestion is very out of touch with modern thinking! Even the ranges go from 0.5 to 4.5 and once on replacement, people have to find a dose that makes THEM well. Advise is that it's likely to need to be under 1. I'm now at 0.35 but not quite well as I need my T3 meds increasing as I don't create enough FT3 without additional help. You might need a different endo if they arent going to treat her on her symtoms. Blood tests are a good guide but it's how you feel that really matters.
Thanks for info on itching. That's my concern now with my DD🙁

Just wanted to say that i gave my daughter antihistamines for a couple of days and her itching has stopped! I just hope it doesn't come back.

Oh that's good. My dd's hives are slightly better this week. Like me she doesn't tolerate anti-histamines well, which makes it a bit trickier. I hope your dd remains itch-free!