What do these blood test results mean? Anemic/thyroid

[omehelpplease38]

Long story short:

daughter (age 3) has subclinical hypothyroidism and is being monitored and not treated until it reaches 10. TSH have been 8 then was 6 at 3 months later.

Serum ferritin was within normal range 23 (13-150) , but Serum Iron was low 8 (60-170.)

Was put on iron and have been for 3 months. Doctors told to re-test, didn't test for serum iron, but only serum ferritin which was 48 now. My question is: don't we have to test serum iron as this was the abnormal one and ferritin was within range? They said it was the same. Surely not?

She suffers from chronic constipation so my concern is that iron is not properly absorbed. We are re-testing thyroid next month. She has had the celiec test which was negative.

Is low iron and normal ferritin linked with thyroid issues?

Getting very little help from our GP so any insights are much appreciated.

Can I just check that your daughter is only 3. If so, you need a referral to a paediatric endocrinologist rather than messing about with this GP.

She may well have autoimmune thyroiditis, in which case her TSH will fluctuate and could take a long time to reach 10, when it has almost certainly already been outside of the lab range for some time.

Low iron and ferritin are definitely linked to thyroid issues and constipation is a classic symptom. Serum iron and ferritin are not the same sigh

I'd ask for a referral. .

Have they tested her for thyroid antibodies? This would indicate autoimmmune thyroiditis (aka Hashimoto's disease)?

People with Hashi's often really struggle with vitamin and mineral absorption and are also at risk of other autoimmune issues, such as coeliac disease. A proper diagnosis should be made, so that your DD will be monitored.

Her ferritin is really low - even though it is in range, and given that her serum iron was also so low, this should be investigated further. Did the GP test her B12 and folate?

She should definitely be investigated further, so ask the GP for a referral.

Thanks for your quick replies, much appreciated.

We have been referred to a general paed, but they wouldn't refer us to a paed endo as TSH was under 10. (We put up a fight, but got nowhere.)

She has been on stool softeners for 6 months now and it's the only thing that helps. They took very lightly on the fact she was constipated and said it was common in toddlers. Since starting solids she's only had pebble poos. We are seeing the general paed again next month to re-check bloods re thyroid.

They did test for thyroid antibodies, they did the full thyroid check eventually and only TSH was out of range. Actually, B-12 was high at 820 (197-771.) Folate was 20 (3.8 - 9999 .)

We tried a strict gluten free diet for 2 months to see if it helped the constipation and there was no change.

If they won't do anything, can you afford a private paed endocrinologist (around£200) for advise? She needs her ft4, ft3 and antibodies tested. You can go through medichecks or similar and get the nhs to draw the blood on her next blood test to send off to medichecks. This sounds really poor from the GP.
Oranges can help with constipation btw.