I'm asking for my daughter. We went in because she was pale and always tired. They did a CBC (OK at 13) but they also ran a TSH which came back slightly elevated .4 over the upper threshold. Any ideas on nutritional support? She has thinned out recently and was already thin. She gets retested in 3 months.

What did the differential on the CBC show? Total hemoglobin is just the start--the number and types of white cells, any breakdown in types of red cells, etc are important.

What is she currently eating? Usually hypothyroidism leads to weight gain, not loss, but being high on TSH at that age might be a concern.

I'd suggest an internist or an endocrinologist; they will look more closely at everything.

Wouldn't high TSH be HYPERthyroidism?

No, just the opposite. The pituitary gland is sending out a signal to the thyroid gland, telling it to produce more hormones, thus the elevated TSH. Elevated TSH (thyroid stimulating hormone) and low T4 and/or T3 are the indicators for hypothyroidism. From what most helpful websites (stopthethyroidmadness.com being the best I've found) most people feel better on the lower end of the TSH spectrum. Like under 2. Your daughter was 4.4? Here in Japan, the upper threshold is 4 and that's the magic number in which they usually medicate. I was 4.4 when I was put on medication in March. Before that, I was self treating by ordering natural hormone online. I got myself into a hormonal mess, making myself hyperthyroid with racing heart rates and a TSH that didn't even register on their blood tests because it was so low. So...low TSH is hyper and high TSH is hypo.

Exactly. Mine was around 6 when I was first prescribed Synthroid. But once you have been diagnosed with hypothyroidism, a good endocrinologist will try as FREE commented, to keep you below 2; any rise in TSH with supplementation means that your thyroid is slowing down again, or for some reason not able to keep up with its current demands.

I changed to Armour thyroid after doing some research, because it's desiccated whole thyroid. Synthetic T4 will deal with the TSH levels, but it won't necessarily deal with other symptoms of hypothyroidism.

But, and this is the very important part: your daughter is losing weight, and doesn't show symptoms, even though her readings demonstrate hypothyroidism.

I'd still vote for an internist--one with a subspecialty in hematology (study of the blood) would be ideal--or an endocrinologist (work with patients with endocrine disorders, significantly, thyroid and diabetes).

Oh, OK, we've never had thyroid issues so I had no clue! It would explain why she's cold all the time and tired. No, she was something like 3.95 or so and was supposed to be under 3.57 - I'd have look at the results again to see for sure. Do you know of any nonhormonal natural support - supplements, etc.?

Well, I did take her in for tiredness, lack of focus and being cold all the time. I was thinking anemia. She has lost a little weight but she also swims a lot now (6 days a week) so she is burning off a lot of the "baby fat", not that she ever had too much to begin with. I was thinking anemia but don't those symptoms match hypo, too?

That's the thing: those symptoms match a whole lot of things, and I'd rather know, or at least go to a doctor who has a better background in seemingly mismatched symptoms. Elevated TSH doesn't lead to pallor. And yeah, tired and weight loss could be from the swimming.

But she feels rotten; an FP can screen for the obvious, a hematologist or an endocrinologist can go deeper, because that's what they do, all day long.

I'm not a huge fan of doctors, in general. But when we don't know what's going on, it's better, IMO, to ask someone who has a good chance of finding out quickly. And without KNOWING, I'd be hesitant to try natural remedies for myself or my child.

I just meant things like nutritional support (avoiding brassicas, that kind of thing). She goes back in three months for a retest - I can't get her to a specialist without a referral so we'll just sit tight. It just drives me crazy that she's so tired and blah. She's supposed to be having a "gap year" to pursue her special interests homeschooling in between grade school and high school but she's tired a lot of the time. She's still doing lots of great things but she runs out of steam easily.

Interesting that you mention anemia because I've NEVER had a problem with that until I became hypo. Literally, doctors would tell me to lay off the meat and warn me to not take a multivitamin with iron. Now, I'm getting iron injections. 😔 My internist says they often go hand in hand. Something to do with the brain signaling something or other. Anyway, I was taking Armour, self treating, following all the protocol of other brave souls who have done this before me, and got myself in a mess. It's hard to tell if the rebound from being ripped off of that cold turkey or because of the anemia, but I had severe hair loss over the summer. Now my folate stores and TSH are on target and the tiredness and hairloss have stopped. They actually found the anemia because my TSH is below 1 and yet I was so tired that I actually felt nauseated. I'd almost fall over if I stood up too fast. That's when they realized my iron stores were 30 on a range of 50-150 or so. Anyway, I'd get that checked out when you go to the doctor again.

For thyroid support, I avoid soy as much as possible, living in Japan. My internist in America also suggested taking selenium. But something that might be a big help for you now is a blog that Janet has referenced in a different thread. Her name is Amy and she can be found at Tuitnutrition.com. She's doing a series on weightloss and has a part about thyroid with stuff about nutrition and support. I'm enjoying it and I think it would be good reading for you.

Personally I don't think cooked bassicas are worth avoiding. Most of the goitrogenic stuff gets cooked out of them.

YES: brassicas that are either cooked or fermented are safe. Hence the prevalence of sauerkraut in Germany, where cabbage (the worst of the bunch) was a staple of the diet.

Thanks I will look at that! Even though her count in 13, she's pale and her fingernails don't fill pink easily, KWIM?

Thanks Nancy and Mickisue, that was information I needed. We eat sauerkraut every day practically and otherwise everything is cooked.

I still remember the nutrition class in nursing school, where the dietician who talk the class told us about sauerkraut. She pointed out that a lot of knowledge about what is and isn't good for you is learned over time, without any formal training.

Boy, was she on to something!