My 10 year old daughters last TSH came in at 1.82 and the endo doesnt want it to be any lower until we run some other tests and see if something else could be the cause of her symptoms which are low energy, low stamina and endurance, weight gain, tiredness, puffy face, constipation. She has ordered: 8am Cortisol, ACTH, TT6, IgA, ESR, rheumatoid factor and ANA. What can expect to learn from these tests? Thanks in advance!

Cortisol is for Addison's disease (or adrenal issues). ESR, ANA and Rheumatoid factor are for various autoimmune diseases.

Have you tried putting your daughter on an elimination diet? I run into a lot of people who those symptoms represent food intolerances.

I havent tried eliminating anything from her diet. I wouldnt know where to start. Is there a guide available somewhere? I will try to see what I find online. Thanks!

I stumbled on this thread on accident and am really curious as to the outcome. I had very low TSH about 5 years ago - numerous tests put me basically at 0. I was on some medicine for sleep and depression at the time. I'm not sure whether I had these issues because of the thyroid issue or not - but about a year after that I wasn't taking the medicine anymore and my tests came out good. So, I was thinking maybe the medication had something to do with lowering my TSH. (FYI I was on Ambien and I think Zoloft at the time).

Basically, I quit investigating the low TSH because I got bounced around to 2 or 3 endocrinologists trying to figure it out, and they were basically making me wait 2 to 3 months for an appointment since they were specialists and apparently I wasn't an emergency. It was a strange time because my regular family doctor wanted my thyroid out but the specialists couldn't really make up there mind. Anyway, sorry, long story - but I really am interested in what causes low TSH and if there are any medicines she may be on that can cause it?

Anyway, I'm not sure if my post is completely on topic, I just saw something about the low TSH and wanted to jump in - but I don't know what your daughter's background is or if she's already been diagnosed with any Thyroid disease.

Take care,

-Matt

SCD is a good place to start. It eliminates a lot of problematic foods all at once and lets you experiment with adding them back. It is a little labor intensive as they don't really trust commercial "products" that would ordinarily be allowed.

A Paleo diet eliminates most of the problem foods too like dairy, grains, soy, legumes.

I'd start with dairy and grains and go from there. People have had some remarkable turn arounds with just that, like me!

1.82 isn't low. In fact, in some people it might be a tad high. The cut off for TSH is under 1, but not exactly sure where.

Here are the results of her labs...the ones we have back. 8am Cortisol was 8.4 with ranges 6.2-22. SED rate was 2 with range of 0-20 and negative for rheumatoid factor. Any insights?

Nope. Sorry. ANA will be important. I don't know a whole lot about cortisol other than you'll feel like pooh with too little or too much. I do think that fatigue is a big part of any autoimmune disease.

Has her ferritin (i.e. iron) levels been checked?

You might want to try to get a referral to a rheumatologist. Maybe the endo will refer you if anything comes back suspicious.

I was impressed with my rheumy, he seemed more in tune with checking things outside his speciality, like my D3 status and thyroid levels, than I've seen other specialists do. They have a tough job trying to figure out autoimmune diseases, a lot of times they're very mysterious.

She did check her ferritin last summer and it was 22 and her iron was 100. She seemed okay with those results.

You might want to double check on the ranges for those. Sometimes what passes for okay isn't really optimal.

Do have free T3 and T4 testing results? TSH is an indirect measure of thyroid, its better to have the actual hormone levels tested. All the symptoms you're describing are thyroid. You can get the testing done for $100 at www.healthcheckusa, if your endo is against that for some reason.

I was diagnosed with a sluggish pituitary, the gland that makes tsh. At one time my tsh was 0 but one of my thyroid hormones was still below normal.
I've found endos to be a waste of time and money. I have no respect for the way most of them treat diabetes or thyroid! I always go to my regular dr whose goal isn't necessarily to understand how and why my body is left of normal, but how to fix it. Most of the time thats meant experimenting, and taking limited risks.

She tests her tsh and free t4 every 8 weeks and the last free t4 was 1.32. She has been pretty good about listening to me and she seems reluctant to lower her tsh anymore so that is why we are testing other things to see if they may be contributing to her symptoms. I would rather stick with my pediatrician but she feels more comfortable with her seeing a pediatric endo. As long as the endo will listen to me, I will stay with her. I have another one picked out if I become unhappy with her. I am just glad we are checking out some other reasons for her symptoms.

I wish endo's would be willing to let people become a little hyperthryoid on medication for a couple of reasons:

1) It's very unpleansant (at least it was for me) and you aren't likely to want to stay that way.

2) Being slightly hyperthyroid isn't dangerous for a short while

3) If you were under medicated and you feel better with a higher dose, and not hyperthyroid, then you've solved a lot of problems.

I would like for her to be slightly hyperthyroid too but she is worried about osteoporosis. From the studies I have read, there is no conclusive evidence to support this and those studies that did show bone loss were in post menopausal women. I am prepared to discuss that with her after all the testing comes back.

Even if it was true, you have to be ALOT hyperthyroid, not just mildly so, and for a long, long time.