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Post by Lethal Lee on Feb 28, 2009 11:15:03 GMT -5
Had daughter's labs checked recently:
TSH=2.25 (.5-4.30) free t3=3.7 (2.5-5.7) free t4= 1.1 (.9-1.5) TPO= 32 (<35) thyroglobulin <20 (<41)
Feb 08: TSH=3.24 free T3=4.7 free T4=1.3 TPO=<10
symptoms: poor stamina, heat and cold intolerance, raynauds, psoriasis, cold hands/feet, hypoglycemia, headaches, acne, weak, fool allergies, dry skin.
Family history of Hashi's and Psoriasis.
Does having antibodies mean she has Hashi's? Over the last year it looks like her thyroid is not functioning as well. Got the famous call that her "labs were normal". Made an appt to go in to follow up. It is a DO and she has me on HC and Armour. Hope to get my daughter on armour.
any thoughts?
thanks, Julie
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Post by julie2 on Mar 1, 2009 11:29:29 GMT -5
Lethal Lee,
Just curious about the antibodies...do most people without Hashi's have no antibodies or very low numbers? Would you agree that 32 for a child means she has Hashi's? All I know is my antibodies have always been elevated. I don't get to see non-Hashi labs so just wondered what they look like.
I hope the doctor will try her on armour just to see. What are your thoughts? Thanks.
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Post by Lethal Lee on Mar 1, 2009 15:32:48 GMT -5
Hi Julie,
How old is your daughter?
Yes I would certainly say she has Hashis. Many Docs & probably all Endos wouldnt agree with me though. They think its fine to wait until Abs have destroyed 80-90% of your Thyroid before considering treatment!!!!
Antibodies will fluctuate & sometimes wont be there at all. In fact low Abs may mean there is little tissue left to attack!! NOT saying that's the case just pointing out that having a "range" and saying you only have Hashis when that range is exponentially exceeded is lunacy!!! In fact you can have Hashis & NEVER have a positive serum result. They know that by autopsy studies.
Your daughters TSH is suspect & her FT3 suboptimal. I'd say the Abs are interfering with TSH feedback as I note that TSH is higher when Frees were higher. And with family history too yes she looks Hypo & Hashis.
Her symptoms sound mainly Adrenal more so than Thyroid related. However there is symptom overlap too. Low Adrenals will also impact Thyroid of course & vice versa..
Heat/cold intolerance, headaches- low Aldosterone & electrolyte issues (Sodium/Potassium) hypoglycemic, allergies, psioriasis, poor stamina, weak- low Cortisol dry skin, cold hands/feet - hypothyroid acne - sex hormones imbalances, digestion issues (Hypot)
I would strongly suggest testing Adrenals before starting Thyroid meds. Can you get Saliva ASI testing done (4xCortisol & DHEA). An 8am Cortisol & ACTH would be good as well.
Whats her basal temp & av daily temps like? What about BP & HR at rest & then standing? If BP falls then also suggests Aldo/Sodium issues. Need Aldosterone, Renin, Sodium & Potassium to check that out.
However if she has had Complete Metabolic Profile done please post that. That is both Liver & Kidney tests & will include Sodium & Potassium. We can look at values & see if Aldo testing is needed.
With Hashis, Psiorisis & food allergies I would also be getting Celiac & Adrenal Abs (Adrenal Cortex Abs & 21-Hydroxy Abs) tested . Having one auto-immune condition predisposes one to more.
She should also have Ferritin (Iron Profile is preferable if Doc willing), B12, RBC Folate, B6, Vit D (25-OHD). Important these are done & supped if needed before Thyroid meds too.
Hypoglycemia is often related to low Cortisol. Need Cortisol to transport Glucose to where its needed. I suggest Fasting Glucose, Fasting Insulin & hbA1C be tested to rule out any blood sugar issues & check for Insulin Resistance.
Other general tests good to have are CBC & ESR (check for Amemia, inflammation, infection) & often done with Iron Profile (Iron, Ferritin, TIBC, Saturation). Also Lipids (Cholesterol, LDL, HDL, Tri's).
If you have any of these tests already please post (with ranges). In fact post ANY Labs you have all will provide extra info & may prompt more suggestions.
If you need to prioritise tests start with the Saliva test & 8am Cortisol & ACTH. If she is young is better & easier on her to just get all tested at once. Not always possible I know.
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Post by julie2 on Mar 1, 2009 16:31:29 GMT -5
Wow, thank you. Daughter is 12, will be 13 in July. No period yet but definitely any time...that is if hormones are working...
Labs from last year: Sodium 139 (135-145) Potassium 4.5 (3.5-5.2) Chloride 103 ( 96-110)
urea (bun) 11 (5-25) creatinine .71 (.60-1.10) Bun/creat ratio 15.5 (10-28)
Albumin 4.7 (3.8-5.4) ALT 36 (2-35) AST 36 (10-41) Lactic deyhyrdogenase 220 (130-300) Bilirubin .2 (.2-1.3) Protein, total 7.6 (5.7-8.0)
glucose 92 (65-99) fasting
cholesterol 117 (<170)
iron and TIBC 82 (28-136) ferritin 36 (9-120)
celiac disease <3 (<5 negative)
IgA 287 (64-246) IgE 926 (<201)
Vit D 25OH 42 (20-100)
I did order a saliva test. My husband lost his job (x 4 months) so I am the only one working. Not sure I can swing the $100 yet but do plan on doing that first thing. Trying to use insurance as much as possible until more cash flow available.
We are starting back up the supplements. She can swallow pills finally! We are doing vit D, zinc (rec for psoriasis), iodoral, B vitamins, probiotics, fish oil. Let me know what else you see. Looks like iron and celtic sea salt is needed.
Did I mention my daughter is very thin...she is jumpy and nervous a lot. Worries and can be intense. Any chewing noises disturb her. Does sound adrenal... I know I was not balanced when pregnant with her. Poor thing-she was under 7 lbs at birth. She has many food allergies! She also puts ice on her neck, head at night during the winter, says she is hot.
I was on heparin with my second daughter due to thick blood, she is much healthier too! she was born at 9 lb 2 oz too.
Thank you for all your time!
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Post by julie2 on Mar 1, 2009 16:43:01 GMT -5
Folate 18.9 (3.1-17.5) B12 1292 (243-894)
I have MTHFR 6777. I wonder if she does too.
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Post by Lethal Lee on Mar 4, 2009 10:19:23 GMT -5
Hi Julie
Daughter is 12, will be 13 in July. No period yet but definitely any time...that is if hormones are working...
Is she showing signs of developing yet? Like groin & pit hair, curves, breast development? I would get Sex Hormones tested too if Doc will agree. The Androgens in particular are helpful to know as they are ADRENAL Hormones too
•Hormonal Panel FSH LH Estradiol (E2) Estrone *available USA Estriol *available USA Progesterone LH/FSH Ratio
•Androgens Panel (early 8am fasting) Testosterone SHGB FAI DHEAS Androstenedione Free Testosterone
----------------------------------------------------------------- Kidney Tests Sodium ............139 (135-145) *too low optimal~144-146 Potassium..........4.5 (3.5-5.2) *slightly low optimal~5 Chloride............103 (96-110) Urea....................11 (5-25) Creatinine .......0.71 (0.60-1.10) Bun/creat ratio.15.5 (10-28)
Comments: Sodium is WAY too low. May indicate Salt wasting caused by low Aldosterone. Sea Salt supping will be benificial. As long as it doesnt cause too much urination and/or diarreah.
Does she have a problem with headaches, heat intolerance, gets dizzy if stands suddenly, urinates frequently, gets up in night to pee, Salt cravings, thirsty?
If any of the above are troubling her & the Salt doesnt help enough then the Aldosterone, Renin, Sodium & potassium test is needed. -------------------------------------------------------------------------- Liver Tests Albumin..............4.7 (3.8-5.4) ALT......................36 (2-35) AST.....................36 (10-41) Bilirubin..............0.2 (0.2-1.3) *bottom of range Protein...............7.6 (5.7-8.0)
Comment: All looks OK except the Biliribin. This is needed for bile production. Does she have any issues digesting food? Get wind, cramps, bloating?
If so some digestive enzymes may help. Stomach Acid may be low HCl (Hydrochloric Acid) is often included in digestive enzyme supps too. Take them just before each meal. The cheaper ones are the ones that have plant derived enzymes. They are fine if you tolerate them. If not tolerated Pancreatic enzymes (animal derived usually Porcine) are superior but more expensive.
Alternatively some find Apple Cider Vinegar heavily watered down works well for Stomach Acid deficiencies. Can take some getting used to. Again need good quality one like Braggs to benefit. --------------------------------------------------------------------- Blood Sugars Glucose Fasting....92 (65-99)
Comments: Maybe getting a bit on high side. If do blood sugars again get Fasting Insulin with the Fasting Glucose. To really know if an issue a hbA1C is good (shows last 3 months "history").
Note IF she has Adrenal problems & low Cortisol then Insulin Resistance is common. Cortisol is needed to get Glucose to cells. With treatment this improves.
Try to cut out Sodas as high in Phosphoric Acid (eats bones) & sugar. The low sugar ones are WORSE as use Aspartame & other nasties.
Go easy on highly refined sugar & white flour products. --------------------------------------------------------------------- Lipids Cholesterol.........117 (<170) *far too low
Comments: Cholesterol is what all Adrenal Hormones are made from. If this is low then hard to have optimal Adrenal hormones levels. Look at diet. Are you all eating plenty of good fats? Avoid transfats & vegetable oils EXCEPT Virgin Olive Oil.
Organic Coconut Oil is VERY good for cooking & great for supplement if you find one that tastes good. Is not destroyed by cooking. Also great for hair conditioner, skin moisturiser, and for sun exposure.
Avocados, eggs, red meat all good sources of quality Cholesterol. --------------------------------------------------------------------------- Iron Labs TIBC......................82 (28-136) Ferritin..................36 (9-120)
Comments: The above is part of an Iron Profile. Where is the rest? Should have Iron , Saturation % maybe UIBC too? Ferritin is suboptimal. Usually aim for 70-90. Optimising will help her use Thyroid hormones better ---------------------------------------------------------------------------- Celiac disease......<3 (<5 negative)
IgA .....................287 (64-246) IgE......................926 (<201)
Comments: Celiac looks negative. However sometimes these tests are not definitive. If you are happy she shows no typical Celiac symptoms I'd accept that for time being. Some say stool testing is more accurate but pricey!!!!
IgA & IgE elevations I assume related to her Psiorisis condition & the food allergies too.
Have you had any CBC with ESR recently? --------------------------------------------------------------------- Other Tests Vit D 25OH............42 (20-100) *suboptimal Folate.................18.9 (3.1-17.5) *slightly elevated B12....................1292 (243-894) *elevated
Comments: Vit D low keep supplementing retest in ~3months B12 has she supplemented in last 12 months? May be skewed high still if so. Folate again supps recently? May be elevated if she is not using/converting well. Active Folate supps may bring this down. Despite B12 level I think Methyl B12 sublinguals would help & certainly wouldnt hurt. ---------------------------------------------------------------------- LDH...................220 (130-300) *looks OK as far as I can tell? ---------------------------------------------------------------------- I did order a saliva test. My husband lost his job (x 4 months) so I am the only one working. Not sure I can swing the $100 yet but do plan on doing that first thing. Trying to use insurance as much as possible until more cash flow available.
Sorry to hear that. Yes do get Insurance to stump up as much as possible. The Saliva test most wont cover though. It is best way to check Cortisol at different times of day. Is FREE Cortisol too while most blood Labs only do TOTAL Cortisol.
We are doing , Zinc (rec for Psoriasis), Iodoral, fish oil. Looks like Iron and celtic sea salt is needed
Iodoral - be careful with this. Some do OK others it flares the Hashis Abs. Probiotics - good. You might want to use DIARY FREE in view of food allergies. I do as I am Lactose intolerant. Probiotics that require refridgeration are more potent/effective. Anything sitting on a shelf dont buy it. Fish Oil - yes is good as long as good quality with Mercury & other toxins removed. Some like to do Cod Liver Oil as has Vit D & Vit A as well. I prefer not & I use Nordic Naturals at half the recommended dose as it is pricey. Iron - yes also basic Vit C will help absorb Iron Celtic Sea Salt- yes 1/4 to 1/2 teasp in water twice a day to start Vit D - yes get oil type softgel try 2000 IU daily do retest ~3 months time. Helpful for Psiorisis too. Vit A will help get the Vit D optimised too 5000-10000 IU daily maximum. Helpful for Psiorisis too. B Vitamins- would recommend active Folate, Methyl B12sublinguals, good B-Multi. If not active forms dont waste your money. Better a low dose of GOOD rather than larger dose of inactive forms. Selenium - can help with Antibodies & is good for Thyroid. No more than 100-200mcg daily Chromium Picolinate - can help with blood sugar regulation. Whether thats too high or simply too many dips & bumps. Has she had any Hypoglycemia at all? That will also cause Adrenaline spikes. Regular small frequent meals helps minimise that. Nuts (Cashews, Almonds) but not Peanuts or Walnuts. Dates are good for Potassium & Magnesium as are Bananas. I love smoothies with bananas, honey & milk. Magnesium - most HypoTs are low on this. Is good to do basic amount say 600-800mg. Note some forms such as oxide are cheap, but little is absorbed & can cause diarreah. If she likes baths some do well with Epsom Salt soaks as it is Mag Sulphate. If Sulphate sensitive may cause itching..maybe try it?
Did I mention my daughter is very thin...she is jumpy and nervous a lot. Worries and can be intense. Any chewing noises disturb her. Does sound adrenal... Certainly does. Adrenaline may be high. Often is when Cortisol is low. Worry can be Adrenals can be low T3 levels. If has sound & noise sensitivity can be low Aldo/Sodium. I know I was not balanced when pregnant with her. Poor thing-she was under 7 lbs at birth. She has many food allergies! She also puts ice on her neck, head at night during the winter, says she is hot.
I have Twin boys (almost 17 now) born ~6 weeks prem. One under 4 lbs the other 5 lbs at birth!!! Breast fed them for 9 months initially every 2 hours round the clock & they took an HOUR to feed. They did NOT like to sleep at all were very early developers & HYPER (energy wise) all the time!!!! Can you spell S-T-R-E-S-S? Both have ADD, Hashis & Adrenal Insufficiency. Exposed to Mercury in utero (I have Amalgams) & I was undiagnosed & untreated at the time.
Food Allergies not surprised with those IgA & IgE. Do you know what she is sensitive to? Again allergies are typical of low Cortisol!
Feeling hot at night in Winter...suspect its the low Aldo/Sodium. Have you a BP monitor at home? Resting (sitting/lying for 15-20mins) then standing BP & HR is good to do. If BP drops when standing (orthostatic hypotension) is suggestive of low Aldo/Sodium. Try the Sea Salt before bed see if it helps?
Have you taken her basal & daily average temps at all?
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Post by julie2 on Mar 7, 2009 16:58:57 GMT -5
Lethal Lee you are so thorough.
Yes my daughter has heat intolerance and headaches. Thinking you are right on with the sodium. Will use the celtic sea salt and recheck sodium next blood draw.
She does get gas and is sensitive to foods like dairy. We have digestive enyzmes, she is not consistent but will take when trouble starts. I have betaine HCL too I can try with her. I think I have low acid too.
We stay away from sodas. I try to keep her away from sugar, but she is a almost a teenager and you know how that is...she is showing all signs of period soon, hair, acne, breast development.
Her iron tests did include the panel? TIBC 339 (250-400 %saturation 24 (15-50)
I plan on doing saliva kit I ordered once husband is employed. We are barely making it right now. So I must prioritize.
I did just start vit A with her, heard from Stephanie (Iodine yahoo leader) that it is good for acne. Her fish oil is good quality, special order through doctor. I took her to an integrative medicine doctor last year and he recommended certain supplements.
We do the soft get Vit D 2000 a day.
Funny, she seems to be my clone with her medical issues. I am thinking not being optimal during pregnancy really didn't give her a good start. She was at an allergist by age one with low weight 18lbs and all kinds of allergies. Her food allergy bloodwork showed she was allergic to everything. The docs joked that she couldn't eat any more...I am suspicious of gluten. She is at a hard age to change her diet. I tell her what choices are best. She needs fat and protein. She can't have nuts and should avoid dairy. It can be hard to feed her. Of course she loves noodles, pizza, chicken nuggets...all the gluten food.
I am hopeful that her psoriasis may improve when she starts armour. My brother has Hashi's and Psoriasis and after pushing him he is finally on armour and now his Psoriasis has cleared- even in the winter in MN.
Her afternoon temps run 97.7-97.8. I need to track her basal. We are on the run in the morning. I will check tomorrow and see. I believe in the past it has been in the range of 97.8 -98.0 but I am not sure.
So I hope to get her on the armour soon and see how she responds. I will keep in the back of my head that she could have adrenal issues so will check her symptoms and tolerance.
Thank you so much for your advice and help! I don't know what I would do without the great forums for us to learn and share information. I guess I would still on syncrap and feeling like crap.
Thanks!
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