Pediatric hypothyroid

[lindser]

My 16year old daughter recently had a physical. Due to 8 day periods acne ,weight and hair loss the Physician ordered some labs. Her TSH was 4.9 and testosterone 98. What should we do next? Is there a relationship between the two? She was a soy formula baby due to colic. She had alot of ear infections as a child and had a T&A at 4. She has had sinus infections every year. Also over the years she has complained of pain behind her knees and pain in her fingers. This year she had a short duration which appeared like trigger finger. Thought related to cheerleading and tendonitis.She eats well and appears overall healthy; she is 5'6" and weighs 136.
Please advise me on my next step.
Thank you SharonM

[Mark Lupo, M.D.]

The TSH is high-normal, would repeat to confirm and consider testing for Hashimoto's (check TPO antibodies).  This would not, however, cause a high testosterone.  There is some increase risk of hypothyroidism (high TSH) in women with PCOS which would explain the acne/hair changes & high Testosterone.

An endocrine evaluation may be in order to see if there is anything else going on (doubt pituitary, but this is a remote possibility).

[lindser]

Thank you so much. Scheduled her to see Pediatric Endocrinologist and have several lab tests ordered. Do they know what causes PCOS in young girls?