High TSH

[TheSwampRabbit]

My 9 month old daughter was label ed failure to thrive a few weeks ago, and had a bunch of labs drawn. Today, the results finally came back and all they told me was that her thyroid levels were high and the doctor is referring her to a pediatric endocrinologist. I thought she had said hyperthyroidism, but according to what I read, high TSH would be hypo?

I have no clue what to expect when we go to the endocrinologist and I am clue less as to which way her levels would be leaning. I guess if they are high, she would be hypo but she is so tiny! She isn't even on the growth charts for weight and is in the 15th percentile for height. Can anyone give me a little insight on which it would be with high TSH and what to expect now when we go to the endocrinologist?

[ahmee]

Hmm, I wonder if it's hypopituitarism that's at the root of the problem. That could explain her slow development. It's good that you are seeing an endocrinologist about this. The situation may be slightly more complex than most of the thyroid problems we're used to seeing on this board. As far as TSH goes, goolarra is right about high TSH correlating with hypothyroidism. However, if there is a pituitary issue, it could also affect the TSH.

[goolarra]

If TSH is high, it indicates hypOthyroidism (low functioning thyroid), if it's low, it indicates hypERthyroidism (high thyroid levels).  Do you know what her TSH was?  Do you have the reference range from the lab that did the test?

Your pedi endo should order more tests at this point.  TSH is a pituitary hormone and a screening test at best.  He should now test the actual thyroid hormones, FREE T3 and FREE T4.  

He should take a careful medical history and examine your daughter's neck and palpate her thyroid.  He might want to order a thyroid ultrasound, which is a painless procedure.