Aa
Aa
A
A
A
Close
Avatar universal

help with results in children

My name is heather. I have a seven year old daughter. I recently noticed what I thought was a lump in her neck. I took her to get lab work done and here are the results
Tsh 5.50 (.5-4.30) freet3 4.4 (3.4-5.1) free t4 1.3 (.9-1.6)
Bun/creatinine ratio 26.2 (6-22)
Alkaline phosphatase 447 (184-415)
Cholesterol 198 (125-170)
Ldl (calculated) 124 (0-110)
Non hdl cholesterol 142 (0-119)
Vitamin d, 25-oh, total 24 (30-100)

These are all the abnormal results. Thyroid disease runs high in my family. Could some please help. I was told by her ped that there is nothing to worry about but I know something is going on. My child does not eat alot of fatty foods so I am having a hard time to believe that her cholesterol is high because she eats junk food. Could something else be happening
8 Responses
Sort by: Helpful Oldest Newest
Avatar universal
I'm no imaging expert.  You might try posting a new question to get comments from people who are good with imaging.  Make sure you indicate in your title that you want help interpreting U/S report.  It might take a little time to get a response.

I have no idea how a 7-year-old's thyroid size compares to adult thyroid size.  I found a site that said normal adult size was 40-48 mm X 10-18 mm X 8-16 mm.  It also said that results outside those ranges didn't necessarily indicate pathology.  

Using those as comparison, it would almost seem that the left lobe is small, rather than the right being large.

Isthmus thickness is normally about 12.5 mm, so once again, your daughter's seems thinner.

My first question would be:  Why the disparity in the size of the two lobes?  There may well be a simple explanation for that, but I'd want to hear the doctor explain it.

I'd start a new thread, and get some help from someone who knows a lot more than I do.  
Helpful - 0
Avatar universal
. She recently had an ultrasound done and the doc said everything was normal. Her neck is rather large, anyone can see something is not quit right.
Finding:
Thyroid gland somewhat hypoechoic and heterogeneous. No focal nodules. Right lobe measures 45x21x15 mm and left lobe measures 21x16x16mm. Isthmus thickness is 4mm.
The right seems larger than the left and the isthmus seems rather larger for a 7 year old.

Any ideas?
Helpful - 0
Avatar universal
I should also have added that it is possible to have hypo symptoms and be hypothyroid at the cellular level, even with good to excellent serum FT3 and FT4 levels.  The presence of adequate vitamin D in the nucleus of cells is imperative for thyroid hormones to work properly there.  D often has to be midrange to mid-high.  
Helpful - 0
Avatar universal
While we always say that the rule of thumb for FT4 is midrange (50%) and the rule for FT3 is upper half of range, that is a general rule, and many people feel best outside those parameters.  We are all very individual.  Some of us have to be very high in the ranges, some of us feel comfortable lower in the ranges.  So, the true test is often the symptoms we have.  However, as you know, the list of thyroid symptoms is long and applies to many other condiions as well.

A goiter indicates inflammation of the thyroid, which is often due to the action of autoimmune antibodies. Antibodies can be present for years, or even decades, before doing enough damage to cause symptoms.  As Red_Star mentioned, TPOab and TGab are the antibodies associated with Hashi's.  A simple blood test will tell if either is elevated.  

Your daughter's vitamin D is abysmal.  Many people find that D has to be well up in the range to feel well.  D deficiency can mimic some hypo symptoms.  Has your doctor suggested supplementing D?  I'm sure you're aware that the sun converts something in our bodies to vitamin D.  That "something" is cholesterol.  I know it's not easy, especially this time of year, but perhaps getting out in the sun for a while every day would address both problems.    
Helpful - 0
Avatar universal
The major thing i noticed was mood change, gaining weight, fatigue, and confession. Why does that make a difference?
Helpful - 0
Avatar universal
Thank you for all the info. That was very helpful... I will get the endocrinologist to look into it. And she has a goiter, that is what prompted me to get all the lab work.
Helpful - 0
Avatar universal
Your daughter's FT4 looks really good at 57% of range.  FT3 also looks very good at 59% of range.  These numbers are not only good, they are pretty close to optimal.  TSH is a little high, but TSH, a pituitary hormone, is the least important of the thyroid tests.  

Does your daughter have any thyroid symptoms?

A thyroid/neck ultrasound might help clear the matter up regarding the lump you thought you noticed.
Helpful - 0
1756321 tn?1547095325
I would recommend testing for Hashimoto's thyroiditis - thyroid peroxidase antibodies (TPOAb) and thyroglobulin antibodies (TgAb).

Elevated TSH, normal free T4 - subclinical hypothyroidism...

"The term subclinical may be inaccurate as some of the patients have symptoms."

"In one study, symptoms in 33 patients with subclinical hypothyroidism were compared with euthyroid patients in the same clinic.[3] Dry skin, cold intolerance and easy fatiguability were significantly more common in the patients with raised TSH levels. The symptoms improved after treatment with thyroxine.

Another study showed that in 69 female patients with subclinical hypothyroidism, the clinical index of signs and symptoms was more abnormal in those with higher TSH levels. Even when they had normal serum thyroxine levels.[4]" = Patient UK - Subclinical Hypothyroidism

***

Bun/creatinine ratio elevated - dehydration.

"General dehydration can be a symptom of an underactive thyroid. When the lack of thyroid hormones slows down your body functions, water and nutrients aren't transported to cells as quickly as needed. This problem can result in constipation, dry skin and dry hair." = Life 123: Common Symptoms of Underactive Thyroid

***

Abnormal lipid panel...

"Thyroid hormone influences the way that cholesterol and other lipids are synthesized and broken down (and where does this happen? – yes, the liver). With Hashimoto’s and hypothyroidism, this is often slowed down resulting in high cholesterol and other lipids like LDL and triglycerides." = Hashimoto's Healing - Hashimoto’s: The Liver and The Thyroid

***

Elevated liver enzymes...

"Several extrahepatic causes of asymptomatic elevations of liver transaminase levels can be pursued based on the clinical scenario. It is not clear how thyroid disorders elevate liver transaminase levels, but measurement of serum thyroid-stimulating hormone can help rule out this potential cause." = American Family Physician - Causes and Evaluation of Mildly Elevated Liver Transaminase Levels

***

Vitamin D deficiency...

"In a recent study of Hashimoto’s thyroiditis it was found that 92% of the subjects had low vitamin D levels when compared to healthy subjects of whom 63% had low vitamin D levels.

Hashimoto’s thyroiditis, also known as chronic thyroiditis, is a swelling and inflammation of the thyroid gland which may cause a reduction of thyroid function and hypothyroidism. It is the most common cause of hypothyroidism. In western countries it occurs in .1% to 5% of the population." = Web vitamin - Hashimoto’s Thyroid Disorder and Vitamin D
Helpful - 0
Have an Answer?

You are reading content posted in the Thyroid Disorders Community

Top Thyroid Answerers
649848 tn?1534633700
FL
Avatar universal
MI
1756321 tn?1547095325
Queensland, Australia
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.