Hi Elaine,

My nine year old daughter was recently diagnosed with GD (a week shy of her 9th birthday). She had been sick with a virus which led us to a dr's visit. The dr. suggested a routine thyroid panel as it is now given routinely (yearly). I took her for the blood work four weeks after she had the virus. The pediatrician called with the results and referred me to a pediatric endo. I was shocked by the results.

Initial pulse rate was 104 before Tapazole. Current pulse rate as of yesterdays dr. appt is 96

5/23/17 ( before Tapazole)

T4 3.79
T3 387
TSH 0.015

Dr. prescribed 10mg of tapazole. Started on May 25th

Blood test results as of 6/7/17

T4 2.55
T3 300
TSH 0.015

Started 15mg on June 2nd. Rash started a week later. Had blood test done and returned to dr.on 6/19 .
Blood results as of 6/19/17

T4 1.58
T3 208
TSH 0.015

She said to lower to 10 mg. The rash disappeared

Blood results as of 7/3/17 (with 10mg)

T4 0.91
T3 170
TSH 0.086

Blood results as of 7/31/17

T4 1.12
T3 136
TSH 1.730

The labs reference ranges are as follows
T4 0.78-2.19
T3 97.00-169.00
TSH 0.465-4680

The dr. wants her to remain on 10mg daily and repeat labs in 4 weeks. Her TSI was 2.4 Rf. range <=1.3. This level will also be repeated in 4 weeks.

I am so scared for my baby. I have only heard terrible things about this disease.Will she ever gain remission? Does this dose sound correct? We have eliminated dairy, gluten and added more organic whole foods.

Thank you.

D

Hi,
Graves' disease is a self-limiting disorder that runs its course and resolves, causing remission. Patients can later relapse especially at times when estrogen levels rise or other triggers occur, but most patients do not relapse.
However, your daughter's dose is too high. The guidelines are to use the lowest dose needed to bring FT4 near the high end of the reference range regardless of the TSH result. A low TSH during treatment is expected and doesn't mean that your daughter is still hyperthyroid. During treatment patients are considered euthyroid (normal thyroid function) when their FT4 falls within the reference range regardless of their TSH level.

Over time the dose should be lowered, always following these guidelines on dosing, until remission is achieved. You're doing a great job managing her diet and be sure to avoid aspartame as well. And make sure that any seasonal allergies are being treated. best to you, elaine34