My son recently had his thyroid checked and the results were 5.25. His family doctor, pediatrician, and diabetes nurse all said this is a normal range. I have recently read that the normal range has been changed to.3 to 3.0, so isn’t that on the high side of the scale? Also, he seems to be losing weight and getting dry patches of skin around his nose. He is almost 11 years old.

I think you are referring to the TSH with the new sensitive assays being redefined vis-a-vis what is truly normal. People with type 1 diabetes can also have thyroiditis and such thyroiditis frequently is associated with hypothyroidism where the T4 would fall and the TSH rise. Screening for thyroid antibodies is usually recommended, but nobody knows exactly how often this should be done. We do this annually. We also check T4 and TSH levels but some use only the new TSH assays alone for screening. If there is some doubt, then more detailed thyroid testing should be done and certainly this could easily be rechecked a few times to see if there is any pattern. Without significant goiter or other symptoms, just a minor aberration in these levels just means to check more frequently than once a year. With symptoms, then consultation with the pediatric endocrine/diabetes team would be helpful to decide if thyroid hormone treatment is needed or not. Looking for patterns over time is often extremely helpful to decide how to proceed with such complex matters.

SB

[Editor’s comment: For more information on thyroid disease, see Thyroid Disease and Diabetes: Patient Education Sheet and Common Tests to Examine Thyroid Gland Function,

BH]