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September 2, 2006

Thyroid

Question from Manchester, United Kingdom:

My five year old daughter has had type 1 for four years and has celiac disease since the age of two. She is now developing hypothyroidism. Her weight has increased even though her diet is low in fat and her last two blood results have come back as borderline. Her consultant says that she will eventually need some medication to treat the underactive thyroid, but not while it is borderline. I have asked for the medication now before she puts on any more weight, but we have to wait to have repeat blood tests in two months. Do you know of anyone who has been put on medication when their blood results have come back borderline?

Answer:

There are different opinions about when to start thyroid hormone. In such cases where there are already two autoimmune disorders, type 1 diabetes and celiac disease, it is highly likely she will need treatment of her presumed Hashimoto’s thyroiditis causing her hypothyroidism. A lot would depend upon her actual thyroid function results. If there are only borderline abnormalities and not many symptoms, then rechecking one to two months later is quite reasonable. If there are symptoms, enlarging goiter and definitive abnormalities of blood work, then there is not much reason to wait longer. Please go back and discuss this further with your physician so you can decide together how best to proceed.

SB