December 17, 2006
Thyroid
Question from Chicago, Illinois, USA:
I was finally diagnosed with Hashimoto’s thyroiditis over a year ago after 10 years of symptoms. I still can’t find a doctor for myself to treat symptoms rather than my ranges (TSH FT3 FT4) and now I find out my 14 year son has positive anti-bodies (mild at +100) and borderline high TSH and low borderline FT4. He has complained about some symptoms and I have noticed some over the past six months, so that’s why I requested test at yearly testing. The endocrinologist says to sit and watch because doesn’t want to put him on life-long drug.
If he will eventually need some form of thyroid replacement for life, why not start him now before he develops more symptoms than he already has? I have and still suffer with many symptoms and don’t want him to have to go through same. I am now on Armour after Synthroid and finally starting to live again normally. Am I being too demanding to ask for this or do I try to find another endocrinologist who will treat both his type 1 diabetes and now Hashimoto’s? My son has had type 1 diabetes for seven years with no history of type 1 on either side or even an autoimmune disease until recently.
Answer:
Hashimoto’s thyroiditis is very common in type 1 diabetes patients, about 20%, but it could be as high as 40%. About 5 to 10% have actual hypothyroidism as your son has. Most of us would treat persistent high TSH levels since this suggests the inflammatory process interfering with thyroid hormone production even if compensated at the moment. Most would not have any symptoms, some only subtle symptoms. He also should be screened for celiac disease and perhaps also pernicious anemia as well as adrenal insufficiency, if not already done. You should go back and discuss this in much more detail with your pediatric endocrinologist and then decide mutually what makes the most sense, close observation and sequential monitoring of blood hormone levels, treatment now, etc.
SB
