Lois 2007-08-12 19:52:55
Here’s something I came across in my research for the a.s.t. site updates,
which might be useful for parents of children who are hypo or suspected of
being hypo. The last part may be useful to adults too.
1. Rose SR. Isolated central hypothyroidism in short stature. Pediatr Res.
“In conclusion, use of a direct FT4 assay to screen short children for
possible subtle hypothyroidism (along with other appropriate testing)
identifies a subgroup with a one in three possibility of an easily treated
cause–isolated central hypothyroidism.”
2. (This article refers to the above article) Victoria Carrozza, Pharm.D.,
Gyorgy Csako, M.D., Jack A. Yanovski, M.D., Monica C. Skarulis, M.D.,
Lynnette Nieman, M.D., Robert Wesley, Ph.D., and Frank Pucino, Pharm.D.
Levothyroxine Replacement Therapy in Central Hypothyroidism: A Practice
Report. Pharmacotherapy 19(3):349-355, 1999.
“In children with documented mild central hypothyroidism and short stature,
increasing serum FT4 from the lower third to near the upper third of normal
during 6 months of levothyroxine therapy significantly increased growth
velocity. [Footnote is to the above article.] Withdrawal of
levothyroxine resulted in a return to a low growth velocity. These
observations provide, at least in children, a justification for targeting
FT4 in the upper half of the reference interval, not just in the normal
“It is difficult to assess what the target FT4 should be in adults.
Improvements in biochemical end points after levothyroxine replacement
therapy may provide guidance. Examples include serum total cholesterol and
low-density lipoprotein in patients with subclinical hypothyroidism, and
serum s** hormone- and corticosteroid-binding globulins, fibronectin, and
procollagen-III peptide in patients with overt thyroid diseases.[24, 25] Perhaps an optimal target FT4 concentration in adults should be the same as
in children, or at least midnormal with associated clinical correlation.
Validation of the best approach ultimately requires prospective studies with
improved, objective methods for determining clinical thyroid status.”
would be different if the patients were on a T4/T3 combo.]
The article is at http://www.medscape.com/viewarticle/417948_print, but you
need to log in to access it. (Login is free.)
Bl1204@aol.com 2007-08-12 19:53:09
This kind of fits what happened to my daughter, I think as a consequence of a
tonsillectomy. She is within normal height ranges, but, honestly, she probably
would have been about three to four inches taller than she is but for going
through this from age ten or eleven through nineteen.
T3, T4, and TSH all within normal ranges but all in the lower 1/4 of reference
BTW, I doubt if I would have figured all this out but for the basal temperature
test that Barnes doctors recommend (and Wilson’s Syndrome). Needless to say,
doctors were no help until I specifically found one who would treat by
“As the waves pass the rock, their shape is changed. There is a hologram of
the rock within the wave that comes forward and crashes on the beach, then
there’s a reflected wave back.” Ralph Abraham
“I’d like to learn to windsurf.” BL
Nora gr ndal 2007-08-15 06:23:51
And check out this one, for those whose doctor freaks at low TSH:
Finally some definite numbers for amount of thyroid replacement per kg
(but you need to print it across because two images are
if your browser is not able to shrink the pages for