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Question

Hello,I am a pediatrian.I have a patient.He is 9month.He has short stature,low weight and small head circumference.He has not have increase in his head circumference.In his lab test :TSH=9 &mild anemia. I prescribed levothyroxin 12.5microgram & ferrous sulfate for him.After pne week I increased dose of levothyroxine to 19microgram.Immediately after that he became restlss.He just took one dose of 19microgram & I immediately discontinued it,but he has not changed & even worse. He is severly pale,tachypneic & restless.?Hb=10 PLT=120000 RBC=3.500000 WBC=125000 Would you please guide me?Is that because of levothyroxine? Thank you.

Answer

TSH appears to be in the normal range. What are the normal laboratory reference values for the particular lab that you got the TSH done from?
If you suspect hypothyroidism, one should do a complete thyroid profile including T3, T4, Free T3 and Free T4 before starting treatment. Also try and find the etiology of hypothyroidism in a nine month old.
In the meantime treat him for anemia.
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