[Mom2GDkid]

#1058715

I have a 15 year old that was diagnosed with Graves August 1, 2010 after having a thryoid storm. She had blood test done about six months before and thyroid was ok. She is type 1 diabetic since April 2009 so she already had a pediatric endocrinologist is why thyroid had previously been tested.
We have been doing this for a year now and her TSH has never been within range. They keep adjusting her dose and no matter what amount of methimazole she takes its not right. Her TSH just bounces low and high. She has thyroid labs done at least every six weeks beacuse of the problems. Will it ever end? What could be causing this? I wonder if there is something we are not doing right that she should have changed or if anything she eats could be a factor. ” title=”Confused” /> ” title=”Confused” /> She just never feels well and school is about to start again and they are telling me she can not miss a day of school without doctors note.

[Kimberly]

#1169525

Hello and welcome! Dosing with ATDs is definitely a trial-and-error process until you find the dose that will control your daughter’s levels *and* your symptoms. Some patients find that they need to split pills and/or alternate different doses on different days to find that “sweet spot”.

One question to ask your doctor is whether he/she is making dosing decisions based on Free T3 and Free T4 as opposed to TSH. TSH can remain suppressed for quite some time in Graves’ patients, so this is not a good benchmark dosing during the early stages of treatment.

In terms of diet, Graves’ patients are generally told to avoid foods with huge amounts of iodine, such as the seaweed wraps that come with sushi. If your daughter is eating sushi off an on, that could potentially affect her levels. Stress can also cause levels to shift towards the hypER end of the spectrum. Also, you might sit down with her doctor to go through all of the other medications and any vitamin/mineral supplements that she is taking, just to make sure there aren’t any potential interactions that could be causing an issue.

Finally, you might talk to an administrator at your daughter’s school about developing an individualized plan under the Individuals with Disabilities Education Act. Students may be eligible for special accommodations, including more time to complete tests and assignments, and the opportunity to take tests in a distraction-free environment. This might help take a bit of pressure off your daughter.

Wishing you all the best!

[Kimberly]

#1169526

One other issue I should have mentioned is making sure your daughter is consistently taking her medication. If that might be an concern, setting a daily timer on a watch, PDA, or computer can be helpful. Another alternative is leaving the meds out someplace where you will definitely see them every day, such as a nightstand so you see the pills when you first wake up.

[Lina1]

#1169527

Hi! Sorry to hear about your daughter’s struggle. I think that the school will definitely work with you on sick days. I’m a teacher at a public high school and there are (unfortunately) many kids who face ongoing health issues all the time that require them to exceed their maximum sick days out of school. (Recurring migraine headaches, serious illness, injuries, pregnancies, etc.) Often doctors will write open-ended sick notes stating that the student may need to miss many days throughout the school year due to a single factor. I recommend making an appointment with the principal and having a nice talk with him or her about your daughters illness and need for frequent absences. (Perhaps the principal is unaware of the serious reason for having so many absences in the past?) Also, if the principal knows that you will do your best to help your daughter catch up in classes, it makes a very good impression, and they’re more likely to work with you on a plan. I hope this helps! Hope she feels better soon!

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