Managing Thyroid Issues: Concerns and Questions for Parents

Thyroid issues

My daughter, who is currently in the ninth grade, previously had some swelling in her neck.
After visiting an endocrinologist, it was discovered that she has no thyroid gland on one side.
The doctor prescribed Eltroxin (levothyroxine) for treatment, which she has been taking for two years.
The dosage increased from half a tablet a day to 0.75 tablets a day.
Recently, she has experienced symptoms such as palpitations, constipation, vomiting, loss of appetite, excessive sweating, and fatigue, and she has stopped taking the medication on her own.
Her T3, T4, and TSH levels were normal before starting the medication but became abnormal afterward (not sure which specific value?).
The doctor mentioned that the medication is used to reduce the secretion of her remaining thyroid gland to allow it to rest.
I have the following questions for the doctor: 1.
Is medication necessary if there is one functioning thyroid gland and one absent? 2.
Given the side effects she is experiencing from the medication, is it advisable to stop taking it? 3.
If she no longer experiences the aforementioned side effects after stopping the medication, should she continue taking it, or should she consult another doctor? Thank you!

John, 40~49 year old female. Ask Date: 2008/09/23

Dr. Yang Hongzhi reply Internal Medicine

The treatment of thyroid nodules with thyroid hormones aims to suppress their growth, but the effectiveness is not very significant, and it is not necessarily required.
Whether the symptoms experienced in the past are related to the thyroid depends on the thyroid function measurements at that time, and it seems that they are not closely related.
Currently, there is no specific recommendation to use thyroid hormones.

Reply Date: 2008/09/23

More Info

Managing thyroid issues, especially in children and adolescents, can be a complex process that requires careful monitoring and collaboration with healthcare providers. Based on your description, it appears that your daughter has been diagnosed with a thyroid condition that necessitates medication, specifically the use of a medication called levothyroxine (often referred to by its brand name, Synthroid or Eltroxin). This medication is typically prescribed to replace or supplement the thyroid hormone that the body is not producing adequately.

Addressing Your Questions:
1. Is medication necessary if one side of the thyroid is absent?
Yes, if one side of the thyroid is absent, it is often necessary to take medication to ensure that the body has enough thyroid hormone. The thyroid gland produces hormones that regulate metabolism, energy levels, and overall growth and development. Without adequate hormone levels, your daughter may experience symptoms of hypothyroidism, such as fatigue, weight gain, and developmental issues. The medication helps to maintain normal hormone levels, which is crucial for her health, especially during her growth years.

2. Can she stop the medication due to side effects?
While it is understandable to want to stop medication if your daughter is experiencing side effects such as heart palpitations, constipation, nausea, loss of appetite, excessive sweating, and fatigue, it is crucial to consult with her healthcare provider before making any changes. Stopping medication abruptly can lead to a return of symptoms associated with low thyroid hormone levels. If the side effects are severe, the doctor may consider adjusting the dosage or switching to a different medication rather than stopping it entirely.

3. If she feels better after stopping the medication, should she continue to avoid it?
If your daughter has stopped taking the medication and is no longer experiencing side effects, it is still important to consult with her healthcare provider. The absence of side effects does not necessarily mean that her thyroid hormone levels are adequate. Regular monitoring of her T3, T4, and TSH levels is essential to ensure that her thyroid function remains stable. The doctor may recommend periodic blood tests to assess her hormone levels and determine whether she needs to resume medication or if an alternative treatment plan is necessary.

Additional Considerations:
- Regular Monitoring: It is essential to have regular follow-ups with an endocrinologist or a healthcare provider specializing in thyroid disorders. They can provide guidance on the appropriate dosage of medication and monitor for any potential side effects or complications.

- Lifestyle and Diet: Encourage a balanced diet rich in nutrients that support thyroid health, such as iodine, selenium, and zinc. However, any dietary changes should also be discussed with her healthcare provider.

- Mental Health: Given the emotional and psychological impact of chronic health issues, consider discussing your daughter's mental well-being with her doctor. Anxiety and stress can exacerbate physical symptoms, so addressing her emotional health is equally important.

- Second Opinion: If you feel uncertain about the current treatment plan or if your daughter continues to experience issues, seeking a second opinion from another endocrinologist may provide additional insights and options.

In conclusion, managing thyroid issues requires a comprehensive approach that includes medication, regular monitoring, and open communication with healthcare providers. It's important to address any concerns about side effects and to ensure that your daughter receives the appropriate care for her specific condition.

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