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Question:

From Tennessee, USA:

My 9 year old niece was diagnosed with Type 1 diabetes today. Her blood sugar was 1295 when she entered the emergency room. Her symptoms are 23 pounds of weight loss in 30 days, racing heart beat occasionally in last 3 months, hair loss, and as of today, dehydrating. A lot of these symptoms other than sugar level point to thyroid problems although the doctors have not mentioned it. Could a thyroid problem cause her sugar level to climb like that if her metabolism is out of whack?

Answer:

Fast heart rate can be seen acutely with dehydration due to ketoacidosis alone, but if there have been symptoms of fast heart rate over the past 3 months, an overactive thyroid should be considered. Hair loss can be seen in an overactive thyroid condition and an underactive thyroid condition and in an autoimmune skin condition called alopecia. If there is any question of an overactive thyroid, this should be evaluated as soon as possible as ketoacidosis can make an overactive thyroid condition worse and vice versa. Acute illness and acidosis can change thyroid function tests for a few days, so you might have to repeat them to be certain.

High levels on blood tests called T4 or T3 would be highly suggestive of an overactive thyroid gland as these hormones usually go down with acute severe illness. Low values may not 100% rule it out. A low value on a lab test called TSH which is seen in hyperthyroidism may be misleading as the TSH may temporarily be low with any acute illness. Measurement of anti-thyroid antibodies may be suggestive but not diagnostic of either an overactive or underactive thyroid. If your child is not greatly improved in 12 - 24 hours with treatment of the ketoacidosis and thyroid tests are confusing a radioactive iodine uptake scan may be helpful even though this is rarely necessary in children to diagnose an overactive thyroid.

TGL

Original posting 24 Mar 1998
Posted to Diagnosis and Symptoms and Thyroid

  
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Last Updated: Tuesday April 06, 2010 15:08:58
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