Hello,
As per the details u have submitted , the child is having sub-clinical symptomatic hypothyroidism , I used the term sub-clinical why becoz her FT4 is normal and TSH is elevates more than 5 . As becoz she is having symptoms of hypothyroidism she requires thyroxine replacement in low dose.
So I advise u to take the child to endocrinologist and take the advise.
For the constipation issues , diet modification is important in children , diet rich in fibres .
Hope this will help u

Hi
Thank you for your query..
Lets take one thing at a time
1. Thyroid. Well a raised TSH suggests hypothyroidism or less functioning thyroid. But since T3 and T4 are normal, it is not significant. It will be helpful if you consult a pediatric endocrinologist for the same. But for now i think you should have a repeat TSH before any drugs are started.
2. Constipation: Hypothyroidism is one of the causes of constipation and it may be related. However improper diet is one of the most contributory factor. Try to give your child a lot of fibres like vegetables, fruits and a lots lots of fluids. Sweeten her milk with additional two teaspoon sugar in every glass. It acts as a laxative. Else you can see a pediatric surgeon for a prescription of a laxative too. He will also be able to rule out other causes of constipation like fissure.
3. Scarred kidney: If your child has had recurrent urinary infection (burning micturation with cloudy urine and fever) then you should get her evaluated for vesico ureteric reflux (it is a condition in which urine from bladder goes back to kidneys and can cause scarring). Your child should be on low dose daily antibiotics and should be further evaluated. I suggest you visit a pediatric surgeon for further evaluation
Hope that solves your query
God bless you

Hi,
Thanks for posting your query.
With the available described symptoms, there appears to be possibility of acute gastroenteritis or hypothyroidism induced constipation.
Possibility of acute gastroenteritis is high as fever is also present.
Gastroenteritis may be associated with watery loose diarrhea or may be in form of recurrent urge to use washroom but not getting any thing.
You should consult with internal medicine specialist/ gastroenterologist and should go for thorough check up.
TSH > 5.50 suggests decrease thyroid hormone with diagnosis of hypothyroidism.
Although treatment for hypothyroidism is generally given when TSH >10uIU/ ml.
She should take L Thyroxine in low dose along with dietary precautions.
She should take complete antibiotic therapy along with probiotics.
She should also go for ultrasound imaging and x ray abdomen.
Take care,
Dr. Mayank Bhargava