Son still gaining weight rapidly!

We see dr in a week but his tsh was 1.47 and free t4 is .08.

[TSH0.70 - 4.17 uIU/mL, FT4 0.9 - 1.4 ng/dL]

He's 11 years old. All other tests have been within normal range (and so is tsh level actually) it's the t4 level that is a bit low.

His insulin is 59 but glucose was 74.

He doesn't go crazy on sweets, no soda, is athletic, but went from 136 last year to 201 presently.....

They've checked heart, kidneys, all ok.

Not Cushings bc cortisol is norm.

WHAT'S WRONG???? He's still gaining!!!!!

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  • Teachermama, I've edited your post to add the lab ref ranges from your previous post.

    Low-normal TSH with FT4 below ranges suggests secondary hypothyroidism. This is usually a pituitary gland dysfunction where the pituitary fails to sense low thyroid hormone levels and fails to produce sufficient TSH to stimulate the thyroid gland to produce hormone. The thyroid gland is usually healthy but lack of TSH stimulus means thyroid hormone replacement is required.

    Secondary hypothyroidism is usually managed in endocrinology as pituitary function needs testing to rule out sex and growth hormone deficiency.

    Low thyroid hormone can raise insulin levels. If they are elevated due to low thyroid they should drop when thyroid levels are adequate.

  • Thank you! Also, he saw pediatrician for pain in testicle (can't remember but I think it was left) and he did X-ray but he determined it was merely constipation although he didnt feel constipated and has diarrhea most days- hmmmm

    Also what are the blood tests for sex and growth hormone levels? I think they may have checked his growth-

    This may be way too much info but his penis is VERY small and no sign of puberty (and his brother and dad are VERY ENDOWED!!)

    Does that mean anything?

  • Teachermama, I'm not medically trained, I'm just making suggestions which might help your son get a diagnosis.

    Testicle pain may be due to low thyroid hormone. Hypothyroidism affects men and women in different ways, this link explains some common symptoms in men and a couple of members discuss testicle pain in their replies.

    healthunlocked.com/thyroidu...

    These are the pituitary function tests

    patient.info/doctor/pituita...

  • Teachermama, FT4 was 0.08 - was that a typo? That seems oddly low...

    If that is right, then it's looking like pituitary gland failure. The signal from the pituitary gland isn't prompting the thyroid gland to make T4. No T4 means no T3 - so effectively hypothyroid due to a pituitary cause. The treatment would be the same though - thyroid replacement medication. Hope the doctor you see on the 18th is more helpful {hugs}

  • Yes it's correct. The range was .09 to 1.4 so it seems just a bit low? I'm wondering if it has dropped since that blood test was three months ago now!

    Also, is it possible (and what kind) to have a pituitary problem (tumor causing havoc?) but normal cortisol Levels?

    Thank you....

  • Ah right - the range appeared to read 0.9 to 1.4, so a 0.08 seemed a lot lower - being nearer 0.1 than 0.9. That wouldn't just be a bit below the range, it would be much lower. :)

    And I think that's possible, yes. It's amazing that such a tiny gland can be soooo important - but it's that tiny-ness which makes even a tiny abnormality have a big impact.

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