12 year old w/hypo symptoms but blood indicates HYPER :-(

[tjmom82]

Tomorrow we go for additional testing. I am so impatient and feel helpless.

My son has been experiencing fatigue and weight gain for the last few years. He works out over an hour a day religiously with a trainer. He wants to be in the NFL. He had blood work done in 2013 that showed T4 high but TSH within normal range, again in 2015 the same T4 higher than the time before TSH lower than 2013 but still within normal range, and the doctor brushed it off although his symptoms of fatigue and sluggishness and attributed them to his busy school and athletics schedule. Now 2016 and we go for his 12 year check up he is now at 140lbs but still at 5 ft 1in, having only grown 2 inches in the last 3 years. No where near puberty. Dad is 6ft 4in, mom is 5ft 4in. His labs this time... I'll attach in a pic, but T4 higher than before, and TSH lower than last year and finally low enough to trigger abnormal. A1c showed high again, and again total cholesterol was even lower. We finally got a referral to pediatric endocrinologist who saw his labs yesterday and called at 4pm requesting us to be there today at 830am. They retested his a1c at the appointment and it was within normal range. She felt his thyroid and said it felt enlarged, inflammed, or something abnormal. Didn't give much explanation to the lack of growth but said they dont really worry about it until age 14. Given his goals that is hard to wait 2 more years to see what the deal is .. She ordered some additional testing to be done tomorrow morning as soon as he wakes up as apparently the cortisol levels are the highest apon waking, so I've preregistered him at the lab at the hospital and have clothes laid out so as soon as he wakes up I can take him to get his blood drawn. My fear is that his TSH will show normal in the morning since it was only slightly out of range and they won't want to do anything! My mom had hypothyroidism that turned into thyroid cancer in adulthood and my mother in law has hypothyroidism treated with meds. I would think given my son's symptoms he would be hypo but the labwork is suggesting hyperthyroidism and I don't understand! The doctor said if he was healthy and on track his full height potential should be 6ft. So now I'm left to worry about what these new labs will say, hoping they say nothing is wrong but at the same time hoping they say something that will explain why he stopped growing. Sorry for such a long post! Can't sleep and just wish we knew what was going on!

[greygoose]

His TSH is not low enough, nor his FT4 high enough, to suggest hyperthyroidism. I've looked at your next post, and the mistake they are making is not to test the FT3. It could be he has a conversion problem - which would be exacerbated by all the working-out he's doing. So, you really must insist on an FT3 - the active thyroid hormone - test.

And, they are obviously not thinking he is hyper, because they aren't testing for Grave's - the autoimmune disease that makes you hyper. But, they are testing for Hashi's - which swings between hypo and hyper - I would think they're thinking that he could be going into or coming out of a Hashi's hyper swing.

As to his growth, I see they've tested his IGF1, which gives a clue to his Growth Hormone. It is slightly low. If his FT3 is low, then his Growth Hormone could be low. But, as they say, they don't consider it a problem until he's 14, because things could pick up before then. And, even if there is a problem, it's not a problem, if you see what I mean. All these hormone deficiencies can be treated with hormone replacement. I doubt any of it will affect his sporting ambitions. So, you really must not fret too much. They will work it out! But, do remember to suggest they test the FT3, because that is key to all this.

Rereading through all that, I'm not sure it's very clear! So, if you can't make out what I'm talking about. Please ask me.

[tjmom82 in reply to greygoose]

Thank you so very much, even if I don't understand half of what you said, your post definitely helped ease my concerns! I have been trying to learn and research as best I can, and I'm beginning to wonder if his levels could possibly be off because of how much he exercises? If so, what kind of doctor or professional should we see to figure out the right amount so that his growth isn't hindered?

[greygoose in reply to tjmom82]

I doubt that's the cause of it, but it might not have helped. There's no point trying to guess anything, you just need to wait for the next lot of results to know more.