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Thyroid UK
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Teenager with possible hypothroidism

I posted a few months back about my 13 year old son who was an extremely fatigued insomniac who has many thyroid symptoms. He was iron deficient ( now hopefully sorted) and saw the endocrinologist today. He is severely Vit D deficient and blood work is

Free T4 11.78 (12-22)

TSH 2.86 (0.2 - 4.2)

TPO negative ( altho Dr said there are false readings so......)

Waiting for next blood test to check thyroid receptor antibodies and T3. Thyroid scan today that looks , unofficially, like there is no growth, inflammation or swelling.

Dr said after next blood results may need to start him on thyroxine as looks like hypo.

A little confused as his TSH is normal and well within range so asking for advice on these results and if it is a thyroid issue or other endocrine glands involved???

New to all this so seeking input and make sure I'm following up on everything I need to.

Thank you

5 Replies

Well Ft4 is at the bottom of the range. A trial is certainly worth a go because you can see if this is what he needs over a period of time. If he improves then this is likely the answer.

TSH is ok, but the FT4 is a better indicator and you also have FT3 coming as well.

This sounds like a positive doctor experience really. I'm surprised they haven't send him away with the depression tag.

If you do get the T4 certainly look at taking it at bedtime as this may help the sleep. I take mine mostly at bedtime as i find it works better this way. Trial and error is the best way though.


Dr has been fab and keen to keep plugging away to find the root cause...thanks for your info!


Has his vitamin B12 and folate been tested.

B12 can drop significantly after anaesthetic (appendix op) You can get an active B12 blood test privately. Very difficult via NHS


Has anyone considered coeliac or gluten intolerance. Both can lead to low iron and vitamin D, stopping thyroid hormones working. Tests for coeliac are unreliable, endoscopy is best option. Endoscopy could check for possible gut infection, following appendix. Did he have antibiotics during that time, perhaps good gut bacteria wiped out

No current NHS tests for non-coeliac gluten sensitivity- you just have to try gluten free. Cyrex tests via nutritionist are an option, but expensive

Central hypothyroidism- when pituitary is not telling Thyroid to work, so the TSH is normal, but FT3 and FT4 are low. If this is suspected you need an endo who is specialists in pituitary (and thyroid)

Iodine deficiency?

Any family history of autoimmune diseases?

Low vitamin D is linked to insomnia



Thanks SlowDragon! Retesting ferritin with T3 and more antibodies. Tests show no coeliac problems ( used private health care) and no family history of note.

Will check into B12 for sure.

Thank you !!


I hate to (potentially) make your life more difficult, but having a negative coeliac test is not a particularly good test to rely on. Lots of us on here have got a negative result on a coeliac test and yet got lots of benefits from going gluten-free. (I'm one of them.)

If you can persuade a 13-year-old boy to give up gluten religiously for 4 weeks, which will be difficult I'm sure, then tell him to eat gluten to his heart's content after the four weeks, you might find that giving it up makes him feel better and starting to eat it again makes him feel terrible.

One thing to point out though... During the first week of going gluten-free many people get withdrawal symptoms that feel like flu - this doesn't mean going gluten-free was a terrible mistake, it just means you have to wait a few days for any benefits.

I noticed my first benefits of going gluten-free after 5 days.

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