Concerned! I suspect my son has central hypothyroidism...opinions on his labs please.

[DippyDame]

My younger son has just received the following results, below, from MMH and has forwarded them to me this morning.... they very much concern me!

He has gained considerable weight ( his diet is not excessive) over recent years and fatigue is an intermittent but continuing problem. He had covid at the start of lockdown, but was not hospitalised, this may, or may not, be a contributing factor.

He has a responsible, demanding and often stressful job which he has blamed for his symptoms....I've been concerned otherwise

Visting us recently on holiday I persuaded him to do the test because I recognised a problem! I should have ordered an FTT instead!!

As this is "close to home" I'd very much appreciate another opinion that is more than just "Mum worrying again". To be fair he has taken my concerns on board, as has his elder brother who also did a test and is clearly hypo with more straightforward labs.

Very sadly they have inherited " Mum's dodgy genes" as they used to say when they were growing up.

The results are not " normal" as this rubbish doctor's report suggests and as he immediately believed.

Before I say any more to him today ( he is back home again) I'd appreciate the opinion of the more experienced members here.

I suspect Central hypothyroidism and want him to be well informed when he visits his GP. ...am I correct?

I'm not hopeful about that visit and feel he may need to see a private endo....but I'm jumping the gun here!

Huge thanks as always ....and apologies for the emotional rant!

Any advice much appreciated

DD.

Results

Overall comment

20/08/2022

Good news, your thyroid hormone levels are all normal (known as euthyroid). There is no indication of

thyroid gland disorder. This interpretation is based on the assumption you do not have a pre-existing

thyroid condition and/or receiving thyroid treatment.

20/08/2022

1.95 mu/L

TSH levels normal (normal range 0.27 - 4.2 mU/L)

13.4 pmol/L

FT4 levels normal (normal range 12 - 22 pmol/L)

5.6 pmol/L

FT3 levels normal (normal range 3.1 - 6.8 pmol/L)

[SlowDragon Administrator]

I don’t think this looks that hypothyroid …Ft3 is pretty good

Next step……full thyroid and vitamin testing…..perhaps consider Blue Horizon as includes cortisol

Same for other son too

[jimh111]

These numbers look very good, certainly not central hypothyroidism as TSH is where you would expect it for fT3, fT4. As you probably know I was severly hypo with good numbers and have a form of RTH caused by endocrine disruption. To make such a diagnosis you need very obvious and substatial signs and symptoms. His weight gain could be due to lots of reasons including his job if it is sedentary and stressful.

[DippyDame in reply to jimh111]

Thanks jimh111 and SlowDragon

His FT4 seems very low at 14% through ref range I thought that should have raised the TSH considerably....although higher FT3 ( 67.57% through ref range) has probably kept TSH on the low side.

Test done as advised here.

Results just seem odd....

His weight gain is not the result of bad diet or lack of exercise....he did a brisk 10K walk when he was with us....then fell asleep!!

Fairly regular occurance when dog walking.

Something is not right and I've been watching without comment for some time.....fatigue like he experiences is not normal for a young man.....or such weight gain.

I realise we need to test more....that was just an initial test to see how things looked.

Unfortunately he's at the other end of the country!!

Work in progress!!

[SeasideSusie Remembering in reply to DippyDame]

See if you can get him to repeat it in a couple of months but suggest he also does the key nutrients.

[DippyDame in reply to SeasideSusie]

Thank you Susie....will do.I'm concerned about any long term effects of what has been his gradually increasing weight....he is now obese.

[SeasideSusie Remembering in reply to DippyDame]

That's worrying for you, I think we mums never stop worrying however old our children are. My daughter is 52 and despite me suggesting she gets a baseline for her thyroid levels, and her 27 yer old daughter, as hypothyroidism is on the female side, she's ignored me.

[DippyDame in reply to SeasideSusie]

It is.... but thankfully both my sons ( aged 41 and 42) are listening now....it took a lot of gentle persuasion!!Hopefully your daughter listens in time too

I think it's fear of the unknown

They both willingly tested during a recent family visit after I ordered the tests!!

They are probably wishing now they hadn't!!!

That very low FT4 is odd I feel

I'm just about to read Tania's post to maybe shut me up!!

thyroidpatients.ca/2020/01/...

Support here is invaluable

Thanks Susie

[RachelP03]

Hello, everyone that has posted above has probably more experience than me but I do remember reading a few things:

1) A low FT4 but reasonably high FT3 can indicate an adrenal issue

2) According to Paul Robinson, the body/thyroid gets very good at flogging the horse so to speak to try to give the body what it needs and to compensate if there is an issue! To me, a low FT4 but high FT3 suggests his thyroid and body are having to work really hard to give him the FT3 he needs!

3) Remember also, unless he has a benchmark from before he was starting to feel unwell, we do not know what his bloods would have shown for thyroid. His range will be much smaller than the lab ranges and for him, he may need both to be a lot higher to feel normal.

4) You have the genes, it’s likely he has a thyroid issue!

5) Agreed though he needs vits etc next as well but also the antibodies! My Dad had similar numbers to your son and no one thought he had a thyroid problem (must have been something else - ME was written down at one point) even though he has full DI02 defect plus marginally elevated antibodies. Then they scanned his thyroid and it’s shrivelled up and the 2 endos have now agreed that yes, he does have a thyroid issue!!

6) Cortisol and sex hormones also need testing!

Good luck!

[RachelP03]

Also, no harm once everything else tested or considered in trying with thyroid replacement given there is wiggle room in his numbers and then monitoring his signs/symptoms to see how he feels!

[DippyDame]

Morning RachelP03

Thank you for this very helpful response.

I've been quite convinced my son has a thyroid problem

However, beyond my own complicated thyroid history which I basically had to unravel myself my knowledge is patchy.

Like your Dad I have the Dio2 snp/ homozygous and was also diagnosed with ME and CFS ( and a lot of other suggestions like IBS) None convinced me!

Turns out that I have a form of RTH...based on medical history and signs and symptoms, I've possibly always had it. And possibly my maternal grandmother before me!

The red flag is my son's weight gain and fatigue which have been concerning me and why I encouraged him ( and his brother) to test recently. His brother's labs suggest hypo but are more straightforward!

Your suggestion looks positive so I will get in touch with him today with suggestions as to how might proceed....and hopefully find a good endo.

Thank you so very much for this.....it makes complete sense

I hope to share updates, with my son's permission, which hopefully may help others

[userotc in reply to DippyDame]

Personally I think I'd act on Rachel's point 1 and test his adrenals first. Also I suspect he may be more likely to do that than try other things you've indicated like thyroid replacement.

[Noelnoel]

A stressful and demanding job can often have adverse effects on lifestyle which in turn add to the stressload of the already stressed adrenals. I.e., eating at odd hours, often too late, skipping meals, a bit too much alcohol to unwind, being unable to fit in the right kind of exercise, not enough sleep …

I saw it with my husband and despite my nagging to include something like yoga instead of pounding the pavement, he ran miles and miles and played squash every week and ate well. His weight climbed and he grew tired and irritable. Your son’s hunch that his job is the cause is highly plausible and hopefully correct but as a parent too I understand your concern. Obviously I have no idea what’s going on with your son’s health but RachelPO3’s point below seems worth investigating

1) A low FT4 but reasonably high FT3 can indicate an adrenal issue

I don’t want to preach but I’ve experienced the kind of concern you and countless parents have/are experiencing and I frequently find myself anxious and in knots over my husband’s and children’s health, who don’t take my concerns seriously. I appreciate most of my worries are unfounded but having thyroid problems has made me hyper aware of the initially silent damage of disease. What really worked for me (and is the only thing that seems to help me) was learning a type of yoga breathing. Every night in bed I spend 5-10 minutes doing it - and at other times if necessary - and I can actually feel my pulse slowing and my mind calming and my body becoming less tense. I can honestly say this has helped my own adrenal issue and I find that overall I’m just a less anxious person

It’s like meditation I suppose in that it takes time, practise and patience. I hope you can find something that brings relief from the worry. Certainly this forum is no end of help. I read it every day and always find hope and learn something new and I’ve seen many of your contributions too, they’re always helpful and thoughtful

[DippyDame]

Thank you for your very thoughtful response which I certainly don't see as preaching!!I think my son has a lot to consider now, which I'll be discussing with him later today....not least an adrenal issue.

I suspect I'm more concerned than he is!

There is a lot to unpick - as I had to do for my own thyroid health.

I concede that I'm somewhat " thyroid obsessed" but nevertheless open to other possibilities.

And, I like the idea of yoga breathing....may practise that myself!!