I was hoping someone could look at my son’s labs and give me their thoughts please. He’s been having vague mysterious symptoms over the last 4 months and we are searching for answers. He’s been very tired, pale, anxious, emotional, stomach issues, flushing, etc. He has had many blood tests and scans and so far the only thing that has turned up is a morning cortisol in the lower part of the range. Negative for Addison’s and he passed the ACTH stim test. I was wondering if he looks like he might not be converting T4 to T3 very well? All of his antibody tests for thyroid were negative.
Edited to add that his total T3 has historically been double what it is now.
Thank you!
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Msmustang1981
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I just attached a new pic of his antibody labs. His vitamin d was considered insufficient, so he’s now on 50,000 injections once a month and is due for a re-check. B12 he supplements so it was over range. Folate was high in range. Ferritin was 98.
Thanks for your thoughtful reply. I thought his conversion was poor too which could explain his multitude of symptoms.
He has not been diagnosed as hypothyroid - his endo said subclincial at best. When I asked about levothyroxine, I was told that his free T4 is already at the top of the range and that meds would push him over.
I am hypothyroid and could not tolerate levothyroxine so I take T3 only and feel perfectly fine. I’m wondering if he would benefit from that too? Especially if T4 is already had the high end of the range?
He is definitely suffering with symptoms but these endos cannot get out of their own way and only pass him along to another specialty.
I need high dose T3-only so I understand where you are coming from
My thoughts are that he needs T3....like you.
I suspect he has the Dio2 polymorphism which impairs conversion...in my case I have inherited this from both parents ( homozygous) which has a greater impact.
Are you able to have him tested for this? Are you in the UK? It proves he would benefit from T3.....though that should be obvious to an endo from his labs!!
In his case, like yours and mine, levo is not the answer and he needs to avoid over range FT4 which can cause other problems. In that, the endo is correct but he is not extending his thoughts to produce an answer. His FT4 is 83.33% through the ref range so in theory there is a little room to try some levo.....but unlikely to be enough.
Are you prescribed T3, or like me, do you have to self medicate?
His endo had glaring gaps in their knowledge if he is missing all this. Your son is not sub clinical, he is hypothyroid.
Is your son an adult?
For good health every cell in the body must be flooded with T3 by way of a constant and adequate supply....looking at his low FT3 level this is not happening.
A further clue is your experience, it looks as if he has inherited your problem. cannot tolerate levo and therefore needs T3!
Ask his endo to give him a trial of T3, they are often more agreeable to that.....his improvement should prove the point!
My son is 17 and we are in the U.S. I’m not sure if they test for that gene or not here, but I do know how much better I am on T3! Thankfully my endo prescribes it.
I have actually had my endo evaluate him for all of these symptoms and she didn’t see an issue which is shocking. However she did order the ultrasound he had yesterday that showed a small, heterogeneous thyroid gland which to me indicated it could be failing or being attacked with antibodies.
I have more than enough T3 to self medicate him to see if he gets any symptom improvement. I remember starting very low and slow. I was thinking of starting him on 2.5mg and increasing by 2.5mg every two weeks. Thoughts?
His symptoms are 24/7 heart palpitations (cleared by cardiology), pale face, hypoglycemic feelings (normal glucose), low BP, feeling dehydrated, fatigue worse upon exertion, digestive issues (cleared by GI), bursts of anxiety and tears, and just an overall “off” feeling. Low in range morning cortisol, too, but passed the stim test and negative for Addison’s.
Thanks again! It’s so tough on my mama heart and trying so hard to get him answers.
I'd be inclined to start him on 2.5mcg T3 and titrate up slowly then when he improves show his medics the proof!!
As you know T3 is a vital hormone I don't understand why medics don't accept this....they seem terrified of it
When I started self medicating T3 my GP thought I was killing myself.....doesn't say anything now that I proved the point!!
You clearly know your stuff....he is lucky lad. I have 2 sons, now in their 40's so I know what you mean by your "mama heart". The younger one is now showing signs of failing thyroid.
I agree with your thoughts on his u/sound results.
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My Endo didn't listen to me, what do I do?
Adolescence and Hypothyroidism 
My son
