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My Teenage boy has an abnormal, low TSH value but T3 and T4 are normal.

My son is 15 years old. He has all the symptoms of hyperthyroidism so I took him to our local practitioner to do a blood test. I have a hard time analyzing the results because it seems that the ranges differ from South Africa to the rest of the Universe.  The doctor said the readings are normal but we should do a retest in 6 weeks just to be certain.
Free T4     10.2 pmol/L       Range is 5.3 - 38.2
Free T3       6.10 pmol/L     Range is 2.65 - 9.68
S-TSH         2.47 mIU/L      Range is 3.50 - 26.40     *L

H=High, L=Low, *H=Critically High, *L=Critically Low

Please help me analyze this.  He struggles at school, with reading and writing. He has hand tremors, he is hot all the time, walks around in t-shirts when it is freezing. He sweats a lot and have clammy hands. He is very irritable and constantly fighting with his younger brothers.  He has some grey hair! He forgets everything. He has zero self confidence. He is tall and lean and very fit, a good boy, very hardworking. I need to help him, I can see he is suffering!
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649848 tn?1534633700
COMMUNITY LEADER
I'm sure they're correct, but please check the reference ranges for the TSH and Free T4... I've never seen anything like them, even in those reports we've seen from Africa.

It isn't TSH that causes symptoms; it's too much/too little of the actual thyroid hormones, so even though the TSH is lower than normal, the Free T4 and Free T3 are not high, as we would expect with hyperthyroidism... If anything, the labs would indicate Central hypothyroidism, which is when the thyroid actually works fine, but there's a problem with the pituitary/hypothalamus axis, in which there isn't enough TSH to signal the thyroid to produce the hormones.
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1 Comments
Thank you Barb135
I wonder if the lab could have made a mistake. That is the exact results, it's a pity I can't send you a copy. We will test again at the end of the month. In the meantime the doctor has put him on Ritalin. I'm not happy about it because I don't believe he has ADHD. Thanks again
Joy
649848 tn?1534633700
COMMUNITY LEADER
Joy, I believe that's what's on the paper.  Can you get hold of the lab and verify the reference ranges, so we can try to figure out what's going on?  

I wouldn't settle for having my son put on Ritalin, if there's a possibility that he has a thyroid issue!!  Thyroid function is too important to bodily functions to just pass it off. ADHD symptoms can mimic thyroid symptoms, so your doctor needs to check this out thoroughly and not just dismiss it so casually.  

In addition, if there's a pituitary/hypothalamus issue your son's other hormones could be out of balance, as well.  That means, his adrenals, pancreas, reproductive organs, etc might all not be getting the signals they require from the pituitary gland.  
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