Those test results are a bit unusual. TSH is affected by so many things that it is reliable as an indicator of thyroid status only when it is at extreme levels, which your son's is not. However the TSH is a bit higher than would be expected, so it was good that the TPO ab test was done. Hashimoto's Thyroiditis can also show as TG ab so I suggest that test also. You should make sure they always test him for both Free T3 and Free T4, since those are the active thyroid hormones, different from Total T4 and Total T3.
With Total T4 in the middle of its range, it is puzzling that Free T3 is above range. This makes me think he should also be tested for cortisol and ferritin (a storage form of iron). Vitamin D and B12 are also important so I also suggest testing those as well. Do you think you can get him tested for cortisol, ferritin, Vitamin D, and B12?
Also, symptoms are the most important indicator of thyroid status. Does he have any of the following symptoms besides fatigue, which is common for teenagers it seems?
Increased sensitivity to cold (temp. below 98.6 which is considered normal)
Constipation ( have to use fiber or laxatives)
Dry skin (have to use moisturizer)
Elevated blood cholesterol level
Muscle aches, tenderness and stiffness
Pain, stiffness or swelling in your joints
Slowed heart rate
Enlarged thyroid gland (goiter)
What are the actual Vitamin D, B12 and ferritin results please? And what do you mean by his Hand H?
I wrote a response but just noticed it did not post. Please give us the actual test results from his B12, Vitamin D and ferritin. Also what are the H and H results you said were high??
His B12 is higher than needed. If supplementing, he can cut back. Vitamin D should be at least 50, so he is close to that. The main issue I see is low ferritin. I know it is within the so-called 'normal" range, but that range is calculated from the database of test results from a lab. It is not an adjudicated range based on science and expert opinion. It is just a lab range. that does not indicate adequacy, or optimal levels. Ferritin should be at least 100.The reason I was especially interested in that is his relatively high Free T3 level, yet he has hypo symptoms. There is info that claims that low cortisol or low ferritin can cause Free T3 to pool in the blood and not get into cells where it is needed to regulate body functions and prevent hypo symptoms. I suggest that you get him started on a good OTC iron supplement like VitronC, which contains 65 mg of iron in each tablet. Other sources are ferrous fumarate, ferrous sulphate, and ferrous bisglycinate.
I suggest that you focus on getting his ferritin level optimal ,at least 100, and then after 5-6 weeks have him tested for Free T4, Free T3, TG ab. You might go ahead and make the Endo appt. in case you decide it is needed by that time. Please keep us tuned in to further results and we can help interpret and advise further.
Thank you for your suggestions! His ferritin has been low in the past so I check it whenever I can. I don’t eat meat so he doesn’t get it often but I’ll give him some and get the ferritin up and will retest as you suggest. Thanks again! I am reading about the T3 pooling.
Has your son hit puberty? At 15 I would think so. If not, I would suggest you may want to take a look at sex hormones. Particularly testosterone and estrogen. Yes estrogen.
men need estrogen to build bone, as well as testosterone. (so do women but in different ratios, women's loss of what little testosterone they have starting at age about 40 is why osteoporosis is almost exclusively a female issue. Simple testosterone replacement will solve most brittle and osteo problems in women. But most Dr's won't do it or even know about it.
Testosterone a portion converts to esttogen. So if he is low in testosterone, he could also be low in estrogen, which is why he is not building bone.
How is his muscle tone? Can he build muscle? If poor, then that may be another sign of low Testosterone.
Low bone building, and higher Free T3 can cause bone loss.
High Free T3 also can cause the LOWERING of Cortisol Binding Globulin. But that should result in higher free Cortisol to be available. So that would not make a lot of sense as Gimel stated above. Low cortisol can cause FT3 pooling.