Abnormal thyroid result in child?

[obser]

I would appreciate any experience/ advice.

My 11 year old DS had a few tests done by the GP recently due to chest pain (most likely a muscular issue due to him being quite tall). She did blood tests just to be thorough and as part of this checked iron levels (low in the past but he’s vegetarian) and thyroid function as I mentioned my only health concern was that he was often low in energy/ tires easily.

I followed up with a call to practice and secretary said GP checked bloods, all normal. I thought no more about it but requested a print out.

I collected this yesterday and his iron stores (ferritin) are low at 15 (range 22 to 274). This isn’t new but annoying that she didn’t highlight for me that he again needs iron supplements.

Even more concerning the thyroid tests showed normal TSH (1.066) but low free T4 of 10.33 (range 11.43 to 17.59). This doesn’t seem very low but does it still have some significance?

I’m just trying to understand if I should ask to speak to the GP, is this concerning and what if anything should I be requesting?

Thanks in advance for any advice.

I suggest you do some research on central hypothyroidism which is usually a low/normal range TSH and a below range/low FT4. People with hypothyroidism often have low ferritin, B12 and Vitamin D as well so it might be worth trying to get those tested as well.

Do you know what time of day the blood test was done. It’s best to get an early morning one with only water to drink beforehand.

Be prepared for a battle with your GP as central hypothyroidism isn’t as common as primary. A lot of GPs have very little knowledge of thyroid issues unfortunately.

This needs testing again as pp says early morning , along with T3, thyroid antibodies and vitamin D.

Thanks that’s really helpful. The sample was taken in the afternoon about 4.30pm I didn’t realise the time of day was important. I’m dreading going back to her and querying it.

Good luck. You really shouldn’t have to battle with your GP to get proper treatment but unfortunately many of us do.

If you have any problems getting the full range of tests via your surgery then there is the option of doing them privately through companies such as Thriva or Blue Horizon but these will mean having to do a finger prick test at home which your DS may not be too keen on.

Just bumping to see if anyone else has had experience of this with their child/ can advise on whether the slightly low free T4 is concerning?

Sorry but I can only confirm Gap's don't seem to have good knowledge of hypothyroidism. I have had it for 27 years during which time I have moved so had 3 different GP's and none of them particularly clued up on it. Ask for repeat test and include Vit D. You will need to keep an eye on it. Tiredness, dry eyes, mild constipation, feeling a bit colder, very slow weight gain. Lots of symptoms but none really dreadful so many just put up with it.

Going through the same thing with my 13 year old - he has borderline low TSH but normal range in everything else.

He has been having blood tests for a year to monitor now and as we have private health we will be seeing a private endocrinologist.

He has seen a private doctor who ran antibody tests and it's not autoimmune.

So he is border line over active as TSH is low.

They will get you to do a few more blood tests as it can be erratic in teenagers, apparently.

PS my son has low energy too but I've no idea if it's his age and being a lazy teen!!

He also feels the cold.