Teenager with red flag thyroid blood results - please help interpreting

[itshotinperth]

Hello, just a bit of background, I have hashimotos, and coeliac, teenage DS with coeliac, eosinophilic eosophagitis, and a host of other food allergy related stuff.

the gastro has just sent him for a heap of blood tests - his TSH has come back at 5.79 - they only tested free t4 which was 16 pmol/L - I know we need free t3 and antibody test as well and will request that in next round of testing. There is a disclaimer with the thyroid tests saying elevations of TSH are common due to intercurrent illness and often regress spontaneously. But his iron panel tells me (I think) its thyroid -
Iron 10 umol/L (7-25)
transferrin 2.7g/L (1.9-3.7)
Transferrin Sat. 0.15 (0.20-0.50)
Ferritin 14 ug/L (12-70)

I think this showing he is significantly iron deficient and if they had tested his Vit D and B12 they would also be low pointing to thyroid disorder.

His coeliac is well managed - no antibodies so we know he is good with his food re gluten. And has been diagnosed 5 years so doubt any deficiencies from way back then.

Any advice would be great re thyroid - interpreting the results. Just as an aside, his serum IgA was 0.6 g/L (0.7-3.1) and IgE 694 KIU/L (

It would be useful to know the ranges for those thyroid tests. Where I live you would be looking at an above range TSH and mid range FT4, which suggests FT3 would be lowish in range, and I certainly agree that you need FT3 and antibodies to get a full picture, especially given the background.

I don't know much about coeliac disease, but my understanding is that you do get absorption issues leading to low B12, folate, vitamin D and ferritin, but if you're saying he's well controlled then yes, that does point to something on the auto-immune spectrum.

Press for full testing and push for the ferritin to be sorted out pronto. At that level he may need an infusion rather than waiting for tablets to take effect.

Thanks mrstweedie, I'm in oz and reference ranges are 0.4 to 4 for TSH and 15-25 for fT4. Actually that tsh ref ranges changes between labs - the other ref is 0.3-3.

I would be prepared for an argument about his results being within ranges from the doctors, but to my (hypo and possible coeliac) mind he looks deficient to me. What are his symptoms? I always thought male ferritin levels were higher anyway due to not menstruating. My ferritin was 12 with a lower limit of 11 and all I get told is that it was "within range", therefore nothing to worry about. Gah!!!!!!! What about lactose intolerance, I have that, and it stopped my ferritin levels from increasing despite supplementation for over a year. Could that be the case with him? Definitely get B12 and D tested, folate is the other one.