15.6 year old w/growth delay??

[Dana44]

My 15.6 year old son recently had his TSH, T4, T3 and antibodies measured along with an X-ray taken of his left hand to determine his bone age. The reason for the tests were no linear growth or weight gain in last 6 months. His symptoms are anxiety, fatigue & vision changes w/ blurring. The Labs reference ranges for our labs normal TSH are .34-5.60 His results were:

TSH - 5.04
T4 - 0.84
T3 - don't have that result yet
Antibodies - still waiting on that too
Bone age - 14.2

My question is this....my doctor feels his results are within normal ranges, but I read that normal TSH levels per the  Assiciation of Clinical Endocrinologists should actually be 0.3-3.0 Based on the information that I have now, should I request an endocrinologist consult for my son?? And are their different guidelines for normal TSH ranges for adolescents??

Thanks!

Dana

[Dana44]

Thanks for your quick response! I do know that his CBC was normal. And it's good to know that the thyroid result is considered normal.

He is a VERY, very active snow and water skier. He has not lost weight, just has had no weight or height gain. He started puberty last year. He also has allergies which seem to be seasonal.

He is not a good eater....he says he is not hungry and does not eat nearly what I think he should for a growing teen. (I have an older son, so know how hungry he should be at this age!). However when we make him finish his dinner he complains that it makes him feel sick to his stomach (*he could be trying to control us?? who knows with teens!) He also has huge desire for sugar.

A repeat exam is scheduled for 3 months to re-check growth.

Thanks again,

Dana

[Deanna L Aftab Guy, MD]

Bone age tells me we have another year at least of growth, thyroid is normal, they need to assess celiac antibodies, cbc, cmp, and somatomedin C level, the thyroid varies with the lab and is specific to each lab so don't follow the aace recs when interpreting.
Repeat growth measurements every 4 months will help to assess growth velocity. He may just have a spurt again, how about puberty exam and the rest, has he lost weight?
What else is going on diet wise and exercise wise?