Thyroid supplementaton recommended part 2!

[sadieandlarry]

Sorry but my last question seemed to get cut off.  Here's the rest of the results.

TPO Ab (rr 10 or fT4 falls below rr.  Since there is such a correlation with childhood vitiligo I am not sure waiting is in my son's best interest.  He is already falling behind in school.  Other symptoms include cold hands/feet, pale skin, tired.  

Dr. says RAIU not consistent with bloodwork and maybe sick euthyroid. Wait and see.

[Deanna L Aftab Guy, MD]

ok, yes there is correlation with autoimmune disease and other autoimmune disease. Vitiligo or hypopigmentation of the skin is an autoimmune disease, thyroid disease and pernicious anemia and celiac disease and parathyroid disease and type 1 diabetes and addison's are also types of autoimmune disease. With history of vitiligo I would be testing his thyroids yearly, but don't go crazy with T3, rT3 etc.
Just get tsh and free T4 and antibodies. If antibodies are positive then this is highly suspicious of hashimoto's and if tsh is elevated and even if free T4 is normal this is subclinical hypothyroidism, once free T4 goes low this is overt hypothyroidism, Be sure you are with a pediatric endocrinologist. Uptake study was done why?
If a thyroid is overactive an uptake is helpful to decide between hashimoto's and grave's, also iodine deficiency can affect it as well.
I would repeat labs in a month include only tsh and free T4, work closely with an endocrinologist and discuss treatment for subclinical hypothyroidism,especially with vitiligo, this could be polyglandular autoimmune disease, they need to test for celiac antibodies and consider testing for possible addison's if there is enough evidence to do so.