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Child has been feeling poorly off. All labs normal. What could be the cause?

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Pediatrician, Neonatology
Practicing since : 1970
Answered : 891 Questions
my son is 7..has been feeling poorly off and on since March 2013...I have seen MD..had labs..had a strep infection went with 2 different meds to finally get treated. His TSH was 4.96 and free t4 was .96 at the end of April. On may 24, 2013 it was TSH 3.70 and T4 was 7.8 MD said to recheck at end of summer and just watch needless to say he has not been feeling well off and on and has been worse last 2 weeks..Had labs drawn yester 9/9/2013 with TSH 8.96 and t4 of 1.0
so what do you think?
Posted Mon, 7 Oct 2013 in General Health
Answered by Dr. Uma Rajah Ananth 2 hours later
Brief Answer:
still not the levels to treat for hypothyroidism

Detailed Answer:

It would be difficult to predict the cause of "feeling poorly" when labs are OK. However if I were to be the treating doctor here, I would consider the following options:
1. You said labs are OK. Please confirm if there is mild anemia. Anemia can be the cause.
2. Minor fluctuations in hormone levels are normal.
The latest TSH is going higher up - still needs watching - not the level to treat now.
3. Look for other causes of ill health like ear infection,sinusitis,
4. Finally if all other factors are negative, then I would look for other social causes like school phobia, bullying in the school, etc.

You can plan a similar set of evaluation through your physician and diagnose his condition.

Let me know if you need clarifications.

Good luck

Dr uma
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