My 10 year old cousin (male) has beened referred to the Endocrinology clinic. He is a little taller than average for his age and bone scans indicate that his skeletal age is closer to the median for a 12-13 year old than a 10 year old. He is, however, very thin and my aunt says that he is on the go all the time –a real problem child because he won’t sit still, he doesn’t sleep as much as he should and often gets up in the night. She suggests that this may be because he seems to need to go to the bathroom more often than normal. He is somewhat hyperactive and irritable, with a bit of a temper, but not dramatically so compared to other boys at that age. His current physician suspects a thyroid problem, but physically the boy has no signs of enlargement of the neck. The physician’s physical examination does not reveal obvious thyroid enlargement, but he has a high resting heart rate for a boy of that age. What tests might you suggest to further explore what might be wrong with him? If it is indeed a thyroid problem, what possible metabolic defects might lead to the observed presentation? If you ran tests and found that circulating thyroid hormone was higher than normal, what might this indicate? How could you treat this condition? What would happen if nothing is done for him