Even though the etiology of declining FT4 as result of mild central hypothyroidism and (mild) ESS may not be comparable, we hypothesize that prolonged lowered thyroid hormone concentrations in (non-acutely ill) children with cancer may contribute to adverse late effects, such as short stature, weight gain, dyslipidemia, fatigue or the pathogenesis of early frailty, on childhood cancer survivors [14,21,22,23]. The gene discussed is TG; the disease is metabolic syndrome.