Initial laboratory work-up demonstrated markedly elevated estradiol (2,690 pmol/L) with suppressed LH/FSH, indicating peripheral precocious puberty; suppressed TSH (<0.01 mIU/L) with elevated free T4 (25.5 pmol/L), confirming primary hyperthyroidism; raised IGF-1 (71.15 nmol/L) and failure of GH suppression on oral glucose tolerance test (OGTT), consistent with growth hormone excess; and increased alkaline phosphatase (702 U/L), reflecting high bone turnover. This evidence concerns the gene GH1 and hyperthyroidism.