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Family Medicine (Expert Forum)
endocrine disorder?
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
Questions in the Family Medicine forum are answered by Dr. J.M. Keyes. Topics covered include general health issues, adolescence, babies, child health, eating disorders, fitness, immunizations and vaccines, infectious diseases, medical tests and procedures, and senior health.
endocrine disorder?
by marmiulli, Feb 24, 2005 12:00AM
My daughter is 11 her height since birth has been in the 95th%and weight in the 93-95%. At age 9 she started sleep disturbances and slowly gaining weight, blood test mostly normal except ACTH <2 on a range of 7-28 TSH 1.30 INSULIN <2.0 range 6.0-27.0 CORTISOL 7(6-30 range)FASTING GLUCOSE 98(60-100range).At age 10 starts extreme sudden headaches come and go with no warning dizzinesss numbness and tingling in hands and feet and feelings of anxiety.saw neuro normal mri mostly normal blood except for +THYROID antibodies TSH is raised to 3.39 CHLORIDE,ALKALINE PHOSPHATE MCH and ALT are slightly elevated above normal range. at age 11 notice decrease in height velocity just below 50% but weight contiues, gains 17lbs. in 1 year tested again now THYROID antibodies - and TSH 3.40 latest blood shows RANDOM GLUCOSE 66(70-100range)(she had just eaten lunch 30minutes prior.) ALT slightly higher than normal range SERUM CORTISOL 0.3 0.4-1.8 range 24 hour URINE FREE CORTISOL 8.6 unknown normal range. I have an appointment with a endo I just don't want to be told lets wait and see some more. Would these findings lead you in any specific directions.we have tried everthing including seeing a nutritionist who said my daughters diet is not the cause of her weight gain. my daughter has expierced so many other crazy symptoms strange seizure like episodes visual hallucinations palpitaions exzema dishydrosis. recuring fungal infections. dispite all this she is still very active and excellent student and very happy and social. I just want to make sure i ask the right questions so i don't get brushed off. Thank you.
Doctor's Answer
by Kevin Pho, MD, Feb 24, 2005 12:00AM
, Feb 24, 2005 12:00AM
I am not an endocrinologist, bu there does not seem to be a clear direction coming from these lab values. The ACTH level is low, which can be caused by pituitary insufficiency - but this would normally cause weight loss, not weight gain.
The TSH level is within normal limits - again, making thyroid disease less likely.
Regarding the elevated ALT, you can consider further evaluation for liver disease - including an ultrasound or a hepatitis screen.
You may want to to discuss these options with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
The TSH level is within normal limits - again, making thyroid disease less likely.
Regarding the elevated ALT, you can consider further evaluation for liver disease - including an ultrasound or a hepatitis screen.
You may want to to discuss these options with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
Member Comments
by I'mallheart, Feb 28, 2005 12:00AM
see a chiropractor... it does wonders and will get to the root of the problem not sugar coat it like meds do
