Adhd med/heart murmer/fainting what is it?

My nephew will be 10yrs old this June. He has a heart murmer which has never caused any problem. He has ADHD and started on time release conserta (sp) one month ago. He gets throat infections about 4 times a year and often ends up with upper resp. infections/bronchitis. His glands in his throat get quite large. He is 70pds (lost four in past week) and about 54 inches tall. Other than tourettes and ADHD no other family history of illness/disease. He is a very athletic smart young boy.
Last week he blacked out/fainted twice while running a mile in PE. School nurse said his b/p ws 90/65, his skin/face was pale and fatigued. He was taken to reg. dr. and various physical tests were performed. All checked out fine. B/p was fine etc..  They took several blood tests. Tests show he is anemic. Megaloblasic anemia. Dr. started him on b12 complex. Said he is low on b12 and folic acid. His diet consists of all the foods mentioned in the diet already. So we are thinking he may have malabsorption. He is not himself. Very pale, tired, not social, etc... Since being on the adhd drug he is fantastic and loves it. Testing well, no problems with doing his work. Very social and able to hold long conversations (always very smart just previously was unable to hold a conversation) This is sudden for him and we are pending appointment with his neuro and a hematologist for more info.  Anything you can comment on would be great appreciated.
1)Should we allow him to continue doing sports (he plays baseball and basketball)
2) Cut out sugars to reduce a sugar dive
3) Could it be the adhd drug?
4) Can you get parvo from a pet rabbit?
5) Since his diet does consist of leafy greens, sea food, meat of all colors doesn't that lead more towards malabsorbtion?
6) Started b12 three days ago and still no improvement. How long does it take?

From what I have read for all the reason for b21 def. you need b12 vitamins. We are wondering if this b12 def. could have caused the adhd or increased the adhd or is it not adhd and just b12 def. with damage as a result of going so long without b12 supplements?
Thank you and I look forward to your response. This boy to me is my own and we are all very close and dont want each precious day going by without knowing more. Thanks again

[Kevin Pho, MD]

To answer your questions:
1) I would consider a cardiology evaluation to make sure there are no strutural heart abnormalities before considering sports.

2) I am not sure if cutting our sugar would be beneficial.  You may want to check glucose and insulin levels to ensure glucose control and metabolism isn't an issue.

3) It is possible that it may be the ADHD medication.  High or low blood pressure, as well as a variety of neurologic side effects can be caused by Concerta.

4) It is possible that the parvovirus may come from animal contact, but it is also possible that transmission can occur from human respiratory secretions.

5) Malabsorption may be possible.  Initial tests to evaluate for this would be a blood test for celiac disease or fat tests looking for fecal fat.

6) The effect from B12 supplementation normally takes effect over the course of weeks to months.  

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.

Thanks,
Kevin, M.D.

[islander]

Wow I am getting nervous about no response :(