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14 yo endocrine issues?
I have a 14 yo daughter with many symptoms that her pediatrician is unable to help us with. We are told that it may just be the way her body is reacting to adolescense/puberty.
She has the following complaints:
• Hot flashes - several X / day, sometimes all day
• Headaches
o diagnosed with migraines
o almost everyday, sometimes all day
o varying in intensity
• Constant pain in veins in forearms – exclusive of Raynaud’s blue/cold hands
• Raynaud’s Syndrome (less apt to occur during "hotflash")
• Feels strong pulse in random places – almost daily
• Light-headedness - dizziness
• Painful, swollen feeling in underarms, uncontrollable sweating
• Lethargic – often feels unhappy
• Constant feeling of Irritability
• Difficulty concentrating, focusing
• Occasional Fatigue
• Weakness
• Cold sweats
• Chronic moderate anemia
I am not sure if the above would warrant a visit to an endocrinologist. She has had most of these symptoms for about 1 1/2 yrs. She started her menses 2 1/2 yrs ago. She is being treated for migraines with Neurontin, takes Niferex, and has been on Yaz for 2 months She has an ANA of 1:160, it has been determined that she does not have an auto-immune disease. Other than CBC's, other test results have been normal, i.e. no thyroid issues, previous undated EBV.
She leads a "normal" life. Is active with friends, but knows her physical limitations. If she feels symptoms strongly, she relaxes. It is most certainly taking a toll on her, i.e. difficulty keeping up with her friends, schoolwork, not able to participate in sports. Often she is extremely down and frustated that she does not feel well. I desparately want to be able to help her, but am at my wits end not knowing what is wrong.
I feel that I have no one to turn to for help. If it does not fall under the specialty of an endocrinologist, do you have any suggestions?
She has the following complaints:
• Hot flashes - several X / day, sometimes all day
• Headaches
o diagnosed with migraines
o almost everyday, sometimes all day
o varying in intensity
• Constant pain in veins in forearms – exclusive of Raynaud’s blue/cold hands
• Raynaud’s Syndrome (less apt to occur during "hotflash")
• Feels strong pulse in random places – almost daily
• Light-headedness - dizziness
• Painful, swollen feeling in underarms, uncontrollable sweating
• Lethargic – often feels unhappy
• Constant feeling of Irritability
• Difficulty concentrating, focusing
• Occasional Fatigue
• Weakness
• Cold sweats
• Chronic moderate anemia
I am not sure if the above would warrant a visit to an endocrinologist. She has had most of these symptoms for about 1 1/2 yrs. She started her menses 2 1/2 yrs ago. She is being treated for migraines with Neurontin, takes Niferex, and has been on Yaz for 2 months She has an ANA of 1:160, it has been determined that she does not have an auto-immune disease. Other than CBC's, other test results have been normal, i.e. no thyroid issues, previous undated EBV.
She leads a "normal" life. Is active with friends, but knows her physical limitations. If she feels symptoms strongly, she relaxes. It is most certainly taking a toll on her, i.e. difficulty keeping up with her friends, schoolwork, not able to participate in sports. Often she is extremely down and frustated that she does not feel well. I desparately want to be able to help her, but am at my wits end not knowing what is wrong.
I feel that I have no one to turn to for help. If it does not fall under the specialty of an endocrinologist, do you have any suggestions?
Interesting..I have an almost 13 year old daughter with Hashimotos, asthma/allergies, joint problems, constant headaches and excessive sweating. She is late for school or misses a lot of morning classes because of the headaches (determined not to be migraine...yet). I'm interested in the sweating problem, because it is a terrible problem with school and socially. We are trying to come up with a cause/or cure. Her twin (fraternal) has no sweating issues so I'm thinking it's caused by either a medication or one of her conditions.
Let me know if you get any answers. Best of luck.
Let me know if you get any answers. Best of luck.
MEDICAL PROFESSIONAL
This is a very good addition, cardiologists also work with autonomic issues, something to consider
has she had a cardiac workup? i wonder if she could be having some arrythmia causing some of the problems..also has she been tested for allergies? just some thoughts
MEDICAL PROFESSIONAL
The main endocrine issues that are related to sweating have been addressed, she is on neurontin for migraines, be sure that her neurologist is assessing her, as mentioned the autonomic system can definitely affect the patient and present with these symptoms.
Also rare but important one last endocrine thing to assess is a pheochromocytoma, doubtful and very very rare but these patients will have spurts of elevated blood pressure, high heart rate etc.
A test that can be done to look for this is urine for catecholamines, sometimes though the test is affected by her medications. Also if she were having low blood sugars this can lead to sweating, but usually patients will have these symptoms at night. I would go back to her neurologist with these symptoms, you have really done a thorough endocrine workup and it may just be simply an effect from her medications. You don't want to miss a neurological problem.
Also rare but important one last endocrine thing to assess is a pheochromocytoma, doubtful and very very rare but these patients will have spurts of elevated blood pressure, high heart rate etc.
A test that can be done to look for this is urine for catecholamines, sometimes though the test is affected by her medications. Also if she were having low blood sugars this can lead to sweating, but usually patients will have these symptoms at night. I would go back to her neurologist with these symptoms, you have really done a thorough endocrine workup and it may just be simply an effect from her medications. You don't want to miss a neurological problem.
MEDICAL PROFESSIONAL
not sure about the hotflashes, it could be related to estrogen or catecholamines(adrenaline) or thyroid or an autonomic thing which is neurological. The waking up in a sweat again can be low sugar, autonomic or estrogen related.
The am cortisol is supposed to be 20 or so this is when it is peaking, I doubt she has excessive cortisol as she would have many other symptoms like weight gain, short stature, hypertension round facies etc.
You have got me stumped, work closely with her pediatrician, be sure her neurologist is also aware of these symptoms. The Yaz is great to regulate things but does not provide much estrogen. But with her having periods her hormones were indeed cycling rather than being deficient per se.
She is not overweight by any means and although this doesn't completely rule out elevated insulin and metabolic syndrome it puts it low on the list.
So my best bet is autonomic or neurological and work with the neurologist. The rheumatologists sound like they have been very thorough.
Wish I could give you more direction.
The am cortisol is supposed to be 20 or so this is when it is peaking, I doubt she has excessive cortisol as she would have many other symptoms like weight gain, short stature, hypertension round facies etc.
You have got me stumped, work closely with her pediatrician, be sure her neurologist is also aware of these symptoms. The Yaz is great to regulate things but does not provide much estrogen. But with her having periods her hormones were indeed cycling rather than being deficient per se.
She is not overweight by any means and although this doesn't completely rule out elevated insulin and metabolic syndrome it puts it low on the list.
So my best bet is autonomic or neurological and work with the neurologist. The rheumatologists sound like they have been very thorough.
Wish I could give you more direction.
The results I have from lab tests are TSH 1.2 - 1.6, T4 total 7.0. I do not see any free T4 or antibodiies. Two rheumatologists rule out auto-immune. Celiac has also been ruled out. She has just begun taking Neurontin, the only side effect is increased pulsating feeling in upper abdomen. She went to a gyn due to avalanche of symptoms at onset of period. Esp. w/ slight anemia and heavy, cramping periods, we decided to see if Yaz would help her out. Went from 7 day period to 5, but still a little heavy and a lot of cramping this last month.
She is 5'2", and 100 lbs. for 2 yrs. no gain, no loss.
Her main complaints are hot flashes and dizziness. What causes a 14 yo to experience hotflashes? She will wake up in a 74 degree room literally damp from sweating. She feels like she has a fever, but does not, as she is cool to the touch. Hoping treatment of her migraines continues positive, as it has so far, if she could not feel warm and dizzy all the time, she could deal with the other symptoms.
I have most test results available to me. Is her cortisol a little high w/ an AM of 22.9?
She is 5'2", and 100 lbs. for 2 yrs. no gain, no loss.
Her main complaints are hot flashes and dizziness. What causes a 14 yo to experience hotflashes? She will wake up in a 74 degree room literally damp from sweating. She feels like she has a fever, but does not, as she is cool to the touch. Hoping treatment of her migraines continues positive, as it has so far, if she could not feel warm and dizzy all the time, she could deal with the other symptoms.
I have most test results available to me. Is her cortisol a little high w/ an AM of 22.9?
MEDICAL PROFESSIONAL
Not sure if this is an endocrine issue either, my first thought would be thyroid and if sometime has passed it is worth repeating but it has to include TSH, free T4 and Total T4, and thyroid antibodies. The positive ANA is indeed not very specific but worth exploring, but remember sometimes the test cross reacts and expect her thyroid antibodies to be slightly higher but still worth checking. Also another crazy hunch, celiac antibodies, celiac disease is a great disease masker and can present anyway. Even without gastrointestinal symptoms, sometimes muscle aches etc.
She may have symptoms related to her medications and this is a possibility worth exploring with her neurologist.
Yaz is very helpful in addressing irregular menses and some symptoms that accompany mild polycystic ovary or metabolic syndrome concerns, she has only been on it for 2 months, it can lead to abnormal potassium levels if not monitored so be sure that she has her labs are followed.
Is she seeing a neurologist? Who put her on Yaz and why? for the anemia and heavy periods?
If this is the case then she may have elevated insulin and insulin resistance and signs of metabolic syndrome.
So the answer I know is not clear but if you can see an endocrinologist and your doc will help it might be worth it to explore the thyroid, menstrual issues and overall fatique, other areas that may not have been looked at that endo can address include adrenal and pituitary concerns.
Hope this help. Tell me about her weight, has she lost weight, gained weight?
She may have symptoms related to her medications and this is a possibility worth exploring with her neurologist.
Yaz is very helpful in addressing irregular menses and some symptoms that accompany mild polycystic ovary or metabolic syndrome concerns, she has only been on it for 2 months, it can lead to abnormal potassium levels if not monitored so be sure that she has her labs are followed.
Is she seeing a neurologist? Who put her on Yaz and why? for the anemia and heavy periods?
If this is the case then she may have elevated insulin and insulin resistance and signs of metabolic syndrome.
So the answer I know is not clear but if you can see an endocrinologist and your doc will help it might be worth it to explore the thyroid, menstrual issues and overall fatique, other areas that may not have been looked at that endo can address include adrenal and pituitary concerns.
Hope this help. Tell me about her weight, has she lost weight, gained weight?
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