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Pediatric Endocrinology (Expert Forum)
16 year old with extreme fatigue and muscle aches
Answered by
Deanna L Aftab Guy, MD - Short Stature, thyroid, Pituitary abnormalit, Puberty concerns, Rapid Growth, Adrenal problems, Parathyroid abnormal, Rickets and bone dis
Vanderbilt Children’s Hospital
Nashville - TN
Questions in the Pediatric Endocrinology forum are answered by Dr. Deanna L Aftab Guy, affiliated with Vanderbilt Children's Hospital. Topics covered include adrenal problems, diabetes insipidus, menstrual irregularities, obesity, parathyroid abnormalities, pituitary abnormalities, puberty concerns, rapid growth, rickets and bone disease, short stature, and thyroid.
16 year old with extreme fatigue and muscle aches
by thyroidmom375, Jul 29, 2008 03:03PM
My 16 year old has been feeling fatigued and achy for 6 months. She is also losing hair, has sharp pains in her side and chest (x ray negative), can't concentrate and is getting depressed at her inability to do anything physical. We have seen 2 endos and a peds rheumatologist and have had auto immune antibodies tested. Her ANA is 1:320 but all the other auto immune antibodies are negative. She is not getting any improvement after 5 1/2 weeks on 100 mcg of Synthroid (her TSH was 11.96) and we are awaiting results on the thyroid antibody tests. Her fatigue is debilitating and she has soreness in her neck (around the thyroid area) and a tightness that extends throughout her whole neck. Our latest "advice" was to wait on the thyroid antibodies and then retest the auto immune antibodies in 6 months. She can't last feeling this way for 6 more months. We are looking for a next step and would appreciate any guidance you could give.
Doctor's Answer
by Deanna L Aftab Guy, MD, Aug 23, 2008 09:09AM
, Aug 23, 2008 09:09AMTo: thyroidmom375
If her tsh is 11.96, this is too high, make sure that you stick with ONE endocrinologist!, let them adjust her dose based on both the tsh and free T4, if the thyroid antibodies are elevated this may be hashimoto's thyroiditis, very common and autoimmune thyroid problem that can also have a cross reactive blood result when ANA titers are tested, If tsh is elevated her dose needs increased, firstly be sure she is taking her medication daily without fail, next increase of her dose needs to be guided and followed by her endocrinologist. Next, be sure that she goes back to see rheumatology to get the remainder of the workup if the ANA is positive so that she is not missing things.
Repeat thyroid functions are done about 4-8 weeks after each dose change, so don't' get her dose changed too quickly, it takes at least a month to see good results labwise from the brain's hormone tsh.
Repeat thyroid functions are done about 4-8 weeks after each dose change, so don't' get her dose changed too quickly, it takes at least a month to see good results labwise from the brain's hormone tsh.
