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Pediatric Endocrinology (Expert Forum)
18yr old female
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.
18yr old female
by jan2n2, Oct 24, 2007 10:48AM
I need answers on where to turn to help my 18yr old daughter. Over the past 8 months my daughter has exhibited severe bouts of anxiety and depression. Before I try to force her to see a psychiatrist, I am wondering if she may have a thyroid disorder. Although she has always been thin, she has lost a substantial amount of weight recently. Her menstrual cycle has never been normal (excessive bleeding and cramps). She began birth control pills 4 months ago and although the bleeding has been regulated, her cramps have not subsided. She has also complained of swollen glands and fatigue many times in the last few months. She is extremely irritable and cannot deal with any kind of stress which results in angry outbursts. She is a college freshman and her grades are suffering because she is unable to focus, this in part is due to a very unhealthy relationship that she is in with a boy. I am at my wits end and do not understand what is happening to my daughter. I don't know if I am grabbing at straws here, but could she have a thyroid problem? And if so, what type of doctor do I take her to? An endocrinologist (thyroid specialist)? Most thyroid specialists in my area seem to specialize in diabetes in older patients. Or maybe pediatric, being she just turned 18?
Doctor's Answer
by Deanna L Aftab Guy, MD, Oct 24, 2007 01:45PM
, Oct 24, 2007 01:45PM
To: jan2n2
Jan,
your 18 yo is ideally on the borderline between a pediatrician and an internist but did you also know that there are doctors that specialize in both? They are called Med/Peds specialists and they do a special residency. At college there may also be a health clinic that she can go to with a physician and this is worth exploring with her. There are also pediatricians who do fellowships in adolescent medicine specifically and this is a type of patient perfect for this type of specialist.
You describe fatigue, weight loss, chronic menstrual irregularity and maybe even some irritability if not depression or mood problems.
This can be related to many things not just thyroid but yes, you have a valid question and any physician can test for thyroid.
Menstrual irregularity can also be assessed, the oral contraceptive may make the blood tests harder to interpret and often they are the treatment for irregular cycles. There may be a component of polycystic ovarian syndrome.
Weight loss can be due to celiac disease, thyroid disease(overactive), poor intake, excessive losses-malabsorption or eating disorders with bulimia or anorexia or both, or many many other problems.
So first start to see who is available near her school and if not see if there is a children's hospital near you that you can see an adolescent specialist or a med/peds specialist.
Any physician can do her exam and narrow things down to see if and who she needs to see, there are a few issues all combined it seems and I know you are concerned, if she is open to your guidance to see someone this is the best thing to do first.
Hope that this helps.
your 18 yo is ideally on the borderline between a pediatrician and an internist but did you also know that there are doctors that specialize in both? They are called Med/Peds specialists and they do a special residency. At college there may also be a health clinic that she can go to with a physician and this is worth exploring with her. There are also pediatricians who do fellowships in adolescent medicine specifically and this is a type of patient perfect for this type of specialist.
You describe fatigue, weight loss, chronic menstrual irregularity and maybe even some irritability if not depression or mood problems.
This can be related to many things not just thyroid but yes, you have a valid question and any physician can test for thyroid.
Menstrual irregularity can also be assessed, the oral contraceptive may make the blood tests harder to interpret and often they are the treatment for irregular cycles. There may be a component of polycystic ovarian syndrome.
Weight loss can be due to celiac disease, thyroid disease(overactive), poor intake, excessive losses-malabsorption or eating disorders with bulimia or anorexia or both, or many many other problems.
So first start to see who is available near her school and if not see if there is a children's hospital near you that you can see an adolescent specialist or a med/peds specialist.
Any physician can do her exam and narrow things down to see if and who she needs to see, there are a few issues all combined it seems and I know you are concerned, if she is open to your guidance to see someone this is the best thing to do first.
Hope that this helps.
