Calling Dr. BBB: If your Dc was losing weight, what tests would you want to run?

[Simon]

Ds2 is losing weight* despite eating normally and being in "good" health (no colds, flu, etc). Low to moderate activity levels. We know he has some unknown chronic illness but losing weight is pretty new for him. Also, no other symptoms. He isn't complaining about anything.

We see the Dr. soon and I am interested what you would ask about.
I am thinking glucose (is blood or urine better) and/or A1C to rule out Type 1 diabetes. Other ideas?
He has been tested for many things before (diabetes, celiac, thyroid, etc.) so I'm not sure what we should re-consider. I feel like maybe he would be sicker with T1D or Celiac's, more symptoms, you know?

*His weight is down from a year ago (was going up/down over the summer) and he has fallen about 20%tile points on the growth charts. He isn't off the bottom yet but is headed that way. BMI is something like the 3rd%tile and might be lower if he has gained any height. I am using current weight but height from the summer.

[abh5e8]

Just curious.... How do you know he has a chronic illness?

[123LuckyMom]

Thyroid? Endocrine system? GI issues?


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[essnce629]

T1D and celiac disease are the only two that came to mind.

DS1 did lose 10lbs when he was first diagnosed with ulcerative colitis, but had many other symptoms to go with it (bloody frequent diarrhea, cramping, etc).

[georgiegirl]

I would ask for an endocrine referral. Some tests might not be covered by insurance unless the endocrinologist runs them. DS1 had basic thyroid before going to endocrine. At endocrine, he had metabolic panel, growth assessment panel, IGA, Tissue Transglut IgA, and vitamin D.


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[klwa]

I feel like maybe he would be sicker with T1D or Celiac's, more symptoms, you know?

Just wanted to comment on this one. My dad was diagnosed with Celiacs about 9 years ago. His only symptom going into it was that his iron levels had dropped dramatically. He felt fine, but one day he went to give blood & his iron levels were so low they couldn't take it. This after a lifetime of high iron levels. There were no outward signs that anything was wrong. His brother was diagnosed about 2 years prior to that, and he had much more traditional symptoms. Even the doctors were surprised that that was Daddy's issue. So, I wouldn't discount Celiacs just because it isn't a traditional presentation.

[wendibird22]

Just wanted to comment on this one. My dad was diagnosed with Celiacs about 9 years ago. His only symptom going into it was that his iron levels had dropped dramatically. He felt fine, but one day he went to give blood & his iron levels were so low they couldn't take it. This after a lifetime of high iron levels. There were no outward signs that anything was wrong. His brother was diagnosed about 2 years prior to that, and he had much more traditional symptoms. Even the doctors were surprised that that was Daddy's issue. So, I wouldn't discount Celiacs just because it isn't a traditional presentation.

Yes very true. There are over 100 different symptoms. The classic presentation for celiac is weight loss and may or may not be accompanied by other symptoms. But some only have vitamin/mineral deficiencies that are unexplained. Depending on how long ago he was tested, it could be worth testing again. False negatives are more common with very young children (most won't test under age 2, some under age 4). Be sure to get a full panel that includes total IgA, tTG IgA, and DGP. Some docs only do the tTG, but the DGP can pick up celiac in those that test negative to tTG.