Fatigue in a teenage girl, help me think this through - update in #36

[NCGrandma]

Lyme was my thought too. I would have hoped they’d run that test though.


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Based on my/my family’s experiences, physicians vary markedly in how much Lyme and other tick-borne illnesses are on their radar, especially in the absence of documented tick bite. My DIL had to really push for DGD1 to be tested for Lyme, despite the fact that they were living in a rural area at the time (and were only about an hour away from Lyme, CT!!). The pediatrician was surprised when the test came back positive...


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[firstbaby]

OP, you have my sympathies. I agree with the PPs that mentioned testing for Lyme, mono and low ferritin.

DS also plays HS sports and he gets home between 9:30 and 10 at night, needs time to eat, wind down, pack for the next day, etc. He's up at 5:45am and catches the bus at 6:30. In our area, it's not possible to play sports and get enough sleep unless you sleep in the car on the way home from practice/game and go right to bed as soon as you get home. DS will nap on the bus on the way to school and will fall asleep if he comes home on the bus after school before he starts on homework or goes to practice. I agree not getting enough sleep can mess with you, but it sounds like your mom intuition is being set off that it's something else.

[ray7694]

I think it’s medical. Sounds like classic mono. I would get full bloodwork done.

[KpbS]

I think it’s medical. Sounds like classic mono. I would get full bloodwork done.

If it is mono (surely they already drew blood for this?) she must stop playing soccer ASAP to protect her spleen.

[petesgirl]

Mono was my first thought also, probably because a few teens in my neighborhood currently have it.
Another thing to test for--Vitamin B12 deficiency, it causes fatigue.

[jerseygirl07067]

If it is mono (surely they already drew blood for this?) she must stop playing soccer ASAP to protect her spleen.

Her pediatrician ordered a CMP (comprehensive metabolic panel). I don't believe she tested specifically for mono but wouldn't her white blood cell count be elevated? Hers came back normal. The ferritin is interesting, and I didn't realize your ferritin could be low despite having a normal hemoglobin level. Hers came back at 13.6 which is probably better than mine.

I was also going to take her to an endocrinologist to check her hormones, could they do all of this testing too? Or would it be better to request it from her PCP?

To the PP who mentioned about their DC having type I diabetes. Thank you for sharing and I am so sorry to hear about that. Thank goodness you caught it when you did. DD did have her fasting glucose checked and it came back normal.

[essnce629]

Did they check her ferritin level or just iron? I was having extreme fatigue and my iron came back fine. I finally pushed her to check my ferritin and it was 13. We're working to get it up to 75-80 and even just at 35 I'm feeling better.

The ferritin is interesting, and I didn't realize your ferritin could be low despite having a normal hemoglobin level. Hers came back at 13.6 which is probably better than mine.

It's the ferritin!!!!!

I've been iron deficient off and on for probably 15 years and have never had anemia because my hemoglobin has always been normal. At a ferritin level of 13 I'd be out of breath, have a racing heartbeat, be cold all the time, be napping daily, and feeling depressed. At a level of 8 I was eating crayons (pica). But still my hemoglobin was always normal so no anemia, just iron deficiency. Does she have heavy periods or is she a vegetarian/vegan? Those are the most common risk factors for iron deficiency. If she has neither of those risk factors then she should be tested for celiac disease (antibodies blood test) since that is another cause of iron deficiency since your body can't absorb nutrients well. Oral iron does nothing for me so I do IV iron infusions now and feel much better.

With a ferritin under 50 you're likely to feel like crap and even have hair loss.

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[solsister]

I think it's probably just her body's way of telling her to take care of it. Slow down. Get to bed earlier. Something has to give, or she will be set up to get mono or some other illness. My daughter is 16, and does all the sports, has a job, is social, etc. She knows she has to get to bed by 9:30, for a 6:15 wake up, at least 2 of her 4 nights of school, or she becomes exhausted, and a wreck. She listens to calming sleep music to fall asleep to. She was really, really dragging today, after two late nights on the weekend, followed by a couple of late nights this week. She went to bed at 9:33. She really listens to her body, which is amazing at this age.

If you have the thyroid panel, check it against the charts at stop the thyroid madness dot com. Thyroid imbalance is very under treated, and most doctors are following ridiculous numbers for testing. Thyroid would be the first thing that I would, personally, double check, and see what you can find. PM me if you want more info.

[specialp]

Her pediatrician ordered a CMP (comprehensive metabolic panel). I don't believe she tested specifically for mono but wouldn't her white blood cell count be elevated? Hers came back normal. The ferritin is interesting, and I didn't realize your ferritin could be low despite having a normal hemoglobin level. Hers came back at 13.6 which is probably better than mine.

I was also going to take her to an endocrinologist to check her hormones, could they do all of this testing too? Or would it be better to request it from her PCP?

To the PP who mentioned about their DC having type I diabetes. Thank you for sharing and I am so sorry to hear about that. Thank goodness you caught it when you did. DD did have her fasting glucose checked and it came back normal.

DO you have the results and can see the White blood cell count on it and it's in normal range? I'm asking because that isn't included on any CMP my kids have had done, but is on CBC.

[georgiegirl]

It's the ferritin!!!!!



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She means hemoglobin is 13, not ferritin. (I have low ferritin and so does DS1).

Endo won’t see her unless there’s something off with thyroid or if something indicates diabetes.

There is a separate blood test for mono. There’s also a rapid test with s finger poke that takes 8 min (DD was tested last weekend)