Advice Please - 10yo girl's results

[Rustypoo]

Hi, my 10 yo daughter has had a mix of symptoms over the last year e.g. tummy pains, restless leg, pins and needles, light headedness/dizziness. The tummy pains have happened since she was quite young and was diagnosed with "tummy migraines" a few years ago i.e. no other obvious diagnosis. I think there is maybe a small gluten intolerance, Coeliac has been ruled out based on blood tests.

Additionally, I've noticed her becoming more anxious over the last year as well. I don't think this is uncommon in children her age, but with the other symptoms, plus the fact that I have PA and Graves, alarm bells have started ringing for me.

Just wondering if anyone on here is able to help read her "normal" blood test results please to let me know if there's something I need to be aware of. I've attached a picture of all results, but some are here:

Serum B12 - 591 (130-900) (Dr said this is normal for children but I remember being told years back that some experts consider 500 to be someone declining and in need?)

Serum Ferritin - 28 (15-300)

Serum Folate - 16.8 (>3)

Vit D - 44LM / D3 72 nmol/L (think I've written this correctly)

Serum TSH - 1.29 (0.30-4.40)

Serum free T4 - 14.7 (9-19.1)

No T3 reported.

Thanks in advance for you help. This post will show in the PA group and the Thyroid group.

[fbirder]

The 'b12 needs to be above 500' myth has been busted several times over.

Both B12 and folate are high normal, quite a bit higher than the average for normal people. So it'll be a big surprise if there's a problem with them. Indeed, I'd be surprised if she hasn't been taking supplements (I take 1000 mcg of folate a day, and mine is only 17.4 mcg/L).

I can't comment on the thyroid function.

Everything else looks OK.

If you want to pursue B12 or folate as possible causes then you should get tests for methylmalonic acid and homocysteine. MMA is used up in one of the reactions mediated by B12. hCys is used up in a reaction that requires B12 and folate. If levels of MMA and hCys are raised then it might indicate a functional B12 deficiency (where there's lots B12 in the blood, but not enough in the cells). But there are other possible causes.

[Rustypoo in reply to fbirder]

Thank you

[Nackapan]

I would keep a food diary to see if gluten is affecting your daughters tummy issues. Also diary.

Is she going dizzy on standing?

Is she clumsy or gets sore wrists ankles or knees?

Just thinking about autonomic function.

It's starts with subtle symptoms that could be put down to so many things.

To me her bloods look good. Nothing jumps out. (But who am I. Not a doctor)

Keep a diary of her symptoms too. So hard to keep track otherwise.

Could the anxiety feeling be her heart going a little faster?

All thoughts as hard on a daily basis to work out what's going on. Something is.

I wish her well.

[Rustypoo in reply to Nackapan]

Thank you

[Foggyme Administrator]

Hi Rustypoo. Just a thought...

Your daughter's blood tests are all marked low for neutrophils, monocytes and eosinophils (white blood cells) - the overall white blood cell count is just under the reference range too. Has your GP said anything about this?

The causes can be benign (i.e. virus or infection), but there can be other causes too (Epstein Bar, allergies, asthma, Coeliac disease, Crohn's disease, inflammatory condition, autoimmune disease...).

The usual test for Coeliac's disease (tTG-IgA) can cause a false negative for Coeliac's disease in those who have low IgA or IgA deficiency (you'd be unlikely to know if you daughters has this). There's a second blood test called tTG-IgG that can pick up Coeliac's disease in those who (perhaps unknowingly) have low IgA. It might be worth asking your GP for the second test (tTG-IgG) just to be sure that Coeliac's has indeed then throughly tested and ruled out. (I got caught with this because the tTG-IgA test showed negative for Coeliac's - and I've just discovered that I have low IgA - so Coeliac's is back in the potential autoimmune mix again).

Also note that ESR and CRP (the so called inflammatory markers) don't appear in the blood test list above. If these haven't been tested, then worth asking for these to. If either of these are raised it indicates that inflammatory processes are at work in the body that requires further investigation (usually by a rheumatologist).

Also - and because of the low white blood cells and your daughter's continued health problems - has your GP run an autoantibody screen (ANA test)? Again, if this is raised, it may suggest an underlying autoimmune condition and referral to a rheumatologist would be needed. Rheumatologists have access to more complex tests and investigations, which would need to be undertaken to rule our an underlying autoimmune condition. (You have autoimmune conditions and given your daughter's health and that fact that these can tend to run in families - to be honest, quite shocking if your GP has not done this!!)

Might also be worth asking your GP to check her immunoglobulins - because immunodeficiency issues can precipitate autoimmune disease...which you have...which, like autoimmune disease, can have a genetic component and therefore run in families...🤔.

I'm not suggesting that your daughter has any of these conditions and, indeed, the low white blood cells may have a benign cause. However, if these tests have not been done, it's possible your GP has 'missed an opportunity' (ha) to identify or rule out other potential causes for your daughter's poor health (which is clearly not good).

It would certainly be worth seeing your GP to discuss the low white blood cells, ask for the FBC test to be re-run to check current status, see if CRP, ESR and autoantibodies have been checked (ask for them, if not), and ask for the second Coeliac's blood test (tTG-IgG) - just in case your daughter has low IgA (and hence undetected Coeliac'a disease). Plus the immunological screen 😉.

It may be that your GP has done the above and all is fine...but...🤷‍♀️

Sincerely hope you manage to get to the bottom of all this RustyPoo...there's nothing worse than having a sick child and having to fight to get heard by the some in medical profession. So...go with your gut and trust to you mother's instincts (your alarms bells) ...and keep pressing until you get some answers.

And if your GP is unable to get to the bottom of this and your daughter's health doesn't improve or continues to decline, it is within your right to ask for referral to a paediatrician for further (and through) investigation of her health issues.

Very best of luck to you both.

Please post again and let us know how you get on 👍

[Rustypoo in reply to Foggyme]

Thank you that’s really helpful

[pollianna]

I agree with the above in regards to autoimmunity. You could ask for an Ana test...Its all there on Dr google what it reveals.

Poor wee thing..It sucks to feel off kilter . Wishing her the best