Following on with test results for my 4yr old son

[musicaljune]

Six or so months ago I spoke of some concerns regarding my son - 5 next month -and there wasn’t much you could say but I’ve just received his blood test results and see his ferritin is very low. I also requested FT3 (there’s a long family history of Hashimoto’s), B12, folate, vit d and and iron panel, which was ignored.

TSH 1.65 (0.35 - 5.5)

FT4 16.5 (10.5 - 21)

Ferritin 25 (8 - 116)

My concerns are that he’s a bit pale, quick to lose his temper, not sleeping or eating enough and struggles to concentrate on school work. My suspicion is: if I can encourage him to eat more things will gradually resolve but in the first instance I just wanted to get our GP’s opinion and rule out a thyroid problem which is difficult without a full TFT

I’m due a call from him and would value your thoughts.

Thank you for reading.

[SeasideSusie Remembering]

musicaljune

His GP needs to investigate his low ferritin. The information given here, based on NICE guidelines so whether that's for both children and adults I don't know, is that a ferritin level below 30 confirms iron deficiency:

cks.nice.org.uk/topics/anae...

In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.

This should prompt his GP to do an iron panel to confirm this and a full blood count to see if he is anaemic. It's possible to have iron deficiency with or without anaemia.

Symptoms of low ferritin include:

◾Weakness

◾Fatigue

◾Difficulty concentrating

◾Poor work productivity

◾Cold hands and feet

◾Poor short-term memory

◾Difficulty remembering names

◾Dizziness

◾Pounding in the ears

◾Shortness of breath

◾Brittle nails

◾Headaches

◾Restless legs

Symptoms of iron deficiency include:

◾Persistent fatigue

◾Pale skin

◾Shortness of breath

◾Headaches

◾Dizziness

◾Heart palpitations

◾Dry skin

◾Brittle hair and hair loss

◾Swelling or soreness of the tongue or mouth

◾Restless legs

◾Brittle or ridged nails

Iron tests should be done after a 12 hour fast (so easiest early morning rather than fast during the day), it's OK to drink water.

If GP wont do any further testing then Blue Horizon is the only company that doesn't have an age limit of 18 so you could use them to do a full thyroid/vitamin panel.

[musicaljune in reply to SeasideSusie]

Hello seasidesusie and thank you for your response. It’s really helpful to hear about blue horizon as that’s something I would never have known.

He did have a full blood count which I meant to take a pic of and post. Will do that later.

[musicaljune in reply to SeasideSusie]

A bit late but here is son’s FBC:

Total white blood count 5 (5.1 -12.9)

Red blood cell count 4.57 (3.85 - 5.15)

Hb concentration 126 (107 - 139)

Haematocrit 0.393 (0.325 - 0.415)

Mean cell volume 86.2 (74 - 89)

Mean cell hb level 27.6 (24.5 - 31.0)

Red blood cell distribution width 13.9% (11 - 16)

Platelet count 223 (200 - 445)

Plateletcrit 0.190 no ref range

Mean platelet vol 8.6 no ref range

Platelet distribution width 51% no ref

Neutrophil 2.40 (1.7 - 8.5)

Lymphocyte count 1.75 (1.8 - 7)

Monocyte count 0.43 (0.1 - 1.0)

Eosinophil count 0.09 (0.02 - 0.75)

Basophil count 0.03 (0.0 - 0.2)

CRP < 4 (0.0 - 6.0)

Potassium 5.1 (3.5 - 5.0)

Creatinine 30 )34.0 - 71.0)

Thanks for any insight or suggestions. GP wants to speak with me.

[SeasideSusie Remembering in reply to musicaljune]

The FBC doesn't show any signs of anaemia so possibly iron deficiency without anaemia then.

I can't help with the low creatinine level, maybe ask GP when you speak to him.

[musicaljune in reply to SeasideSusie]

Ok, thank you.

[Anthea55]

Just a thought (I'm not a medic, just a granny) - is it worth getting him tested for coeliac disease when you speak to your GP? A friend's grandson was diagnosed coeliac - I think aged under 5 - and I was told that it made a great difference to him. A bit of a surprise to the family as they had to learn about it.

If some foods make your son feel unwell then he might avoid them so don't push him to eat what he doesn't like. Sounds as if he's old enough to talk to you about the foods he likes.

[musicaljune in reply to Anthea55]

Hi Anthea55, I appreciate your response and suggestion to have coeliac tested. This was done at the same time and thankfully is negative.

You’re right, he is indeed old enough to talk about his likes and dislikes and is very vocal about it!

Thanks again.