Suggest treatment for headaches and frequent urination in child

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Posted on Wed, 29 Apr 2015 in Child Health
Question: My son is 13 year old. He complains that he feels bad all the time, headaches, stays pale and has dark circles under his eyes, urinates frequency, stays sick alot, has an attention issue, stays fatigued sleeps alot which has gotten progressively worse over the last couple of years and worse in the last month. He has several cysts in his thyroid the largest being 1.0 cm in width and .7cm in depth. His thyroid levels show to be normal and his calcium level reads normal. I was just reviewing his lab work and notice that his ALK. Phosphatase level is 284. What are your thoughts? What should be asking his doctors to check?
doctor
Answered by Dr. Pradeep Kumar 39 minutes later
Brief Answer:
Get a hemoglobin,random blood sugar and urine test done

Detailed Answer:
Hello

Thanks for the query

The cyst in thyroid is common in this age group and in most of the cases it does not require any treatment. The thyroid cyst if not increasing in size, not associated with hormonal abnormality and if noncancerous should be observed for a period of 6-12 months. In many cases it gradually shrinks in size.

The alkaline phospahatase level of 284 is considered to be normal for this age(range is 170 to 600).

The symptoms you mentioned can be due to anemia(low hemoglobin). In anemia there can be dizziness,lethargy,headache and paleness of body.

The increased urinary frequency can be due to diabetes mellitus, diabetes insipidus or urinary tract infection.
Sometimes thyroid cysts can be associated with other hormonal abnormalities (polyglandular syndrome). Diabetes mellitus or insipidus may be associated with this.

So I would suggest you to get a hemogram(for anemia) fasting and post prandial blood sugar(for diabetes mellitus) done along with urinary test to rule out diabetes insipidus or urinary tract infection after consulting your pediatrician.

I shall be glad to answer if you have any further query
Regards

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Pradeep Kumar 1 hour later
He has been checked for diabetes. He doesn't have diabetes but they did say that he had the antibodies that suggest he has an autoimmune disorder. What can I do? Are there medicines that can be given for that. I feel because he feels bad all the time he may be getting depressed. He was diagnosed with ADHD in the 3rd grade by his medical doctor. I recently had him reevaluated. And they said he had oppositional defiant disorder. They say he can only pay attention for about 5 minutes. He gets bored easily. He has an IQ score of 121. Grabbing at straws. The other blood work that has been done are the following. BUN - 13, Creatinine- .08, BUN/Creat Ration is 16.3, Sodium 139, Potassium 4.4 Chloride - 100, Carbon Dioxide- 27.00, Anion Gap 12.0, GFR Causasian- 135, GFR XXXXXXX XXXXXXX 163, Osmolality 268.00 Calcium- 9.4, total Potein, 7.2, Albumin 4.5, Globulin 2.7, A/G ratio- 1.7 Complete metabolic panel: ALT(SGPT) 59, AST(SGOT)39, Total bilirubin .66 TSH 2.68. So has is what you are saying I need to have done include in this?
doctor
Answered by Dr. Pradeep Kumar 10 hours later
Brief Answer:
Continue the treatment of ADHD and get a hemogram done

Detailed Answer:
Hello

Autoantibodies against the thyroid cells or enzymes is one of the cause of thyroid cyst.The involvement of thyroid gland may be a part of polyglandular syndrome or autoimmune polyendocrinopathy. Involvement of parathyroid(gland for calcium regulation) and pancreas(regulates blood sugar) should be ruled out by doing blood sugar and serum calcium and parathyroid hormone level.
There can be anemia also as a part of autoimmune disorder(pernicious anemia).
The symptoms of your son like paleness,headache,lethargy can be due to anemia.
The report you have mentioned is almost normal,but it does not include calcium level and hemogram(for anemia).
Apart from this as your son has been diagnosed as a case of 3rd grade ADHD continue the treatment as advised by your doctor.Keep him in regular follow up.

I would suggest you to consult your doctor for the need of investigations like hemogram and calcium level.
Regards
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Pradeep Kumar 4 hours later
Thanks for your help. I will definitely get the additional blood work done.
doctor
Answered by Dr. Pradeep Kumar 9 hours later
Brief Answer:
Will be more than happy to help you

Detailed Answer:
Hi


Thanks a lot for following my suggestions.
I will be more than happy to help you,if you have any doubt in future.
Wish your family specially your son good health

Warm regards
Above answer was peer-reviewed by : Dr. Shanthi.E
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Answered by
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Dr. Pradeep Kumar

Pediatrician, Cardiology

Practicing since :2006

Answered : 1990 Questions

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