16 year old previous low folate now extremely weak,tired and losing weight?

[aufolandedonmyface]

My 16 year old dd had faint last year (while she had covid) it was fairly dramatic as she bounced her head off the bathroom sink. As a result of that they found she had low folate and they asked for a 5 day heart monitor to check if there were any issues there.

she took folic acid her levels went back to normal and shes actually currently wearing the heart monitor but she has been ok since .

BUT the last few weeks shw has been increasingly tired to the pount where she gets home from college and just falls asleep.

yesterday we went out shopping and inwas shocked as her trousers which were previiusly the right size in her were so loose you could fold the waist band over. She struggled going round the shops , she had to sit outside becaue she felt so weak and had to lean in a fence to rest she got home and fell striaght to sleep. She was pale weak and exhausted.

obviously im calling gp tomorrow when it opens but i was just wondering if anyone had any experience with this. I have no idea if its related to the previous issues or not. Its so hard to tell whats going on at this very moment shes sitting chatting she seems well? But she is so exhausted as soon as she does anythung. I had in the last few weeks put it down to her starting college in september but this seems extreme now. She seems happy enough has made friends etc.

this morning i asked her how she felt as she said fine - but then she said she wasnt going to her volunteering job as she “thought she would die of tiredness” so i really have no idea how she feels!

i thought it was supposed to get easier as they got older - its seems not!

any advice would be appreciated as i have no idea what im dealimg with here!

If she’s losing weight, has she actually reduced what she is eating/changed her diet since starting college, or is this nothing to do with diet? What’s her nutrition like in general?

If she’s had low folate what were her b12/ferritin & thyroid levels like?

Drs frequently mark b12/ferritin as ‘normal’ if the levels are at the very low end of the labs reference range, but normal isn’t the same as optimal and you can be symptomatic at the low end of normal Eg a ferritin level of 20 may be classed as ‘normal’ but you’d likely feel hugely better if levels were above 80 (the lab range in our area is 20-300 so there’s a huge difference between low and high end of normal!) you can be dizzy/light headed/weak/exhausted at the low end of the reference ranges for lots of things but GPs tend to go on lab ranges, rather than symptoms unfortunately.

If she’s low weight she may also have low BP, that can cause weakness/tiredness/dizziness etc. I hope you manage to get an appointment and can find the cause asap. It must be such a worry

I had these symptoms and it was an overactive thyroid on top of all my vitamin levels being through the floor. It's the unintended weight loss that makes me say get the thyroid checked

Is she eating op?

It doesn't get any easier sadly 😕

Low folate can be linked to low B12 and low iron. What were her levels for those? UK GPs are notorious for ignoring low levels of both.

Also does she eat any meat? Vegetarian/vegans MUST supplement their diet with Vit B12 tablets.

Ask the GP to do a blood test not just for iron levels but also a screen for coeliac disease and thyroid issues.

her diet at home has stayed the same she either takes lunch or goes to gregs etc. i have been obsessive including folate rich
foods!

a year ago when she had the inital tests they said her folate was less than 2 but everything else was normal i dont have actual numbers though.

Yes she eats all kinds of meat and veg she doesnt have a limited diet at all.

Are her periods heavy? That’s a common reason for being anemic for females.

Ask for a morning cortisol blood test to check for Addisons disease / adrenal insufficiency. It needs to be taken between 8-9am and if it comes back under 300 she should be referred to endocrinology. It is very rare but the fatigue and loss of weight alongside the other things you describe makes me wonder about it. I have many autoimmune issues that started in my late teens and I was diagnosed with Addisons some years later. Google Addisons and look at the Addisons org website for more information.

Definitely ask for a coeliac test, don’t be fobbed off by saying anemia can be caused by heavy periods. Dd was like this before her diagnosis. You don’t have to be having stomach or poo issues to have coeliac disease.

My folate was low, but I had to have a B12 course of injections before a folate top up, as folate can deplete B12! Worth going back, as having one top up without the other can make it worse.

?mfthr

I wasn’t suggesting it was the only cause. Just that it was a common cause.

We eat lots of meat but still ended up VitB12 deficient and had to have injections and now take tablets.

Is she thirsty or passing more urine than usual? Ruling out diabetes would be my first thoughts with these symptoms and is the most urgent - needs seen today if suspected.
Otherwise anaemia, coeliac, Addison’s and thyroid disease all need checked for and potentially inflammatory bowel disease if she has any bowel or stomach symptoms.

No in fact she has extremely light periods where she barely needs pads at all im not sure why.

I dont think so my mother had type 1 diabetes but im not sure if that puts her any more at risk i have had no problems myself. If it was this would it come on quickly as its been a week or two of symptoms being getting worse really i dont know why but i always imagiend diabetes coming on extremely quickly .

I think you’ve had some good advice, but would try and look at how much she’s eating a little deeper. Is she underweight?

today she was off her food saying she wasnt hungry but thats just been today so i dont know why. She isnt under weight. Before this began she was a size 12-14 clothes i woudl say shes more like a 10 now. But shes still not thin really.

This can be a sign of pituitary issues. She needs her prolactin levels checked and a full pituitary screening. Lack of periods can also be related to adrenal insufficiency.

You absolutely need to get her seen and pushed for tests urgently as it isn’t normal which you know so don’t let them fob you off.

Have you ruled out glandular fever? When I had that as a teen I was ill and in bed on and off for most of a year. She definitely needs to be seen and have bloods done and some answers.

i have messaged the doctor this morning i think it is normally ip to 48 hours for a non urgent reply so om hoping they do some bloos tests or something im not sure if that would show up something like that?

Yes, they can test for Epstein Barr in a blood test. It usually starts with high temp, sore throat and swollen lymph nodes and then afterwards you get the extreme fatigue and flu like symptoms that can do on for weeks and weeks. Most common in 15-24 year olds.

It could be a deficiency, an infection, a hormone or endocrine issue or something else. At this point they need to pursue some testing to work out what’s going on and how to help her.