12-year-old always exhausted, mood changes and feeling unreal, puberty or illness?

[Receptive1]

I am worried about my 12.5-year-old son. I am not sure whether his symptoms are physical or psychological (or both). For the past few months I’ve been putting his snappy mood, “kevin and perry” like behaviour down to puberty, which he is fully in the midst of. But something hasn’t felt quite right and I’d like an opinion here from those who have experienced the teenage years. He says he feels exhausted all the time, no matter how much sleep he gets, and sometimes he is so tired that he can barely make it to lunch. He did not used to be like this. He plays football but seems to have lost interest recently which is a big change, and his play on the pitch has been declining, and he has been slower and less sharp. He is under no pressure to be “good” it’s just a marked decline.
At training the other night, he said the lights felt too bright, and he felt confused about whether what he was experiencing was real. It felt like he was describing depersonalisation. He has also mentioned that life feels boring and repetitive, with the same routine of school, home, and sleep. He has lots of friends, so I do not think it is a social issue, and his school reports have been good. He is mostly out and about at weekends with Friends and not holed up in his room, so I don’t understand his “it’s all just so boring, it’s the same everyday”
He occasionally notices floaters in his eyes, though his most recent eye exam was normal. Again, occcasional headaches but few and far between. Generally eats well and is a healthy BMI so nothing jumping out there.
Saw a GP who was very dismissive, probably didn’t help my son said “fine” to every question he was asked and she basically shrugged it off as welcome to your teenager. Which is fine if correct, but something feels off to me and I’m worried 😢

If your senses are off, I think it might be sensible to ask GP to run a panel of blood tests, make sure not anaemic, check all the basic liver and kidney tests, thyroid etc are ok. Then when they’re normal you can go full teenage etc.

my spidey senses have not been off until the last month when he’s seemed SO snappy, so much less energy on the pitch, and broke down tonight saying he’s exhausted even after 10 hours sleep and can barely make it until lunch time. I even wondered briefly about substance use but he’s very anti -drugs and because he plays at q
competitive level they do urine drug test them so I really don’t think it’s that. In many ways it felt like he was describing depression, but the Gp was adamant its “teenage-it is”

I don't know what's wrong, but I think you are right something is off, whether it be hormonal, brewing for something, post-viral fatigue- or even a concussion, has he had a knock on the head recently? I would keep a close eye and keep talking, his experience of derealisation/depersonalisation needs watching and openly talking about, just to make sure nothing lurches worse. He does sound down, but I don't think leaping in with meds when you don't know what's wrong and that might not be the answer anyway is a solution. I can't help but I don't think you are wrong for keeping an eye.

Definitely no concussion. He’s adamant he doesn’t want meds (I foolishly said prior to GP that there could be something physical causing the exhaustion eg low iron levels and an easy fix, and same if it’s psychological and he hit the roof saying he’s not taking anything for emotions as he’s just fed up and tired. So I messed up there. But he describes exhaustion on a level that I’ve only ever known with low iron or depression 😥

What could cause him to feel odd at
training with the lights feeling too bright
and suddenly realising he was at training and wondering what was going on? That’s odd isn’t it 😢GP said we can all feel a bit spaced out after a long day but that didn’t quite explain it for me but as he’s nearly 13 she mainly talked to him and he kept saying “fine” 🤦‍♀️

Something is off - please take him to another doctor and speak for him this time.

Nothing you're describing is 'normal'.

Does he head the ball much?

He may need a brain scan.

No he never heads the ball -
has a strong left kick and I can’t remember the last time he headed it. At least a year. Given the gp wouldn’t so much as entertain bloods for iron levels I don’t think I’d have any luck getting an MRI scan 😥

I have ME/CFS. It sounds like that. He will need a long list of blood tests - Vit D, Ferritn, B12, thyroid, diabetes, celiac etc etc. They are usually all mornal in people with me/CFS.

The only thing that I think doesn’t fit with ME/CFS is the depersonalization. However, I think that can be caused by stress. My DD had that and saw a psychologist. Although we did later find out that DD had ADHD and I wouldn’t be surprised if she has some link to that. ADHD and ME/CFS are suspected to be comorbid.

For more information:

https://meassociation.org.uk/

Just a warning - if you want to ask the GP about ME/CFS, go fully prepared with printouts. Most GPs know very little about it. Even my very good GP had outdated knowledge, which is also common.

Thank you, I will do this. Had a battle to educate gp on a completely
unrelated condition my daughter has which they knew nothing about. So I will go armed!

I am also thinking migraines, look up the diagnostic criteria, if he feels sick, has headache or is sensitive to light, you only need two of those to be diagnosed with migraine and often we forget boys and men can develop them. I know a 17 year old who has these now, looks pale, feel spacey and weird.

I am not a doctor though and if you aren't happy with the doctor's answer, ask to see another doctor in the practice.

Did he have a bad virus before all this started? Post-viral syndrome, post-concussive syndrome, migraines, absence seizures, start of MH issues, or just teen boys being exhausted and uncommunicative! So hard to know, but always worth a second opinion.

I agree with it possibly being post viral.

I’d also be looking carefully at his diet. He’s growing, so is he getting enough nutrients? You say diet is generally good, which is great, but his needs are changing so it’s worth paying attention to it. Maybe a good multi vitamin supplement for a while would help?

Look up visual snow syndrome.

This sounds like post viral fatigue (which must be taken seriously as it can progress to ME).

Could he have had glandular fever that wasn’t diagnosed at some point shortly before this began? Or if not glandular fever, has he had flu or Covid in the months leading up to this?

He says no meds but it would make sense to add iron, vitamin d and a b complex to just diet as these three will make a difference quickly.
B6 deficiency can manifest as low mood, iron and vit D as exhaustion.

I have no advice but my child of a similar age is exactly the same, every symptom you described. Barrage of blood tests shows everything ok (apart from low iron) and now waiting for a hospital referral. It's taken a year of GP appointments to get the referral. Hope yours is OK.

I don't have time to read this myself at the moment but it may be useful:

https://pmc.ncbi.nlm.nih.gov/articles/PMC2528817/#:~:text=Not%20surprisingly%2C%20the%20usual%20cause,rise%20times%20on%20weekend%20mornings.

Hi Op, I have a son the same age and pretty much the same symptoms - my son is coeliac. He can experience brain fog / tiredness / a whole host of issues that arent onviously related to the gut issues, which are commonly associated with CD. I would speak with your GP about a blood test to rule out deficiencies/ CD.

I did an e consult on behalf of my child and after spelling out what I was seeing I asked for a list of bloods and said if they did not wish to authorise please give me the rationale because we are so concerned we may run them privately and their view would help inform our next steps. They ran them. We also found some deficiencies

Thank you all so much. I ended up paying for a private GP who was pretty horrified our nhs gp had done nothing, he said his symptoms are not normal so something is going on. He took bloods for lots of things from iron deficiency to long covid, so will see when they come back. He also did a full physical exam and found lymph nodes in his groin. Will update when the results come back.

I'm glad you've been taken seriously. Hopefully the tests will shed some light and get him on the mend.

Could lymph node swellings in the groin suggest glandular fever? That has very similar symptoms to what you describe.

Thank you so much. It was expensive but I’m so glad I did it as the GP said definitely something going on, and that it’s definitely not “just” teenager stuff

I don’t know - he’s not had a VERY sore
throat in the last year, and I think he would have if it was GF? But I’m not sure. The fact he found groin lymph nodes has me a bit worried but at least it’s now being investigated

Well done for advocating for your son, OP. Just for a smidge of reassurance; my DS (same age as yours) has always had enlarged lymph nodes (groin / neck / everywhere) but I had never noticed - hopefully this is the same for your boy.