DD no periods - Thyroid?

[ShortyShortLegs]

DD1 is 15.8 and hasn't started her periods yet, all other signs of puberty have progressed as normal. (she had a tiny show of blood at age 9, referred to paeds., no blood tests as never had any more bleeds and puberty starting as normal).
GP ordered blood tests and an ultrasound scan (still waiting for scan).
Blood tests came back as all normal apart from one thing, the prolactin serum was low to borderline, and (different GP) he would have liked the female hormone tested, because he suspected under-active thyroid so sent her for another blood test. He is now on leave for two weeks, but receptionist tells me the latest results are normal.

First GP asked family history, my mum and I were earlier starters, we both have bicornate uterus (heart shaped womb) which is why she order the scan.

Second GP asked if DD is cold or has dry skin. She is always freezing cold, with cold clammy hands and feet, always wears a jumper and fluffy socks, sleeps in socks even in a heatwave! And terrible dry skin, diagnosed as discus eczema, round, dry, scaly patches which are red and take ages to settle. She always has 3-4 of these at any one time, on arms, legs, tummy. And dry skin in general.

Looking at list on NHS symptoms she also possibly has:

weight gain - she has put on weight since starting puberty, more than I would have expected, and all on her tummy, she does not have a big appetite or sweet tooth, is active, plus at least an hours walk every day, physio exercises for a knee injury 2x a day and before the injury a weekly dance class plus practice sessions.
Slow movements - she is the worlds slowest person, especially in the mornings, needing prompting and reminding.
Muscle aches and weakness - she does have an underlying joint disorder, but has a lot of muscle pain too and diagnosed weakness.
Brittle hair and nails - nails are great but I've noticed she has a lot of broken/snapped hairs (hair is waist length I banned her from putting up with elastic hair bands, thinking they were damaging it)
No periods at all.
I feel mean saying this, but she has a big double chin, much larger than anyone else in the family, and not what you would expect looking at her skinny arms and legs!

Anyone got any ideas what is going on? 13.3 year old DD2 hasn't started periods yet either GP said they should start around 12, but we should get DD1 tested first.

TIA

My initial thought was Polycystic Ovary Syndrome, especially with the large weight gain round her stomach. I think she'd need a scan to diagnose that so hopefully that will give you some answers. Does she have any excess body hair at all or bad acne? They can be other symptoms of PCOS. Really, it's very hard to say what the matter is though - I think the scan results will give you more of an idea of what's going on.

As for your DD2, I'm surprised your GP was mentioning getting her tested. 12 is the average age to start but 13 is hardly outside the norm - really any age between about 10 and 16 is classed as normal. I wouldn't be concerned about her at the moment unless she's showing signs of not developing normally.

Underactive thyroid is certainly a possibility here with regards to your DD, her other symptoms also seem to be indicative of this. BTW never accept "normal" with regards to blood tests for potential thyroid issues. If TSH alone was tested, its not enough.

This is a good website re the thyroid and it also contains issues on testing re the thyroid too:-

www.thyroiduk.org.uk/tuk/

Thanks for the replies and the link Attila .....no excessive body hair and no acne, in fact she had 'teenage spots' for a while but for the last 3 years her skin has been lovely and clear.

The GP said as DD2 has started puberty, hips/underarm hair/etc. but no periods same as her sister, then they might have the same issues....she seemed surprised that DD2 hadn't started yet.

DD1 is also being investigated for high blood pressure which is on the symptoms list on the thyroid link. DD1's was found to be high twice when tested by the nurse, so they are keeping an eye and testing every 3 months....it was normal today.

She has the scan on Monday, so hopefully we will have some answers soon.

Hi, Shortyshortlegs,

from your description , your daughter has several of the symptoms of Vitamin D deficiency meaning : The auto immune symptoms ( eczema), joint problems and also muscle weakness/ fatigue ?

      Let me suggest that I would be a good idea if she could have her level checked. 

       One of the possible symptoms of a long term deficiency would be bone pain.  Press on her sternum , with a few pounds of pressure.  Does she report that as painful,  as if it is bruised , a few days ago.   Also press on her front  of shin bone , about  3 inches below the knee,  does that feel painful,  like it has been knocked or bruised  ( but has not ) .   This is not a definative test ,  however if  the answer is yes, to either ,  then I would seriously consider checking vitamin d.  

         Vitamin D  is an essential micronutrient, which affects at least 10% of our genes, expression of those genes can be hindered by lack of it, which can have multivariate effects on the human body. 

Whilst your daughter may not have a deficiency of Vitamin D , it is a fairly easy thing to check and if you find it , putting it right will be of great benefit to her overall health.

Can I suggest you have a really good read of this thread

www.mumsnet.com/Talk/general_health/2421492-Vitimin-D-can-it-have-this-effect.

It is a long thread , but lots of useful information !

Hope this helps

BTBH

Thanks for the reply BTBH, my daughter has a joint disorder (Ehlers Danlos Syndrome) plus a knee injury so I think the points you mention would be tender in any case. I will have a read of the thread though.

Is Vitamin D deficiency associated with a lack of periods? I haven't read/been told anything to suggest this. Plus, she has a good diet and takes a daily multivitamin.

Quick Update: DD1 has had her scan today, all findings are normal, so back to the GP next week. I will be asking for more thorough thyroid levels testing.

Hello again , shortyshortlegs

Well yes , Vitamin D does appear to have effects regarding periods. in adults, so there very well may be effects in young adults as well

Here is a link , to the Vitamin D council.

www.vitamindcouncil.org/vitamin-d-news/new-study-finds-low-vitamin-d-status-linked-to-irregular-menstrual-cycles/

With regards to diet ,

                            unfortunately there is practically no Vitamin D   in our diet ,   except in  oily fish  and then only  wild caught fish, salmon , mackrel  etc.    Farmed salmon has  approx  1/4 that level  i.e.very little.   Eggs are practically the only other source ,  with about  40  IU  per egg   There are some fortified ( supplemented sources)  like  M&S  bread,  Petit Filou yogurt,   but they are very few and far between.Also milk is not supplemented in this country ( UK ) so no vit D in that either. 

If your daughter does not have these items in her consumption pattern , then her source of vitamin D , will be sunlight , ( by far the greatest effect) , and possibly from some of the meat that she eats, such as outdoor raised pork, or beef. Some indoor raised animals are supplemented, and could provide some.

A multi-vit contains a very low dose of Vit D . The dose level was set to avoid rickets. i.e. probably only about 200 IU ( 5 ug). VitaminD has so many more functions , as you have seen in that thread I have posted above.

It has been calculated that our bodies require about 70 IU per day ,per Kilogram of body weight , from sun , food and supplement, child or adult alike.

I do suggest that your daughter should be checked, the benefits to her health of a replete Vit D level will be great. It is easy and quick to check.

If does turn out that her level is low , if you need more advice about vit D , let me know.

BTBH

Just read your last message,

great to hear that all looks normal,

What was her level of Vit D ? Important to know ...!

BTBH

I know the results were 'normal' but what were they? You need to know numbers.

Our GPs have a stupid new system where the receptionists triage you over the phone then the GP phones you back rather than have an appointment....I am waiting for the scan results to be back (7 days) and then will request a face to face appointment and ask for the actual blood test results, and see if we can get further testing.

The lady was very thorough with the scan, looked for cysts on the ovaries, abnormalities because of family history and found no problems so that is a relief. But I won't let it lie, DD1 will be 16 in January so they've said she be referred to paediatrics if needed, although the GP's seem much more efficient.

BTBH, she gets at the very least an hour of sunlight a day, she eats well with plenty of eggs and fortified cereal, plus her daily multivitamin. Not much fish (once a week-ish) because I have a severe allergy so only when my mum cooks it for the kids or if we eat out, she was on cod liver oil too, but found the capsules too difficult to swallow.

There doesn't seem to be any evidence (that I have seen) about lack of periods linked to lack of Vitamin D..... I don't want the GP to go off on a tangent looking into something that isn't there. Having said that I have a Vitamin B12 deficiency and am allergic to the injections so am having to go without...so I will keep it in mind and check her results, and thankyou for your advice.

I have absolutely no experience of thyroid problems....So, can anyone tell me exactly what tests I should be asking for please?

Update: DD1 has an appointment with a new paediatrician in three weeks, so I am going back to the GP in the meantime and ask for repeat blood tests so we have up to date results to take with us.