13 year old dd falling asleep in lessons

[ReflectiveGilet]

Unsure if I should post in health. Dd2 is in year 8. Her teacher has spoken to her today very kindly about her falling asleep in lessons and encouraged her to talk to me about getting her checked for anemia.

We already have bloods booked end of the month. Gp booked then after prescribing her the contraceptive pill got awful heavy and painful periods. we are 3 weeks in to that. We have had a paediatrician for about 3 years as she has diagnosed IBS and she is medicated for that. We have an appointment coming up so I will be reporting this and asking for help.

She goes to bed around 10 and gets up at 6. She leaves the house for the school bus at 7.15 so not much I can do about that.

This started about a year ago and her teacher is right it’s got much worse. I feel a bit scared now. She is very active, does 4 hours of dance a week which she loves. She is lean and muscly. She snacks like all teens but she eats meat and 2 veg type meals most days. She has a packed lunch because I don’t want her eating friend beige food at school.
When she goes to bed she usually goes straight to sleep. She rarely wakes in the night.
i am panicking as she loves school and gets on with most teachers but she is clearly struggling.
Im worried she doesn’t eat v much at school so we have agreed to much more snacks - friend fruit and nuts etc and some flapjack to try and keep her energy up.

only iced coffee at weekends never on a school day and no pop as a rule just occasionally.

dd1 has never fallen asleep at school and has normal periods and none of these challenges and I feel a bit lost. Dd1 looked a bit tired during her exams but she’s radiant again now.

I don’t even know if the tiredness is linked to the heavy periods and the IBS I feel clueless

Does your daughter lie in at the weekends? What time does she wake up naturally on a Saturday and Sunday?

My thoughts exactly. I would go and request to get her tested - remembering you have to continue to eat gluten in the interim. And the initial blood test can reasonably often provide a false negative (it did with me) so if negative, may still be worth seeing about an endoscopy to check. I used to be exhausted prior to being diagnosed and had always struggled with tiredness.

Holland and Barratt often have it on offer - the tropical one is nice

Vitamin D?

I suspect she's amenic.

There's no tiredness like it. I used to fall asleep frequently before diagnosis.

Is she very pale?
Does she bruise easily?
Are her eye heavy - like she ferls at times that it's a struggle to keep them open, even after a good sleep?
Do her bone/limbs feel heavy?
Does she have restless legs?
Does she get pins and neddles in her fingers?

Has she had her thyroid tested along with b12, folic acid, and vitamin D. If not get those added to her blood test before she takes it.

I also have IBS and it caused malabsorption so I was very low on iron / b12 / D / folic acid and also had severe hypothyroidism. I was a walking zombie in the run up to being diagnosed and was sleeping up to 16 hours a day.

Getting my thyroid under control helped calm down the IBS a lot and that meant I started absorbing the supplements I was taking a bit better. I still need very high doses to stay at normal levels but I feel so much better it's unreal.

I would ask to have her thryiod checked and not just her TSH but also her thryoid antibodies.

When my daughter had the same her gyno put her on the pill and suggested she took it continuously for 3 months and then had a break - to help with iron / ferritin but also protect her fertility just incase she has endo as its in my family.

And I am sorry but I am also going to throw you a curve ball after dealing with my daughters low iron / ferritin issues for several years. If your daughter has IBS - its likely she has the hypermobile / or elhlers danlos gene .. it doesn't mean that she would be diagnosed with either of these but she could have a problem with collagen in parts of her body. People with IBS are thought to have an issue with their digestive muscle due to poor collagen development in these areas. There is a link between having the hypermobile / or elhlers danlos gene and low iron / ferritin and a link to issues with mast cells and if she has a problem with mast cells she won't feel well on anti-inflammatories. And then as part of this - collagen is in nerves so sometimes nerves aren't sending correct messages around.

Endometriosis?? Can get misdiagnosed as IBS, with period problems as well it could be thid

@Springpartyideasi get her up at about 8.30/9 but she would sleep until lunch time

I’d let her sleep in on the weekends. Sounds like she needs it while you figure it out. Have you done an elimination diet? She might be gluten sensitive but not coeliac. We are trying gluten free with my son just now but we know he isn’t coeliac. Im guessing low iron as well but the stomach issues won’t be helping.

I'm sure it's been done, but have they ruled out a possible UTI?

Ibs often means a food intolerance.

if she is coeliac or dairy intolerant it won’t matter how”healthy” in normal terms her diet is if it’s got the thing in that irritates her gut.

good that you are testing for coeliac.
the pead that you are under for ibs - have you tried an exclusion diet at any point?

heavy periods mean she is very likely anemic. Getting iron in is tricky though - adsorption is a problem.

my dd ran packets of pills together to halve the number of periods (with doctors approval) which helped on a number of levels

@Random321shes tired and yes I think limbs heavy. I’m not sure about the bruising.
she’s had a cough/snot germ for ages she cant seem to shake off.

Coeliac blood test isn’t always accurate. Lots of people on my fb group who had a negative blood test but positive endoscopy/ biopsy. If iron and more sleep don’t help, might be worth revisiting that.

@PurpleThistle7we have done much stricter diets in the past and she was under a dietician. It didn’t show us much except too much bread isn’t great for her.

@Octavia64i will revisit this with her paed. I think I will write to her. The more I talk. About this the more I realise dd2 has gone downhill but it’s been dd1 GCSE’s so we have been a bit fixated on that.

Take the phone and any other devices out of the room

Is she taking some sort of stomach protection along side the Naproxen? It's strange the GP has kept with this along side the other issues as it's very common for it to irritate the stomach.

Is she old enough to try buscopan? This can help with IBS and some people say it's really good for period cramps too. If you can't more the blood test appointment forward I'd probably try some sort of multi vitamin for the short term and let her sleep in at the weekend.

@ReflectiveGiletI would let her sleep until lunchtime at the weekends and during the school holidays as it sounds like she really needs the extra sleep. I think teenagers just need a lot more sleep than you think - I’d also have her go to sleep 30 mins earlier and wake up 30 mins later on school mornings too.

Is she taking omeprazole for her digestive problems and to protect her stomach from the naproxen? If you take them for an extended period omeprazole can cause your iron to plummet.

This happened to me a year ago - I became clinically anaemic, ferritin in single figures but also folate, haemoglobin and haematocrit below the normal range.

Main symptoms were incredible fatigue, lightheadedness, faint, etc. all exacerbated by very heavy periods.

I was switched to Famotidine, which works differently from PPIs like omeprazole, and given two series of ferrous fumerate, and my iron has gradually come back up to the normal range.

Please explore this - gps are reluctant to admit a prescription medicine can cause such a severe side effect but it is real.

With her having IBS, could she be struggling to maintain vitamin absorption?

@TeaWithASplashOfMilkPleasegp won’t let her have omeprazole long term for these reasons. I do like our gp I hand picked them when we moved house because I work with the surgery professionally and I really rate them. I think the issue is us not telling them the whole range of symptoms. Also we are treated actually just dd2 not me between paeds, gp and outpatients (just podiatry hopefully unrelated!), at times dietician too. We got the pill for her because I asked for transanemic sorry I can’t spell it acid and gp balked a bit an ordered bloods and wants to refer to gynae if they are not happy with them. Which I’m grateful for but that will be another disjointed professional.
it works better when paeds do everything which I think may be what happened next. Dd2 has had the same paed (female and very good with dd2) for about 2 years so at least some consistency,

@DeathMetalMumthebk you I appreciate all the suggestions and advice but we ditched buscopan a long time ago as dd2 said it had no effect at all. Which makes me question if it’s ibs at all!!

@LuckyCharmzi have considered insisting they do all the screens again. I was content with them until my coeliac friend told me she couldn’t ever cope with regular oats. I was making dd2 overnight oats thinking this would help her and made her do much worse! And oats are gluten free!

Just want to thank everyone for all the comments. I feel contorted with anxiety but at least I have some leads to explore with the gp. Dd2 loves school, really turned a corner academically this year and has a strong hobby with her dance, has really defined muscles and is a default positive child ‘I’m so excited’ is her catch phrase. She has lots of friends and seems to enjoy most things in life but there is clearly something medically not right that’s got much worse and it’s really scaring me.

she has her height and weight fine by paeds every 3 months and she’s never been off her centile though.