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Dr. K.
Dr. K., Board Certified Pediatrician
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My 16 year old son is losing weight, has a loss of appetitie,

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My 16 year old son is losing weight, has a loss of appetitie, you have to make him eat. He has no taste or desire to eat. He is tired all the time and moody. He has Celiac disease. We try to stick to diet , but not much change. He doesn't want to go to the YMCA anymore. He is wasting away. Do you think thyroid or ulcer colitis? Help thanks, XXXXX XXXXX
Submitted: 4 years ago.
Category: Pediatrics
Expert:  Dr. K. replied 4 years ago.
Thanks for your question.

Weight loss deserves some laboratory evaluation to exclude other problems such as the conditions you mentioned. Several simple blood tests will help exclude these conditions

CBC
ESR
Chem panel
Urinalyis
TSH and Free T4
Liver panel

The first step is to do these tests and if they are all negative. I strongly urge you to contact a dietician to help manage diet with celiac disease and possibly a therapist to help him cope with this. It is VERY common for adolescents to rebel against a chronic disease. A good example is when a teenager is diabetic and stops taking their insulin because they do not wan to deal with their condition anymore


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Customer: replied 4 years ago.
I heard that some of the thyroid test come back normal and yet they still have a thyroid disease. How do you know this is the right thyroid test.
Expert:  Dr. K. replied 4 years ago.
A free T4 and a TSH are excellent tests to screen for thyroid disfunction. Usually post pubertal kids will gain weight with hypothyroidism, and growing kids will fail to gain weight if they have new onset hypothyroidism


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Customer: replied 4 years ago.
I think he fits the symptoms of hyperthryoidism versus hypo?
Expert:  Dr. K. replied 4 years ago.
I disagree, I dont think he fits either of the classic descriptions. Hyperthyroidism will present with increased heart rate, palpitations, heat intolerance, INCREASED apetite and weight loss despite eating more because the metabolic rate is increased. It sounds as if he is losing weight because he is not eating and it is likely a direct consequence of his celiac. If the ESR blood test is negative, it will exclude ulcerative colitis and chrons disease
Customer: replied 4 years ago.
He says he feels like he doesn't have enought saliva to swallow food. He always has to drink alot when eating. He feels like it gets stuck when swallowing. He has had Celiac for many years and been on the diet for a long time. I find it hard to believe that celiac has the major role in this. There has to be more...
Expert:  Dr. K. replied 4 years ago.
Thanks for the additional info.

If he feels like his food is getting stuck, then a swallowing study and/or an esophogram is appropriate. Chrons disease can affect the esophagus (which is a cousin to ulcerative colitis) The ESR would be helpful in differentiating


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Customer: replied 4 years ago.
Is an ESR - a esinophil sedimentation rate?
Expert:  Dr. K. replied 4 years ago.
Erythrocyte sedimentation rate
Normal is under 20 (some say under 15). It's a marker of inflammation. It's usually elavated in inflammatory bowel disease


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Dr. K., Board Certified Pediatrician
Category: Pediatrics
Satisfied Customers: 2139
Experience: Board Certified, Ivy League educated Pediatrician.
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