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Post by chemom on Nov 22, 2008 17:00:10 GMT -5
My question is similar to Day's, but I didn't want to hijack her thread.
I am taking my youngest daughter, Abby (8 yo) to a ped. endo. Tuesday to talk about growth delay (her bone age is 5, she weighs 38 lbs. and is 44 in. tall - completely off the charts.) From what I have read, GH varies throughout the day, and not according to a circadian rhythm like cortisol, so how can we accurately measure it? I thought that's why the IGF-1 and IGFBP-3 tests were used instead?
Thanks.
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Post by Chris Jackson on Nov 23, 2008 16:55:36 GMT -5
10 percent of short stature is low GH. There are many other things like heart disease, low thyroid, kidney disease that can cause it. Those tests are preliminary tests. Igf-1 can be high and GH low and vise versa. I say if anyone other pitutiary hormones are low, then GH has to be tested regardless.
You're welcome, Chris
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Post by chemom on Nov 23, 2008 17:10:32 GMT -5
It's not just her short stature - she only weighs 38 lbs, at 8 years old. I am so pissed at our ped. for not keeping up with this, but also mad at myself for the same reason. From the time she was approx. 2, she has been dropping lower and lower on the growth chart, and at 4 she fell off. But the ped. didn't care I haven't tested her thyroid yet - all our ped. tested was her TSH, which, of course, was "normal" at 1.76. It does appear she may have a B12 deficiency, but I need her B12 level tested. I have printed out and read, and reread your Stickies on the ITT, the GHRH and the Arginine Stim tests - should I go in Tuesday asking for an ITT Stim test for her? Thanks.
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Post by Chris Jackson on Nov 23, 2008 18:03:43 GMT -5
Low cortisol may be causing her low weight. Her TSH looks like could be low. For under 5 years, I look for 2.5 for males and females, At eight years hard to say what it should be. I'm thinking around 2.0 Of course looking at symptoms and free tests you know is what really matters. The doc is probably going to do random blood cortisol first if not done yet, but ask for ACTH too. The ACTh stim costs at least $300 so they don't give it first.
Arginine and ITT can't be entertained until she has had igf-1 and GH tested. If low, then these tests can be considered. There is a risk with these tests (given in hospital), so aren't given to kids unless the doc is sure is needed.
You're welcome, Chris
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Post by chemom on Nov 23, 2008 21:25:20 GMT -5
Alright, first things first then, I'll be patient. I was concerned about the ITT because her fasting glucose came back at 69, which the lab range says is low, but I believe you've said that as low as 50 is actually "o.k."
I wanted to add that symptoms are what throw me off with her, because she has none of the symptoms I'm used to seeing in children that are hypoadrenal/hypothyroid. She gets up bright and early every day and is full of energy all day long. Still, I'll test her Frees and antibodies to check, since Duane has Hashi's.
Thanks for the help.
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