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Dr. Hive -- teen is tired all the time

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My early teen dd has been complaining of fatigue for months. She says she is just as tired when she gets up as she is when she goes to bed. She also looks pale and sometimes has undereye circles.


The doctor did a blood draw.


White blood count, iron level, thyroid, vitamin D all normal.


The doctor is thinking maybe some kind of sinus infection, and wants to x-ray her sinuses. Dd doesn't have headaches, sinus pressure, or discharge, though she always has a runny nose.


What else could be causing the fatigue? Allergies, maybe? But she doesn't sneeze or feel itchy.


Any ideas of what I could possibly ask the doctor to check?

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How much sleep is she getting? I know I went through a phase as a teen where I got up, went to school, came home and napped for a few hours, then ate dinner, did homework, and went right back to bed. I couldn't get enough sleep. And my friends all went through the same thing at some point. Growth spurt really.


that said, allergies do seem likely with the runny nose all the time. Mine exhaust me. Can she take some zyrtec for a few days to see if it helps?

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Exhaustion was one of my symptoms when I had a bad sinus infection. I could sleep for twelve hours and was still falling asleep on the couch by lunch. They thought I might have had MS, then did an MRI and found out I had a massive sinus infection. I didn't even have the runny nose. After a couple courses of strong antibiotics, I was a million times better.

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My first thought is go ahead and do allergy meds (my son does Zyrtec) and see if that might be the underlying issue. That said, my MIL had a sinus infection where her only symptom was fatigue and runny nose if I recall. She had no clue she might have an infection and thought it was allergies. I would not discount the sinus angle.


Get her lab numbers and make sure "normal" is really normal. The vitamin D level should be in the 50's or higher. The lab slip likely says 30 is normal. I can get you references on that if needed. See if the did a ferritin level for iron.


It's worth checking for mono if the doctor didn't do that initially. A friend's son had that and fatigue was his only sign. It took a while to figure out.


If all that checks I would push for a sleep study.

Edited by sbgrace
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Well if you figure it out, let me know! My 16-year old has been exhausted for two years. She has been tested for everything we can think of: thyroid, mono, celiac, food absorption problems... Everything was always normal. She gets tons of sleep, averaging 10 hours/night. She has mild allergies, and is on Claritin for that.


We did recently put her on a high protein diet, and she actually seems a little better. Not sure if that's coincidence, or what.


If your daughter has dark circles under her eyes, that's definitely a sign of allergies, so I'd investigate that more.


For my daughter, I'm thinking migraines are a possibility. We have a very, very strong migraine gene in our family, and though this daughter only gets a migraine headache occasionally, I have read that there are migraines that only show up as fatigue.

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