how to help a chronically crummy-feeling teen?

[cave canem]

Does anyone know how to help a teen who feels exhausted and vaguely crummy most of the time?  Sometimes the crumminess includes nausea.  He is a glass-half-empty type, so I am not sure the crumminess fills as much of his time as he says, but he brings it up often. It does not stop him from being physically active or being interested in learning/following news/pursuing interests.

 

This has been going on for at least several months.  His pediatrician did limited blood work and did not find anything.  I have experience with mental health issues in teens, and I don't think that is what is going on here. 

 

Can anyone recommend something to look for or try? 

 

Lee in New England

[catz]

Honestly, I would look closer at mental health. Depression and/or anxiety can manifest in physical symptoms in some people and I am saying this from experience. Gut issues can be a part of that. I would follow up more medically for sure. And work to be consistent with a clean diet and regular activity.

[fraidycat]

Try going off gluten for a month.

[gardenmom5]

have you taken him in for a workup looking for a physical reason he feels crummy?  there are quite a few *physical* reasons he might feel crummy.  (and a lot of them will be missed with "limited blood work".)

 

 

[bolt.]

Is it possible that his personal need for sleep is higher than what he is getting -- long term?

[J-rap]

Four our of my five kids have migraines.  When the migraines first started rearing their ugly heads, they often presented themselves as a vague crummy feeling, sometimes nausea, sometimes an unexplained crankiness -- but no headache.  Eventually it turned into the typical full-blown headache migraine.  Do migraines run in your family at all?

[Katy]

I second the migraine thing.  That's pretty much how they started for me as a teen.

 

I'd also try giving some Benadryl and sending him to bed two hours earlier for about a week.  Lack of sleep or spring allergies could cause that.  One of mine was feeling crummy just before a big growth spurt.

 

I would also take a good look at his diet and figure out if any nutrient is missing, including water and salt.  Food journal for a week then enter the information into cronometer.com.

 

Then I'd ask him how serious he was about getting better.  Three hours of hard exercise per day and an elimination diet will go a long way to making most people feel much better, even if the issue is depression.

[Crimson Wife]

Put him on an elimination diet and see if it's a food allergy or intolerance. Don't rely on allergy tests that the doctor ran because they can have false negatives.

[cave canem]

I know nothing about elimination diets.  Does anyone have a favorite resource?

 

Katy, what sort of site is chronometer.com?  I can't find it.

 

 

 

[lovinmyboys]

I would also make sure he is getting enough sleep. I felt kinda crummy and definitely tired when I was a teen and now I really think it was because I needed more sleep. I think teens in general underestimate the amount of sleep they need.

 

Also, it could be a response to stress, not necessarily rising to a mental health issue. I know as a teen I almost always had a low level of stress..keeping grades up, working, school activities, learning to drive, negotiating the social scene, dating, making decisions about the future, figuring out who I was apart from my parents. I know as an adult when I am stressed I feel crummy and tired.

 

Anyway, it may be more serious than that, but pretty much every teen I know tells me they are "tired " or "stressed" when I ask them how they are.

[Ethel Mertz]

Test for LYME and other tick borne illnesses!

 

His symptoms could be many things - including such chronic conditions as chronic lyme, migraines, even MS. 

[Butter]

For my daughter, it turned out she had Celiac.  She's a different kid off gluten.

[Katy]

I know nothing about elimination diets.  Does anyone have a favorite resource?

 

Katy, what sort of site is chronometer.com?  I can't find it.

 

that's because there's not an H in it:  https://cronometer.com

 

It's a website for people who  CRON (calorie restricton optimal nutrition), which theoretically increases lifespan.  But really it's an awesome and free nutrition tracker that will tell you what nutrients are missing.  Mine are most frequently low in magnesium and vitamin E when we track what we've been eating.  I've added bone broth soups and sunflower seeds to our diets specifically to cover the nutrients we weren't getting.   I've also experimented with trying to get more organ meats into our diets.

 

 

ETA: I'd focus on nutrients, sleep, and some antihistimine for a few weeks before I try elimination diets, because it's likely to be one of those and elimination diets take months and are very difficult.  Essentially you start by just eating foods that are unlikely to cause allergies- some people start with just brown rice and lamb, or something like that, and then try one new food every three days and see how they react.  Others look up the foods most likely to cause allergies and just quit those for six weeks, then slowly add back in one at a time to see how they react to those. The problem with elimination diets is that for some allergens (like wheat), the effect of the allergen stays in your system for six weeks after the last time you ate it, so even if you feel crummy weeks after eating it you might attribute that feelling to some other food.

[prairiewindmomma]

You've gotten great advice---as far as the nutrition goes, I'd also add looking into possible hypoglycemia. Two of my kids react to low blood sugar with a feeling of nausea & low energy

[Crimson Wife]

I know nothing about elimination diets.  Does anyone have a favorite resource?

 

I don't know your feelings about Dr. Oz, but he has an easy-to-understand one: http://www.doctoroz.com/article/elimination-diet-printable-one-sheet

 

If you prefer to avoid Dr. Oz, there's also some good information here: http://www.webmd.com/allergies/guide/allergies-elimination-diet

[Suzanne in ABQ]

Could he possibly have mononucleosis?

[heartosunshine]

My teen boy had this issue & his doc recommended eating healthy snacks more frequently. It worked for him. He's growing like a weed right now and just needs more sleep and more food or he feels crummy.

[Peaceful Isle]

Could he possibly have mononucleosis?

My teen had mono this year and acted just like your son. Maybe get him tested. Hers turned into chronic mono and we are now just seeing glimmers of hope of her recovery.

If not, I would say, get him a good multivitamin like Alive.

 

Also, teens need lots of sleep, hugs, and coffee. Lol ;)

[Ellie]

His pediatrician did limited blood work and did not find anything.  

 

More in-depth blood work, including thyroid--not just TSH, but also T3 and T4. Don't take "no" for an answer. Be your dc's advocate and insist. If the pediatrician won't do it, find another one.

[Spryte]

Lyme Disease and co-infections. He sounds like me, as a teen. :( I went 20+ years undiagnosed, remitting and relapsing.

 

Lyme often shows false negatives. I would not rule it out based on a WB from Quest or Labcorp, certainly. Go to a LLMD, or at least find an open-minded doc who will send blood to Igenex.

 

Test for babesiosis, erlichiosis, bartonella, etc as well. You can get info on more co-infections from many of us here, if you want. I had 13 co-infections. Eek. But still initially tested neg for Lyme, so it kept being missed.

[Tiramisu]

In addition to Lyme and full thyroid tests, I'd ask for an ANA. It's not perfect, but it's a start to rule out some auto-immune diseases.

 

My oldest dd was a teen who felt tired and crummy. She has a problem that could be messing with her endocrine system. And she has auto-antibodies. They weren't elevated at first but became so over time. It really was years figuring it out.

[cave canem]

Thank you for the responses.  I am going to work these angles.

We already have been working on sleep. 

The mono test was negative.  I don't know all the specifics of the bloodwork, so I'll follow up with that.

[LibraryLover]

I agree about checking physical avenues!. I say this a person with Lyme. It wipes one out if not treated.

 

Otherl issues can matter as well. Is he bored? Does he have a hobby/passion? What are his interests? Does he feel he has a purpose? What kind of physical activity does he engage (in)?

[happi duck]

...

 

I would also take a good look at his diet and figure out if any nutrient is missing, including water and salt. Food journal for a week then enter the information into cronometer.com.

 

Then I'd ask him how serious he was about getting better. Three hours of hard exercise per day and an elimination diet will go a long way to making most people feel much better, even if the issue is depression.

I keep coming back to this for myself...how serious am I about getting better? I say I am but act like I'm not.

 

I'm intrigued by the 3 hours of exercise and maybe eat clean instead of elimination.

 

Thanks for posting.

[kewb]

Test for lyme and the co-infections that go with it. You will need to see a doctor who is lyme literate. Many infectious disease doctors are lyme deniers.

[Lizzie in Ma]

In addition to Lyme and full thyroid tests, I'd ask for an ANA. It's not perfect, but it's a start to rule out some auto-immune diseases.

 

My oldest dd was a teen who felt tired and crummy. She has a problem that could be messing with her endocrine system. And she has auto-antibodies. They weren't elevated at first but became so over time. It really was years figuring it out.

 

Good idea.  Just wanted to say often people with Lyme have an elevated ana as well on occasion.

[shanezomom]

I agree about checking physical avenues!. I say this a person with Lyme. It wipes one out if not treated.

 

Otherl issues can matter as well. Is he bored? Does he have a hobby/passion? What are his interests? Does he feel he has a purpose? What kind of physical activity does he engage (in)?

 

To the OP, Our son (along with 3 more of us in the family) tested positive for Lyme in the last year via Igenex, ( a reliable lab) last Oct. Ds is 13 and is often "wiped out" with low energy level and used to ask why he was so tired at his age. We are in Western PA, the hotspot for Lyme. Our LLMD did gluten testing through EnteroLab and ds is intolerant so diet went gluten free about 3 weeks ago. No noticeable improvements yet. Ds is on antibiotic Biaxin.

 

Library Lover, you touched on an issue that I am concerned about. Ds has minimal interests. We had him do soccer, little kid baseball and basketball for 2 years each to find a sport for him. He disliked all of them. Like a lot of only kids, I suspect, he prefers one on one time with his one good friend or adult company He loves school (favorites are Latin and logic) but doesn't like to read novels. He is mowing five lawns this summer (not all in one day) for some spending money but gets very hot and tired. At night he talks about being bored and I suggest a book. He would rather play Minecraft and board games. How do those of us with teens who feel lousy rule out depression and or help them develop more interests?

[Tiramisu]

To the OP, Our son (along with 3 more of us in the family) tested positive for Lyme in the last year via Igenex, ( a reliable lab) last Oct. Ds is 13 and is often "wiped out" with low energy level and used to ask why he was so tired at his age. We are in Western PA, the hotspot for Lyme. Our LLMD did gluten testing through EnteroLab and ds is intolerant so diet went gluten free about 3 weeks ago. No noticeable improvements yet. Ds is on antibiotic Biaxin.

 

Library Lover, you touched on an issue that I am concerned about. Ds has minimal interests. We had him do soccer, little kid baseball and basketball for 2 years each to find a sport for him. He disliked all of them. Like a lot of only kids, I suspect, he prefers one on one time with his one good friend or adult company He loves school (favorites are Latin and logic) but doesn't like to read novels. He is mowing five lawns this summer (not all in one day) for some spending money but gets very hot and tired. At night he talks about being bored and I suggest a book. He would rather play Minecraft and board games. How do those of us with teens who feel lousy rule out depression and or help them develop more interests?

 

We discovered depression through neuropsychological testing my dd went through to rule of learning disabilities. I was initially skeptical because she had been in therapy over the years for anxiety and no specialist had ever mentioned depression. Ironically, the neuropsychologist didn't pick up on the anxiety which was very obvious to anyone who knew my dd, so I believe different specialists are better at honing in on the various issues. 

 

The tricky thing is that physical conditions can cause depression; conditions that cause inflammation are known to do this. A neurologist also told us he believed dd's anxiety was caused by her processing disorder, a neurological issue. It's still important to treat depression and anxiety even if it has a physical cause.

 

I have two dc who experienced an alleviation of physical symptoms after treatment for depression and anxiety, mostly in the form of fewer headaches and stomachaches. One dd was scoped and had inflammation of her stomach, so her discomfort was real. But this physical condition improved with treatment for the emotional side of things. 

[Crimson Wife]

 

I'm intrigued by the 3 hours of exercise and maybe eat clean instead of elimination.

 

Eating clean is a good idea for everyone, but it won't solve a food allergy/intolerance. Plenty of whole foods that are healthy for the majority of people can still trigger problems in a subset of the population.