Hello doctor, My daughter is 8 years old and we found out that she has low iron at the end of last month due to fainting episodes she was having. She has been on a liquid Iron supplement that she takes with a glass of orange juice since this month. Her iron levels we found have continued to drop even with the supplements. She is constantly fatigued and sleeps half the time. We also discovered she is vitamin D deficient. The doctor has tried to refer her to a specialist but they have said to continue doing what we have been doing. We have been doing this for two months with the opposite of our desired results. Any suggestion?
Hi. According to the history provided, fatigue, sleepiness, low energy are the main complaints. Let me tell you that in the attached reports (attachment removed to protect patient identity), serum ferritin, serum iron, HB level, WBC counts, platelet count all are within limit. It does not look abnormal. So her iron deficiency anemia seems to be improving. But weakness is still present. Hence, neurological examination and all reflexes should be checked. Investigate with serum TSH, T4 estimation which is strongly recommended to rule out thyroid issues. Check her electrolytes levels also, serum sodium, calcium, and potassium. For low vitamin D level, Cholecalciferol sachet with milk can be prescribed. Check liver and kidney profile also as the disorder also can lead to chronic weakness. If the cause is not identified, then, the muscular dystrophy-like muscular disorder has to be ruled out by EMG like an investigation. Take care. Consult nearby pediatrician doctor or neurophysician for examination and accordingly further work up can be planned (with keeping my answer in mind).