Thanks to vague symptoms, parents are increasingly insisting their otherwise healthy kids have hormone-related tests unnecessarily, says the American Academy of Pediatrics. Before you ask for a referral to a specialist, consider these issues in their context, says Benjamin U. Nwosu, M.D., a pediatric endocrinologist in Worcester, Massachusetts.
1. B.O. in first grade
Adult body odor in a child is usually caused by early activation of the adrenal glands, which doesn’t require treatment. It’s still a good idea to tell your pediatrician. She should evaluate your child to rule out precocious (early) puberty, which would involve activation of both the adrenal and the sex glands, as well as congenital adrenal hyperplasia, a genetic disorder whose mild form will not show symptoms at birth. If she does see signs of early puberty, it’s time to go to an endocrinologist to review the next steps.
2. Growing fast or slowly
Kids grow about 12 inches in their first year of life, another 5 inches by their second birthday, and 2 to 3 inches each year until they hit puberty. Short term growth spurts or lulls in growth are normal, but if your child keeps growing or doesn’t grow at all for more than ten months, ask your doctor for a referral to an endocrinologist to test for excess or deficient growth hormone and other disorders.
3. Being underweight or overweight
If your child is growing along the low percentiles on the growth chart, consider whether he’s a picky eater. If he takes a stimulant for attention deficit hyperactivity disorder, that can suppress appetite. Both can hinder normal weight gain. If that’s not it, ask an endocrinologist to check for hyperthyroidism. If your child is overweight, discuss diet and exercise with the pediatrician. If the weight gain continues, have an endocrinologist check for conditions such as hypothyroidism, although this is rare in overweight kids.
4. Constant thirst and frequent urination
If your child has these symptoms but is growing normally and at a healthy weight, she might have a urinary tract infection. If she’s hungrier than usual, complains of blurred vision, has lost weight, and has had yeast infections, have her tested for juvenile diabetes by an endocrinologist. While yeast infections are rare in boys, your son should still see the doc if he has other diabetes-related symptoms.