Teen Health/Nutrition

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Question
First off, I would like to thank you for taking the time to answer my question. It will serve as a great help, I'm sure.
Okay, my name is Andrea and I am 16 year old female. I've suffered from anxiety in the past but haven't experienced any sort of episode in the past six months or so. I'm 5'2 and half and I currently weigh somewhere between 97-99 lbs. This has changed recently, as a month ago or so I was weighing in a range between 101-104. I lost that weight without trying, but I've noticed that I've eaten MORE in the month or so that I noticed the weight loss. I typically skip breakfast and lunch, but eat when I get home from school in a series of snacks throughout the afternoon and evening. I get home at about 4:10 pm everyday. I've also become extremely tired. I used to stay up until the wee hours of the morning and be perfectly okay. I would pay my sleep debt during the weekends. But, incidentally, also in the last month or so, I've been completely knocking out by 9 or 10 every night. And taking naps when I can.
I figure that the weight loss and fatigue are related but I really don't know. I was wondering if you could tell me if I may have a disorder of disease of some kind, or it's simply me not taking care of my body. Any advice, diagnoses, or assistance would be greatly appreciated. Thank you again for taking the time out of your day to answer my question.

Answer
Hi Andrea,

First of all, I want to say that you sound incredibly articulate and self-aware. I think as far as health is concerned it's critical that you learn your body's trends and patterns so, like you're experiencing, when something goes a little off track, you notice and can respond to your own needs. Good for you!

As for your unintentional weight loss and profound fatigue, I'm sorry this has you so worried and I know from experience how it feels to be so incapacitated from tiredness. I don't have any easy answers or cures, but I do have some thoughts:

Do I think you have a disease or disorder? Well, probably not, but as with many things, it's better to have the appropriate screenings done in order to rule out the worst case scenarios. It would probably not be a bad idea to check in with a doctor so he/she can make sure you're okay.

Some things they might look for, test, or ask you about:

Thyroid function: Your thyroid is a small gland located in your neck and it secretes hormones that are essential to metabolism as they determine how your cells use energy. It works by using the iodine found in your food and water and binding it with a certain amino acid to create these hormones. When the thyroid doesn't supply the body with the proper amount of hormones, problems can arise. The thyroid can be either overactive or under-active and in your case the former (hyperthyroidism)is more likely. There are several symptoms including fatigue, weight loss, weakness and increased appetite.

Anemia from iron deficiency: As you might know, red blood cells have a protein called hemoglobin in them, which binds to oxygen and delivers it all over the body. In order to produce hemoglobin and red blood cells, we use iron that comes from our food. If we don't get enough iron, healthy RBC's aren't created, hemoglobin levels can drop and the result is a form of anemia. Again, symptoms include abnormal fatigue. This is a fairly common condition especially in young women and is usually addressed by supplements and some diet tweaks.

Your doctor may also ask you about your periods, and your mood/anxiety levels.

Other than medical treatment, I have some other ideas:

Diet: To be completely honest, your diet sounds like a teensy bit of an issue to me. Skipping breakfast isn't great, but if you're missing lunch too, I can see how this could cause some imbalances. If your body is running on empty all day long and then you shovel on the coal in the late afternoon you're creating dramatic drops and spikes in your blood sugar, causing all sorts of whacky things to happen to your insulin levels, your metabolism, digestion efficiency and how energized you feel. Speaking of digestion, is everything okay in that department? If not, it's worth mentioning to your doctor.

I'm also curious about the quality of your diet , just because I know what mine was like when I was your age. If you're going all day without food and then getting the majority of your calories solely from snacks and dinner, I'm wondering if your body is lacking some essential nutrients. Personal story: I come from a family where my mom cooks from scratch, had a giant garden, and everything she bought was organic - and yet when I was 15-18 I still managed to eat several meals a day that consisted of nothing but cheetos and mountain dew -- I'm probably the reason everyone wants to take vending machines out of schools. My entire life I, maybe like you, have been a little underweight, constantly fighting fatigue, and I swear, I get the flu just from being looked at funny. When I started eating real food for all of my meals, mostly in the form of protein and green vegetables, my life got exponentially better, especially when I threw a little exercise into the mix.

Vitamins/electrolyte balance: consider taking a vitamin with B12, Folic Acid (they even make a birth control with this in it), Vitamin C, Vitamin D and Omega 3. While they don't hit every note, I like Emergen-c or Airborne for a jolt of nutrients.

Exercise: Too much? Too little? It's all a part of the balance game. Find what makes you feel good.

How do you look: physical appearance can (though not definitively and always within reason) be a barometer for health. Your skin, your hair, your nails, muscle tone, etc are all part of this network that reflects your overall health status. Are you breaking out, is your hair brittle, are your nails thing and peeling? Diet, hormone levels, and stress are all good places to start looking.

So in conclusion:
1. get a check up, tell the doctor what's going on and be prepared for a couple of routine tests.

2. Eat more regularly. Don't be afraid to get a little experimental with your diet. Everyone's body has different sensitivities and needs and the earlier you figure out what is going to optimize your body's performance, the better. Gluten and dairy are common triggers in a lot of people, but whatever you decide to eliminate or play around with, make sure you have a solid and nutritious foundation of protein, healthy fats and vegetables.

3. Take some vitamins.

4. Move your body a little.

5. Make time for fun. Let off stress. Hang out with friends, gossip on the phone, go to the movies; whatever makes you feel good.

6.If your body is demanding sleep, give it what it wants. Seriously. Maybe it just needs a little more sleep right now. For me, people kept telling me I'd grow out of needing ten hours a night -- never happened.

7.If you're feeling off, not yourself, run down, or weird: play with variables (diet, sleep, exercise, relaxation techniques) but also tell people. Tell your parents, your school nurse, your doctor, or your friends. Access your network and ask for support, or at least acknowledgement. Even if that means saying something as minor as "hey, I'm feeling really run-down lately, I'm going to take it easy" -- it makes people aware of the situation and more likely to take your health-related efforts seriously.  I don't want you to feel worried about what you're going through, because in all likelihood these are issues that can be addressed with some self-love and some lifestyle adjustments, but I want you to feel empowered to be your body's best advocate.

Best of luck and let me know if I can be of further help,

Julia

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Julia Fout

Expertise

I can answer questions about sex/relationships/sexual orientation, HIV/STIs, pregnancy and contraception, nutrition, puberty, how to talk to parents/friends/teachers, depression and anxiety and drug use/drinking.
I think teens need sensitive, practical, fact-based information that's relevant to real life and is drawn from experience - I'm here to provide just that.
Note: I am not a medical doctor, I cannot diagnose illnesses and my advice is not meant to replace the care of a qualified physician.

Experience

I have a degree in Psychology and am working towards my Masters of Public Health with the goal of being a Health Educator. In both of these fields I've spent a lot of time focusing on the needs (mental, emotional, and physical) of teens. My undergraduate courses were heavily focused on the development of the adolescent and all accompanying issues. In my graduate program, I've been enjoying learning about disease prevention/control and behavioral health science, especially as it pertains to sex education. Both in school and out,I've logged many hours mentoring and tutoring kids of all ages; competently responding and reacting to their needs and providing thoughtful direction.

Organizations
East Carolina University
The Brody School of Medicine
Masters of Public Health Program

Education/Credentials
B.A. Psychology with a minor in Education
MPH Candidate

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