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  1. Does anybody have any insights on this? PANDAS dd first got her period in 6th grade (11.5 years). She had pretty normal cycles until the spring of 8th grade (March) where her period came but was very light. Now, in the past several months, her period has stopped altogether. We saw her pediatrician in July. Ped wasn't concerned but did run a few blood tests (I'd have to look up what they were) which were normal. But since then, the problem has gotten worse but not better. She did have PANDAS anorexia in 2nd grade. At that point she went from the 25th percentile of weight (50th percentile for height) to totally off the growth chart (down to about 43 pounds.) Body weight wise she is normal now (has been since 3rd grade), about 105 pounds and 5 foot 1/2 inch. If you look at her, you wouldn't say she was too skinny, certainly not at all unhealthy looking. Diet wise, I can't say it's the best, she does crave a lot of processed carbs. She also exercises a lot (is a fencer). She doesn't look at all anorexic or unhealthy however and she seems to have plenty of energy. PANDAS-wise, she's doing pretty well. She has some low grade symptoms (weight, food related unfortunately) but her symptoms seem stable or better vs 3-4 years ago. She was on a low dose of Prozac until 7th grade which she doesn't need anymore. Now she only takes Azithromycin 500mg 2-3x weekly. She does have some low grade OCD, but not debilitating. Unfortunately, lots of her OCD that is left is food/weight related. I know she checks her weight (although now we are getting into "normal' teenage girl stuff). She has a strange doorway OCD which is PANDAS/weight related as well. But to the average person, she is a quite normal. I made another appointment this Thursday with her ped. From what I've been reading, it's not uncommon for teens to be irregular (but I was always regular). One thing I'm worried about the female athlete triad and osteoporosis (my mom has severe osteoporosis from other causes). Then again, she's not super skinny, not like some of those long distance runners w/no body fat. She just looks quite healthy to me actually, so I don't even know if that is the problem, but I am concerned. "Amenorrhea: Loss of menstrual periods may signal a change in your body's intricate and complicated hormone system. Hormone imbalance from underfueling your body can result in lowered estrogen production. There are also other causes of lowered estrogen levels. A diminished estrogen level can have many effects; the most immediately apparent one can be bone loss. Amenorrhea can often go unreported to medical providers because of the common belief it is "just part of the training effect." We do know that the bone loss that occurs as a result of this is NOT "just part of the training effect" and can start to occur after just a few months with no period. Click for more information on amenorrhea. Osteoporosis: Loss of bone, especially if you are an athlete, can be an unfortunate setup for an injury. Stress fractures can sideline sports activity and be slow to repair if you are underfueled. Repeated stress fractures and unexplained injuries should be a red flag to further evaluate your eating and exercise patterns. Bone loss that occurs because of amenorrhea can be permanent; osteoporosis is not just a disease grandmothers get!" http://www.brown.edu/Student_Services/Health_Services/Health_Education/nutrition_&_eating_concerns/eating_concerns/female_athlete_triad.php Does anyone have any insights or tips? Things to ask my ped, what type of doctor to follow up with if ped isn't helpful. (Frankly, I don't think this is an area of expertise for my ped, but I will see her to hopefully get a referral). Also, could this be tied into PANDAS somehow?
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