Deficient in Vitamin D, Growth Hormone, Testosterone

[MichaelTampa]

I just got a mess of blood test results yesterday. A few things were deficient, and I am curious how much might be PANDAS-related versus how much might be due to other factors. It did show deficiency in vitamin D, growth hormone, and testosterone. Has anyone else seen this? I have been supplementing with vitamin D, although admittedly not as perfectly as I might. Has anyone heard these things are common in PANDAS, or anything like that?

 

Michael

[momto2pandas]

Growth hormone deficiency can be associated with a primary immune deficiency. Have you been checked for that? I always thought that that was interesting given that children with anxiety disorders tend to have short stature, statistically speaking.

 

Vitamin D deficiency can also go along with primary immune deficiency. However, I'm not sure if the relationship here is that PID patients are often told to keep completely out of the sun (risk of skin cancer) or if the relationship is intrinsic in some way.

 

I just got a mess of blood test results yesterday. A few things were deficient, and I am curious how much might be PANDAS-related versus how much might be due to other factors. It did show deficiency in vitamin D, growth hormone, and testosterone. Has anyone else seen this? I have been supplementing with vitamin D, although admittedly not as perfectly as I might. Has anyone heard these things are common in PANDAS, or anything like that?

 

Michael

[MichaelTampa]

I am 5'5", so a bit on the small side. I should add that the growth hormone and testosterone were on the low side but not way out of range. Insulin like growth factor IGF-1 was 99 with a normal range of 101-267. Testosterone 7.9 with a normal range of 6.8-21.5. Vitamin D 25 hydroxy 17.7 with a normal range of 32-100, he said he had never seen so low. He suggested supplements for all of these to start with, but thought we might need growth hormones later on, so, though just a little low, it seems he saw it as a real problem.

 

Regarding primary immune deficiency, I don't really know what that is. We did test CD4 and CD8 levels, and he said that was good, showing slightly high immune system "availability", not sure exactly the word, but this is not measuring immune system activity, but, rather the cells that would be used for such activity. Is PID different?

 

Michael

[momto2pandas]

Yes, primary immune deficiency is different, and it seems to be more common in PANDAS that one would expect. You can research it on the internet, I think primaryimmune.org is a good place to start. To really investigate it for yourself, you need to go to an immnologist who does that kind of work (many, who just specialize in allergies, do not work on primary immune diseases). You won't get the answer from CD4/CD8 alone.

 

I am 5'5", so a bit on the small side. I should add that the growth hormone and testosterone were on the low side but not way out of range. Insulin like growth factor IGF-1 was 99 with a normal range of 101-267. Testosterone 7.9 with a normal range of 6.8-21.5. Vitamin D 25 hydroxy 17.7 with a normal range of 32-100, he said he had never seen so low. He suggested supplements for all of these to start with, but thought we might need growth hormones later on, so, though just a little low, it seems he saw it as a real problem.

 

Regarding primary immune deficiency, I don't really know what that is. We did test CD4 and CD8 levels, and he said that was good, showing slightly high immune system "availability", not sure exactly the word, but this is not measuring immune system activity, but, rather the cells that would be used for such activity. Is PID different?

 

Michael

[KeithandElizabeth]

My PANDAS son had low Vitamin D as well. I agree with another reply in that you should get an immunological work up, including IGG levels and T and B cell flow.

 

Elizabeth

[dcmom]

mom2pandas- help me here. My pandas dd Julia is TINY. She is always the shortest in her class by quite a bit. She is not quite 5th percentile last doctor exam. I am short myself (5 ft 3 in)- but she seems much smaller. Should I have her tested? No one ever mentioned that....

[faith]

little guy here too, .....

 

momto2pandas, are you saying that PID could be the case in for this, especially if PANDAS is suscpected? when you say that primary immune deficiencies are common in PANDAS, does that necessarily mean the child gets sick alot? can anyone clarify that? for those that seem to have the immune deficiencis, does that correlate to frequent illness, or not necessarily.

 

michael,

what kind of doc did these tests?

 

 

thanks

Faith

[familyof4]

Interesting that this topic should come up. When I met with the pediatrician last week I expressed concern that my six year old son had been having teenage type body odor. I was told it was being caused by his anxiety and that if he was having adrenal problems we would be seeing much more serious health issues. Well, last night when I put him to bed I noticed that he has underarm hair - it's very fair so isn't easy to spot but a lot longer than the hair on the rest of his body. I'm now wondering if it's precocious puberty and if I should have him seen by an endocrinologist?

 

I'm just waiting for the day someone locks me up for munchenhousen ....

[momto2pandas]

This is all on my long list of research projects that I never have time to work on!

 

This is what I know:

1. Anxiety disorders in general in children are associated with short stature. There is a load of literature on this, and a bunch of hypotheses for this, including low levels of growth hormone. I don't have it all at my fingertips right now, but the following articles probably have references in them. Danny Pine, who is the author of the first study, was a colleague of mine when I worked in this field. Great guy, very smart. If there is a need to know more about this, I'm sure that we could get in touch with him.

2. Growth hormone deficiency goes hand in hand with primary immune deficiency more often than you would expect. Not all the time. This may just be an association (not causal), or there may be more to it.

3. Unpublished (I think!), but based on the results reported on this board, there appears to be a relationship between PANDAS and primary immune deficiency/low immunity on bloodwork. In some cases, this matches with a clinical picture of lots of infections; in others, the bloodwork seems to have come as a surprise.

4. I believe that there may be a connection between 1, 2, and 3. One of the subjects of some upcoming work. Stay tuned.

 

Generally, growth hormone doesn't get supplemented if kids are just on the low side. It involves injections, is expensive, etc., and a lot of people ask for growth hormone for their kids just because they'd rather have tall kids than short kids - so peds are on guard for this. Treatment is generally reserved for kids who have a marked deficiency.

 

 

 

Pediatrics. 1996 Jun;97(6 Pt 1):856-63.

 

Emotional problems during youth as predictors of stature during early adulthood: results from a prospective epidemiologic study.

Pine DS, Cohen P, Brook J.

 

Division of Child Psychiatry, New York State Psychiatric Institute, NY 10032, USA.

 

Comment in:

 

Pediatrics. 1997 Mar;99(3):499-500; author reply 500.

Pediatrics. 1997 Mar;99(3):500.

 

OBJECTIVE. Adults with emotional disorders exhibit abnormalities in growth hormone secretion. If these abnormalities were to occur during childhood, they could affect growth. The purpose of this study was to examine the relationship between youth emotional disorders and stature in early adulthood. METHODS. Using data from a prospective epidemiologic study of youth psychopathologic status, we used linear regression to examine the prospective relationship between anxiety disorders (separation anxiety and over-anxious disorders) or major depressive disorder in youth and stature in early adulthood. RESULTS. Anxiety disorders during childhood prospectively predicted relatively short stature in early adulthood among females, accounting for more than 5% of the variance in adult height. However, these associations were not found among males. CONCLUSIONS. There may be an association between abnormalities in growth and emotional problems in youth. Further research should examine biological measures related to growth among youth with emotional disorders.

 

PMID: 8657527 [PubMed - indexed for MEDLINE]

 

 

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J Clin Psychiatry. 1994 Jun;55 Suppl:17-27.

 

Anxiety and growth disturbance: is there a connection? A review of biological studies in social phobia.

Uhde TW.

 

Department of Psychiatry and Behavioral Neurosciences, College of Medicine, Wayne State University, Detroit, MI 48201.

 

Current knowledge of the neurobiology of social anxiety and social phobia is reviewed within the framework of chemical models of anxiety. Preliminary evidence for noradrenergic, serotonergic, and adenosinergic systems in the neurobiology of social phobia is presented and discussed within the context of medical model versus continuum theories of anxiety. The clinical and theoretical implications of a hypothesized linkage between anxiety disorders and hypothalamic-growth hormone dysfunction are presented. The author recommends that additional research strategies be developed to examine growth patterns and the function of growth hormone and other growth factors in children and adults with anxiety disorders; moreover, the rationale for additional longitudinal investigations of children with growth hormone deficiency short stature and psychosocial short stature is presented. It is hypothesized that individuals with growth hormone deficiency may be at high risk for the development of anxiety disorders.

 

PMID: 8077162 [PubMed - indexed for MEDLINE]

 

 

 

 

I just got a mess of blood test results yesterday. A few things were deficient, and I am curious how much might be PANDAS-related versus how much might be due to other factors. It did show deficiency in vitamin D, growth hormone, and testosterone. Has anyone else seen this? I have been supplementing with vitamin D, although admittedly not as perfectly as I might. Has anyone heard these things are common in PANDAS, or anything like that?

 

Michael

[MichaelTampa]

Faith,

 

This is an integrative MD who is not an immunologist but knows a lot more about immunology than most MD's. His wife apparently is also an MD with quite a bit of immunology knowledge. He did quite a work-up, almost felt like an AIDS panel (to me, in terms of lots of things I've heard of), cytomeglavirus, epstein barr, mycoplasm, herpes, pylori, and so on. Given my health situation, he and I were both surprised how they were all negative.

 

Michael

[momto2pandas]

Or, the tests, most of which are presumably antibody tests, might be negative if you're getting the infections but your immune system is not competent to fight them properly - doesn't produce or maintain the expected immune responses.

 

 

Faith,

 

This is an integrative MD who is not an immunologist but knows a lot more about immunology than most MD's. His wife apparently is also an MD with quite a bit of immunology knowledge. He did quite a work-up, almost felt like an AIDS panel (to me, in terms of lots of things I've heard of), cytomeglavirus, epstein barr, mycoplasm, herpes, pylori, and so on. Given my health situation, he and I were both surprised how they were all negative.

 

Michael

[faith]

Or, the tests, most of which are presumably antibody tests, might be negative if you're getting the infections but your immune system is not competent to fight them properly - doesn't produce or maintain the expected immune responses.

 

 

Faith,

 

This is an integrative MD who is not an immunologist but knows a lot more about immunology than most MD's. His wife apparently is also an MD with quite a bit of immunology knowledge. He did quite a work-up, almost felt like an AIDS panel (to me, in terms of lots of things I've heard of), cytomeglavirus, epstein barr, mycoplasm, herpes, pylori, and so on. Given my health situation, he and I were both surprised how they were all negative.

 

Michael

 

 

mati'smom,

would this be evident to the doctor, re the immune system not competent? or something that would have to be deduced, looked into further? if that were the case, wouldn't one have symptoms of these things, something to show for it? could there be those infections present, but not necessarily have symptoms, however vague?

 

Faith

[GatsMom]

Or, the tests, most of which are presumably antibody tests, might be negative if you're getting the infections but your immune system is not competent to fight them properly - doesn't produce or maintain the expected immune responses.

 

 

Faith,

 

This is an integrative MD who is not an immunologist but knows a lot more about immunology than most MD's. His wife apparently is also an MD with quite a bit of immunology knowledge. He did quite a work-up, almost felt like an AIDS panel (to me, in terms of lots of things I've heard of), cytomeglavirus, epstein barr, mycoplasm, herpes, pylori, and so on. Given my health situation, he and I were both surprised how they were all negative.

 

Michael

 

 

mati'smom,

would this be evident to the doctor, re the immune system not competent? or something that would have to be deduced, looked into further? if that were the case, wouldn't one have symptoms of these things, something to show for it? could there be those infections present, but not necessarily have symptoms, however vague?

 

Faith

 

If I understand correctly what some of the autism researchers and parents believe correctly, viruses like cytomegalovirus, epstein barr and the entire cascade of HHV's can, like the heavy metals those kids have problems with, hide in tissue. During that period the patient will sometimes test negative but if successful attempts are made to release those toxins from their binding sites, the patient will test positive and this is considered a good thing. It also brings us back to the biofilm theory which I'd be willing to bet my next paycheck will become a key in treating not only autism spectrum disorders and other autoimmune diseases but PANDAS as well. I've said for four years that PANDAS is like an episodic placement on the autism spectrum.

 

Gat's mom.

[peglem]

momto2pandas

 

post Today, 10:30 AM

Post #11

 

Or, the tests, most of which are presumably antibody tests, might be negative if you're getting the infections but your immune system is not competent to fight them properly - doesn't produce or maintain the expected immune responses.

 

That makes sense to me...and this is what I thought was happening with my child. But, the immunologist looks at her low IgG (below range low, not low in range), low IgA levels (again below range-considerably) and says, no she doesn't have a deficiency...she'd be really sick all the time if she really had a deficiency- but I keep thinking the symptoms of illness are signs the immune system is fighting something...what if it isn't fighting very hard? Would there still be symptoms?

[momto2pandas]

momto2pandas

 

post Today, 10:30 AM

Post #11

 

Or, the tests, most of which are presumably antibody tests, might be negative if you're getting the infections but your immune system is not competent to fight them properly - doesn't produce or maintain the expected immune responses.

 

That makes sense to me...and this is what I thought was happening with my child. But, the immunologist looks at her low IgG (below range low, not low in range), low IgA levels (again below range-considerably) and says, no she doesn't have a deficiency...she'd be really sick all the time if she really had a deficiency- but I keep thinking the symptoms of illness are signs the immune system is fighting something...what if it isn't fighting very hard? Would there still be symptoms?

 

 

I think I would get a second opinion from another immunologist. That sounds strange to me. Is it really true that she comes up that deficient but is never sick? I believe that you would generally see some signs of some infections even if the immune system wasn't fighting very hard. Abcesses? Skin infections/long time to heal? Anything like that?