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December 28, 2002

Diagnosis and Symptoms

Question from Hockessin, Delaware, USA:

I am 14 years old, weigh 107 pounds, and I was recently diagnosed with hypoglycemia. I have passed out in church and when on upside down roller coasters. I get morning sickness, and I go to the bathroom a lot. I have protein in my urine, and my doctor said she is worried about my blood pressure because it's a little high for my weight and age. I have to see an endocrinologist, but my doctor didn't tell me why. Why do you think I have to see an endocrinologist? What do you think is wrong?

Answer:

You seem to have two separate problems and need to keep closely in touch with your doctors if you are to understand them properly. The first is the protein in the urine.

This may be benign if it occurs primarily when you are upright as opposed to an early morning specimen when it is called orthostatic. Protein in the urine (and the amount is important) may reflect a variety of kidney problems especially in someone your age who is symptomless and does not have a previous or current urinary tract infection. There are a variety of laboratory studies that are routine in evaluating this, and I rather suppose that the doctor thinks that your proteinuria is orthostatic which is why you haven’t been investigated further even though you say the your blood pressure may be a little high.

I expect the referral to an endocrinologist is to do some further tests to see if you might have diabetes, even though hypoglycemia is really a very rare way for this to present at your age. There are, of course, many other causes of hypoglycemia, especially if you have been dieting. When you go to the endocrinology clinic, I think it might help to talk all this over with the Medical Social Worker because many of the symptoms that you complain of can really be a reflection of stress rather than of an organic problem.

DOB