From New Jersey, USA

My four year old son, who has had type 1 diabetes for a year and a half, complains of headaches and stomachaches enough to be concerned about it. There are times when he gets headaches from being low and occasionally when he has an extreme high, but there are often times when his blood sugar levels are in normal range, and he still complains of headaches often. Also, his stomach aches enough to wonder if something else is going on (i.e. celiac disease). I read recently about hypothyroidism, and one of the symptoms is headaches along with puffiness in the face and weight. He has the first two symptoms, if they are accurate, and his weight is 41 pounds. with a height of 41 1/4 inches.

I don’t want to ignore symptoms if there is something to be concerned about, especially since he can be more susceptible to developing other autoimmune diseases and/or certain complications due to diabetes. Should this be a concern? If so, what will need to be done?

It is easy to screen for thyroid problems with a simple blood test. Celiac disease can also be screened for with a blood test, that may be quite accurate and sensitive, but I believe that current recommendations remain to confirm an abnormal celiac screen with a small intestine biopsy (which would be done with an endoscopy procedure). Celiac disease has significant implications as there are important dietary considerations. Also there is some increased incidence of certain intestinal tumors with poorly controlled Celiac disease.

However, remember that common things happen commonly: most stomachaches in children are functional or related to bowel habits. Children (especially stressed children with chronic illnesses) can have peptic ulcer-like disease. Your pediatrician may be able to help you or refer you to a pediatric gastroenterologist . Peptic ulcer-like diseases are best diagnosed with endoscopy also so the biopsy for celiac disease can be done at the same time.

I’d say that my experience is that headaches are not common symptoms in children with mild hypothyroidism. While there are “bad things” that can cause serious headaches (brain tumors, migraines for example), those headaches tend not to be mild and often are associated with nausea/vomiting. They have somewhat distinctive patterns.

Your son’s pediatrician and endocrinologist should be informed of these issues, and try to explore for you and reassure you.

DS