December 30, 2000
Other Illnesses
Question from Los Angeles, California, USA:
My three year old son had been fatigued for several months, so I asked his pediatrician to run blood tests. His bicarbonate level (14 mmol/L on a normal scale of 22-30 mmol/L ) and glucose levels were low. The doctor was more concerned with the bicarbonate level than the glucose, and suggested we retest in one month, which we just did. The bicarbonate level is now 20 mmol/L (on a normal scale of 22-30 mmol/L). The doctor did not mention whether the glucose was also re-tested, but said he’s no longer concerned because the bicarbonate level is close to normal and other kidney functions are normal. Should we be concerned and take him to a pediatric nephrologist or wait six months and re-test?
Answer:
I think that your son’s pediatrician is right and that a serum bicarbonate level of 20 mmol/L is comfortably within normal limits for a three year old, and there is no need to take him to a nephrologist. However, if he remains chronically tired, and, especially if there has been any fall off in his growth curve, there are other possibilities like hypothyroidism that need to be discussed with the doctor, especially if your son has diabetes.
DOB
