My son just turned 15, Sept 2007, he want last week for his HS physical and the ped said he still is showing no signs of starting puberty. She refered him to a Ped Endo. The appt is next week. Can anyone tell me what tests to request / expect? Does anyone know if there is a treatment course to kick start puberty? The last thing I would let them do is try HRT unless all other possibilites have been exhausted... Please let me know what you can...
My son just turned 15, Sept 2007, he want last week for his HS physical and the ped said he still is showing no signs of starting puberty. She refered him to a Ped Endo. The appt is next week. Can anyone tell me what tests to request / expect? Does anyone know if there is a treatment course to kick start puberty? The last thing I would let them do is try HRT unless all other possibilites have been exhausted... Please let me know what you can...
thx...
I didn't show any signs of puberty (hair growing in etc) until I was nearly 17 didnt' get chest hair until I was 19. Puberty can start at 15 but doesnt' have to. My cousin started at 13.
Yes, I am aware that it can start late or early... I just want to be informed about what the endo is going to look for to decide if in fact he is just a late bloomer or he has some physical problem. As is often discussed on this board in regards to hormones; nature does not always play fair... The thing is that some kids start purberty early, but it is sometimes, from what I have read, effected by outside causes, like hormones in meat, being overweight etc, and late puberty can be influenced by malnutrition; among other things. The thing is why wait until he is 17 or 18 to look into this when the Dr could easily run a test and say, here is the problem... or he could run test's and say there is no problem wait another year and lets see.... know what i mean???
Yes, I am aware that it can start late or early... I just want to be informed about what the endo is going to look for to decide if in fact he is just a late bloomer or he has some physical problem. As is often discussed on this board in regards to hormones; nature does not always play fair... The thing is that some kids start purberty early, but it is sometimes, from what I have read, effected by outside causes, like hormones in meat, being overweight etc, and late puberty can be influenced by malnutrition; among other things. The thing is why wait until he is 17 or 18 to look into this when the Dr could easily run a test and say, here is the problem... or he could run test's and say there is no problem wait another year and lets see.... know what i mean???
Is your son physically active? How about his size and weight? Did he have his "growth spurt?" How are his energy levels? Does he otherwise seem like a normal 15 year old?
I would want to know exactly what does "no signs of starting puberty" mean. And I guess that is where you are at right now. I would think that, other than the obvious physical signs discussed above by Bengie, they would look for undescended testicles. I knew a man who was not diagnosed until in his 20's! They will then, hopefully, do a full hormone blood workup.
Insist on actually seeing the results and look for anything that, although may appear within range, may be close to either end of that range and then ask questions and raise concerns.
I think you are a very good father to be concerned at this point but also be prepared that if everything does come back normal, you may just have to relax, keep playing ball or shooting hoops with your son and wait it out. Let us know what they say.
AZman, yes he is very active, but very thin....He is 5'4" but like 95lbs... when the Dr said she saw no signs she meant as in no pubic hair, no voice change and testicles seem to be growing but not at the rate she feels is typical. Having been thru hormone issues myself, I always get copies of blood work... I am fine with him being a late bloomer, I just want to know if there is anything wrong and if not it will be business as usual and just keep waiting for nature to take its course....
thx....
btw...If anybody knows what test they would run in this case please let me know... I assume the std LH test would be one, if the LH is very high then that could mean a problem that the testicles have not started working??!?!?! but what else?!?!?!?!?!
AZman, yes he is very active, but very thin....He is 5'4" but like 95lbs... when the Dr said she saw no signs she meant as in no pubic hair, no voice change and testicles seem to be growing but not at the rate she feels is typical. Having been thru hormone issues myself, I always get copies of blood work... I am fine with him being a late bloomer, I just want to know if there is anything wrong and if not it will be business as usual and just keep waiting for nature to take its course....
thx....
btw...If anybody knows what test they would run in this case please let me know... I assume the std LH test would be one, if the LH is very high then that could mean a problem that the testicles have not started working??!?!?! but what else?!?!?!?!?!
thx...
I would think any doctor would first take at least a Total T test as active males of this age should have very high total Testosterone. If low, it would indicate further testing of LH as LH stimulates Leydig cell production of testosterone. This is also used to rule out a pituitary or hypothalamic disorder and delayed puberty is a reason to test for these along with Total T, imo, at the outset. No point in wasting time.
They may also test for FSH although that is more of an indicator if the Sertoli cells of the testes are producing sperm.
My limited knowledge of hormone testing is restricted to hypogonadism +age 50. There can certainly be many other reasons for delayed puberty in boys but I think the basic hormone tests is where they start to make sure the HPTA (Hypothalamus Pituitary Testicular Axis) is working.
It seems to me that a total blood workup including CBC, Immunoglobulins (immune system), Glucose (to check for diabetes), TSH for Thyroid, Iron, Zinc, and possibly even cortisol (Adrenal Gland function) would be indicated to get to the root asap.
I would expect them to test to see if his LH has ramped up yet or not. If not, check for possible problems as to why. For example is estradiol or total estrogen too high. Is prolactin too high? There are also genetic tests to make sure he does not have Klienfelters syndrome or something like that they might run.
I agree with you, it would not make sense to start any T replacement for him at 15. It would be nuts. If the genetic tests showed a genetic disorder then you might have something to treat....but most likely with HCG, not T replacement. HCG would also develop his testicles so he would be fertile instead of just pumping him with T which would make his body develop normally but also render him infertile, probably permanently.
Jinxy, at leat I think you have some experience in all this so you will be a great asset and advocate for your son over a normal parent who has no knowledge of these problems. I'm truly sorry to hear about this. As much as I curse my condition at least I was blessed with normal hormones until about the age of 40. This is just not fair for someone so young to have these issues.
reading your previous post now, don't rely too much on LH vs. T at his age. LH will stimulate the testicles to grow and to make T. But if LH is just ramping up it may be high for some time before the testicles grow and make significant amounts of T. I'm not sure of the exact timing of this but I know LH ramps up first, then after some (unknown to me) amount of time the testicles will grow and start making T.
For now I would look to see if LH has ramped up or not, check T, and look for any genetic disorders if LH has not ramped up along with the other things I mentioned which can hold LH down, like high estrogen or prolactin.
