Dear Swimmer’s Mom,
The most common reasons that I see for teenagers not being able to suddenly keep up with their peers is twofold: inadequate sleep and inadequate hydration. Someone her age needs as much as 10 to even 14 hours of sleep per night consistently. Teenagers frequently drop sleep for TV, computer, friends, cell phones, etc. From a hydration standpoint, teens frequently run themselves dry. Her dizziness when she stands is pretty common for this. I recommend four 8-12 ounce glasses of fluid (water, milk, juice) and a salty snack (pretzels, saltines, pickles) in addition to everything she is eating and drinking during the day. She should also not skip meals, and should eliminate caffeine intake. This helps most of the kids that I see. Even a little sleep deprivation and mild dehydration can significantly decrease exercise performance as well as overall daily attitude.
However, if this does not help her within 1-2 weeks of these changes, other things that could be considered include anemia, thyroid disease, chronic fatigue, and other chronic viral infections. I would discuss these with your primary care provider. I would say that the risk of iron supplementation without an etiology means that you could miss another, potentially more dangerous etiology. Certainly, a problem with the heart’s pump function can cause these symptoms, although this should be something that your primary care provider would be able to assess on an examination. Finally, autonomic nervous system dysfunction could be considered as an etiology if other evaluations end up as negative.
Thanks for your response.
We'll try the hydration... I think she is dehydrated, but I didn't know that would cause thes sort of issues. She was chronically sleep-deprived during the school year, so that could be part of it; she's catching up now. (Slept until 1 p.m. yesterday!)
If she doesn't feel better in a couple weeks, we'll go see the doctor. I will hold off on the iron until then.