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AnthonyinMaine

Celiac And Poor Growth

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Hi,

My son turned 15 years old this summer prior to starting his sophomore year in high school, and is much smaller than all of his classmates. He is currently about 5' 2" and weighs 104 pounds. We charted his growth from the age of 3. He was in the 80th percentile through age 6, dropped to the 50th percentile through age 9, and then continued to drop steadily to the point where he has been below the 5th percentile since age 13. All of his classmates have experienced their growth spurt and voice change, etc., but he appears to be about 11 or 12 years old. I am 6' 1" and 220 pounds, and my wife is 5' 6" and 120 pounds, so I would assume he would normally end up between 5' 10" and 6' 0"?

My son has been seeing a pediatric endocrinologist for the past 2+ years, given our concern for his delayed puberty. This doctor is apparently very conservative in nature, according to our PCP, and has not prescribed testosterone or any other hormone treatment. A blood test was given to my son a few months back by the endocrinologist, which resulted in a borderline positive result for Celiac disease (tissue transglutaminase was 20). His HLA type was also positive, and his IgG type deamidated gliadin antibodies came back positive at 6, so about 6 months ago, our Endo Dr. referred our son to a Gastrointestinologist, to check for Celiac or Crohn's symptoms through an esophagogastroduodenoscopy test. According to the Gastro Dr's report, his esophagus was normal, but in his stomach, he had some erythema in his antral area and in the duodenal bulb (duodenitis). The remainder of his duodenum and proximal jejunum were normal, and the villi appeared to be intact. Biopsies from the duodenal bulb showed total villous atrophy with lymphocytosis, from which the Gastro Dr. indicated that our son is exhibiting early (indicative) signs of Celiac disease, so we started him on a gluten-free diet 4 months ago. The Gastro Dr. believes that 6 months of the gluten-free diet will improve his growth pace, so our Endo Dr. has delayed use of any growth stimulants, which normally would have been initiated by now. My concern is that the longer we wait, the greater the chance that my son's growth window will close. Does anyone have any thoughts as to whether Celiac is likely to be the true cause of his delayed growth, especially since 4 months of a gluten-free diet has resulted in no increase in his physical development?

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Well I can give you my experience.

My daughter was falling off the growth chart. Started gluten free diet and then had a major growth spurt. She was in the todler age bracket. Very common story for parents to see a MAJOR growth spurt once they start the gluten free diet.

We had a member, celiac3270, who was in his teenage years and had a major growth spurt too. He had some other issues (and surgery) but nutrition is key for growing children.

As a parent I understand your concern. Give it some time. If you have that "gut" feeling you need to do something else ~ do it. No doctor who visits for about 15 minutes an appointment knows your child like you do. They may have a degree, but you are the expert in your child's care.

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I saw many doctors as a child, for the numerous health problems I had, including very delayed growth and development. Never did any of them know anything about Celiac, nor did they offer any insight or help worth mentioning. Even with all that, and the fact that gluten was still a major part of my diet, I did finally have a growth spurt. I think the body eventually did what it knew it had to do.

In contrast, I know someone who I have always suspected is Celiac, and they were given those growth hormones. Result? Their growth window closed very rapidly, which I understand is what happens from growth hormones. They are still very short, stunted, and have no chance of any further growth whatsoever. The hormones didn't seem to do much of anything except hasten the closure of the growth window.

So, my recommendation would be to allow nature to do what it knows how to do, when it is able to do it. But, proper nutrition is vitally important. I'd double and triple check everything for possible contamination, give him a good quality multivitamin/mineral formula (not the typical drug store garbage - go to your local health food store), and take the entire family gluten-free if necessary to prevent cross-contamination. Give your son a wonderfully nutritious diet, full of fresh vegetables, fruits, legumes, nuts, seeds, grains, and as much diversity and variety as possible. Plenty of protein, essential fatty acids, vitamins, minerals, etc, etc.

Does he have his own dedicated gluten-free toaster? Do you use only stainless steel or other smooth-surfaced pots, pans and so forth? Throw away and scratched "non-stick" type cookware, wooden spoons, cast iron, wooden cutting boards and rolling pins, and any other cookware and utensils with porous or scratched surfaces.

However, this doesn't mean your son will have a good growth spurt. It depends on many factors, and I do not believe modern medicine knows what all those factors are. Just giving the hormones won't do it. As I understand it, the hormones are the body's way of signaling when growth should take place, not the substance which is actually responsible for the growth. In other words, bones, muscles, and so forth are not made of growth hormones, but of countless nutrients. The hormones (from my understanding) just tell the body when it's time to use those nutrients for growth. So I think adequate nutrients have to come first, before the body will decide that it's time to grow. If the additional resources required for proper growth are not present, then it makes sense to me that the body will try to wait until they're available. Otherwise there may be growth deformities.

Oh, and it may be necessary for your son to avoid dairy, soy, corn, and/or other things. Many on this board have found other foods of which they are intolerant or allergic. The top allergens are often top suspects, though not always. If your son has any other health issues, it may be helpful to post about them. There may be something further in his diet which needs to be corrected besides going gluten-free.

Incidentally, that short (and now stunted) person I mentioned never had a nutritious diet. I'm sure that was a factor.

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Also, as far as I recall, boys continue to grow until they're about 18 or 19 or so. I stopped growing when I was about 14 I think (at 5'2") and my twin brother grew a bit even after high school I think? That was a little over 30 years ago... :rolleyes: At any rate, he's a foot taller than I am.

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Well I can give you my experience.

My daughter was falling off the growth chart. Started gluten free diet and then had a major growth spurt. She was in the todler age bracket. Very common story for parents to see a MAJOR growth spurt once they start the gluten free diet.

We had a member, celiac3270, who was in his teenage years and had a major growth spurt too. He had some other issues (and surgery) but nutrition is key for growing children.

As a parent I understand your concern. Give it some time. If you have that "gut" feeling you need to do something else ~ do it. No doctor who visits for about 15 minutes an appointment knows your child like you do. They may have a degree, but you are the expert in your child's care.

Thanks so much for your response! I'm wondering how long does it usually take for the body to recover after eliminating glutens from his diet? He's never experienced any gastrointestinal problems, so I'm not sure how to tell if going gluten-free is effectively enabling his body to correctly absorb the nutrients that he needs to develop? Most of the reported damage in my son's case was in his duodenal bulb, while the rest of his duodenum appeared to be normal. I'm not sure what role the duodenal bulb plays in the absorption of nutrients essential to growth, compared to other parts of his stomach and digestive tract?

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I saw many doctors as a child, for the numerous health problems I had, including very delayed growth and development. Never did any of them know anything about Celiac, nor did they offer any insight or help worth mentioning. Even with all that, and the fact that gluten was still a major part of my diet, I did finally have a growth spurt. I think the body eventually did what it knew it had to do.

In contrast, I know someone who I have always suspected is Celiac, and they were given those growth hormones. Result? Their growth window closed very rapidly, which I understand is what happens from growth hormones. They are still very short, stunted, and have no chance of any further growth whatsoever. The hormones didn't seem to do much of anything except hasten the closure of the growth window.

So, my recommendation would be to allow nature to do what it knows how to do, when it is able to do it. But, proper nutrition is vitally important. I'd double and triple check everything for possible contamination, give him a good quality multivitamin/mineral formula (not the typical drug store garbage - go to your local health food store), and take the entire family gluten-free if necessary to prevent cross-contamination. Give your son a wonderfully nutritious diet, full of fresh vegetables, fruits, legumes, nuts, seeds, grains, and as much diversity and variety as possible. Plenty of protein, essential fatty acids, vitamins, minerals, etc, etc.

Does he have his own dedicated gluten-free toaster? Do you use only stainless steel or other smooth-surfaced pots, pans and so forth? Throw away and scratched "non-stick" type cookware, wooden spoons, cast iron, wooden cutting boards and rolling pins, and any other cookware and utensils with porous or scratched surfaces.

However, this doesn't mean your son will have a good growth spurt. It depends on many factors, and I do not believe modern medicine knows what all those factors are. Just giving the hormones won't do it. As I understand it, the hormones are the body's way of signaling when growth should take place, not the substance which is actually responsible for the growth. In other words, bones, muscles, and so forth are not made of growth hormones, but of countless nutrients. The hormones (from my understanding) just tell the body when it's time to use those nutrients for growth. So I think adequate nutrients have to come first, before the body will decide that it's time to grow. If the additional resources required for proper growth are not present, then it makes sense to me that the body will try to wait until they're available. Otherwise there may be growth deformities.

Oh, and it may be necessary for your son to avoid dairy, soy, corn, and/or other things. Many on this board have found other foods of which they are intolerant or allergic. The top allergens are often top suspects, though not always. If your son has any other health issues, it may be helpful to post about them. There may be something further in his diet which needs to be corrected besides going gluten-free.

Incidentally, that short (and now stunted) person I mentioned never had a nutritious diet. I'm sure that was a factor.

Thank you for your reply! Any thoughts as to how long it will take his body to begin to absorb nutrients effectively, now that he's been gluten-free for the past 4 months? My concern is that he may have issues other than Celiac which is impacting him, such as reduced testosterone production. In addition to his slow growth, I have seen no evidence of a voice change, hair growth, or acne that is typical for teens at his age. Would Celiac also limit these other signs of puberty other than physical growth?

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I would agree with giving it more time. I self diagnosed myself with celiac and I think I may have had it most of my life because of my delayed growth. I was always one of the smallest kids in my grade. I didnt hit 5 foot until 9th grade and didnt really have my growth spurt until junior year. Im 23 now and I cant even grow facial hair lol. Id say give it time...it takes time to heal and repair

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Kids are very resilient. The damage seems to be very mild (compared to many cases we discuss here).

There are so many factors. How well is the individual sticking to the diet? Is the immune system being challenged by other illnesses?

How did his nutrient levels look? Make sure the B12 and iron levels are looking good. Concentrate on healthy meals and snacks. Has his appetite increased? (My 12 year old is an eating machine!)

Did his doctor give you an evaluation on the "stage of puberty"?

Another off the wall question... what is the hereditary background? There can be slight variations for maturity for different hereditary groups. i.e. dental maturity in Norwegian children can be up to 2 years advanced. So you might want to consider that. You might have a bigger "window".

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Kids are very resilient. The damage seems to be very mild (compared to many cases we discuss here).

There are so many factors. How well is the individual sticking to the diet? Is the immune system being challenged by other illnesses?

How did his nutrient levels look? Make sure the B12 and iron levels are looking good. Concentrate on healthy meals and snacks. Has his appetite increased? (My 12 year old is an eating machine!)

Did his doctor give you an evaluation on the "stage of puberty"?

Another off the wall question... what is the hereditary background? There can be slight variations for maturity for different hereditary groups. i.e. dental maturity in Norwegian children can be up to 2 years advanced. So you might want to consider that. You might have a bigger "window".

He has been very strict in sticking with the gluten-free diet. I'm not aware of any other illnesses--he is very active physically and near the top of his class. He was in stage 3 at his last doctor visit 1 month ago. I'm not sure what his nutrient levels are. We've requested written medical records, so perhaps that information will be in there. He has a typical appetite, as far as I can tell--I haven't noticed any significant increase. His hereditary background is primarily English & German.

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I was about the same size as your son at that age and always short compared to my peers. My parents are nearly as tall as you and your wife but I managed to get to 5'7" but went undiagnosed celiac for many year. I suspect that I would have been another inch or so taller if I was gluten-free in my teenage years.

I'd suggest letting nature run it's course. He'll continue to grow.

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Celiac disease can delay puberty. Here are some references.

http://emedicine.medscape.com/article/932104-overview

http://cpj.sagepub.com/content/47/6/607.abstract

http://versusmed.org/articles/view/57172/

My son was diagnosed at age 10. He is now 14. He has had periods of symptom reoccurance including delayed growth which we treated by dietary changes. In those cases his growth returned to normal. He went back to the percentiles that he had been on before he got sick. That way the doctor told us that we were doing the right thing with the dietary changes which consisted mainly of removing certain processed foods.

He is younger than your son. I'm not sure at what age it is too late. My daughter didn't get diagnosed till age 16 and had delayed puberty, and we thought that she had stopped growing. Since diagnosis she has grown 1 3/4 inches, so there should be hope for your son.

This can be a difficult time for a parent. Take good care of yourself too.

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Thank you for your reply! Any thoughts as to how long it will take his body to begin to absorb nutrients effectively, now that he's been gluten-free for the past 4 months? My concern is that he may have issues other than Celiac which is impacting him, such as reduced testosterone production. In addition to his slow growth, I have seen no evidence of a voice change, hair growth, or acne that is typical for teens at his age. Would Celiac also limit these other signs of puberty other than physical growth?

It is tough to say how long it may take for proper nutrient absorption to take hold. It took my digestive system over a year to get to the point where it could handle something other than pureed vegetables. However, I never got diagnosed by a doctor. I figured it out myself, as an adult. So there are many years of damage, and I have my doubts that a full recovery is possible for me at this point. But your son is young, and it sounds like his body has not been ravaged by Celiac nearly as much as so many others.

I'd say though, that since the best tests for damage to the digestive system are not 100% accurate, there may be spotty damage, effecting the absorption of certain nutrients more than others.

From a young age, I was always hungry. I practically lived on peanut butter, and along with everything else, eventually added a dozen eggs or more per week. My appetite for fat was also ever-present, and I could eat a pound of butter per week as well. Yet for many years I didn't gain weight, nor did I get any taller. Like you, my parents were quite concerned, but doctors were clueless as always. I was still eating a ton of gluten when the growth spurt finally began, which, looking back, makes me wonder how the body managed it.

While the experience of myself and others isn't proof of what your son will experience, it does suggest that the body is amazingly resilient in its ability to get things done.

I'll suggest a digestive enzyme supplement, such as Digest Platinum, from NOW Foods. It should assist in the breakdown and absorption of nutrients. Some nutrients can compete for absorption, so nutritionists often recommend taking certain supplements and eating certain foods at different times of the day, so that each can be absorbed more effectively. Doing some research and/or consulting with a nutritionist might be worthwhile.

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Has his Vit D & iron levels been chkd? Oftentimes these will be low especially vit D.

Also, has he had a bone age scan? That will let you know how much potential growth he has left. Also has his thyroid been chk? As stated above give him good multivitamins & make sure they are gluten-free. Gluten is hidden in so many things its unbelievable: lipstick, shampoo, the glue on envelopes, certain ice cream flavors, etc. If he is kissing girls he can get cc'd from their kiss unless they brush their teeth just b4. Read the threads on here to learn more about cc.

My DD's growth was stunted as well but she is 13 and is a shade under 4'10 in the 8th grd. She looks like a 10/11 yo compared to her peers. After going gluten-free in Jun she has growth 3 in & gained 7 lbs. She is still short & probably won't get past 5'2 but we have short stature in our history so how much she was affected by celiac & how much is heredity will always be a mystery.

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Were there is one celiac, (in a family) there is commonly more....take the whole household gluten free. Also, you dont WANT to see those secondary sex characteristics of facial hair and voice change, till after some sig growth....good luck

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Has his Vit D & iron levels been chkd? Oftentimes these will be low especially vit D.

Also, has he had a bone age scan? That will let you know how much potential growth he has left. Also has his thyroid been chk?

His thyroid and other lab tests were "essentially normal" for his age when taken 2 years ago. I don't believe that they've tested it since then. He had a bone age test done 7 months ago, when he was 14 years 11 months old, and his bone age was listed as 13 years 0 months.

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Were there is one celiac, (in a family) there is commonly more....take the whole household gluten free. Also, you dont WANT to see those secondary sex characteristics of facial hair and voice change, till after some sig growth....good luck

I was tested for Celiac last week, and the results were negative. My wife is going to get tested too very soon. She has had periods of stomach pain over the years, and has even gone through endoscopy, colonoscopy, and other such tests about 6 or 7 years ago. She was never told that she had Celiac, but was informed that she did have some redness in her stomach. Do you suppose that it is possible that she may also have Celiac disease?

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Celiac disease can delay puberty. Here are some references.

http://emedicine.medscape.com/article/932104-overview

http://cpj.sagepub.com/content/47/6/607.abstract

http://versusmed.org/articles/view/57172/

My son was diagnosed at age 10. He is now 14. He has had periods of symptom reoccurance including delayed growth which we treated by dietary changes. In those cases his growth returned to normal. He went back to the percentiles that he had been on before he got sick. That way the doctor told us that we were doing the right thing with the dietary changes which consisted mainly of removing certain processed foods.

He is younger than your son. I'm not sure at what age it is too late. My daughter didn't get diagnosed till age 16 and had delayed puberty, and we thought that she had stopped growing. Since diagnosis she has grown 1 3/4 inches, so there should be hope for your son.

This can be a difficult time for a parent. Take good care of yourself too.

Thanks for posting those articles! We actually have an appointment for my son set up in 2 weeks with the doctor that was referenced in the versusmed website, Endocrinologist Dr. Paul Boepple of Harvard Med & Mass General. Hopefully Dr. Boepple has some extensive knowledge of the impact of Celiac upon growth? Our local endocrinologist admitted to being "baffled" by my son's condition at our last appointment, and indicated that she didn't know what to do at this point, other than to wait and see if his growth comes around.

It is our hope that he begins to grow again, now that he is gluten-free, and that he hasn't lost any of his growth potential. His bone age was about 2 years behind his actual age during his last scan this summer. What's odd is that about the only thing on him that has grown normally is his feet! He's 5'2" and 104 pounds, but he already wears a size 11 shoe!

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well typically the feet grow really fast b4 a growth spurt. I've observed this occurring in many children. Most likely his body will grow soon to match those size 11's.

Btw, does he sleep alot? Growing occurs during sleep. DD was sleeping 13/14 hrs a dy during this summer's growth spurt.

Since its been two yrs I would have his VIt D other levels rechkd.

I understand that height is highly revered in this country & many others but when it comes down to it we all know height does not matter & does not stop anybody from achieving their goals or becoming successful. President James Madison was 5'4. Michael J Fox & Prince are vertically challenged as well. So try not to stress about it & let nature take its course.

GOOD LUCK!

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Anthony, our story is similar.

It took me a while after I was diagnosed with celiac to suspect that that was my son's problem too. The only problem was that his blood test was negative. My son was 15, not in puberty (zero testosterone via blood test) and had a bone age of 12.1 when I refused to take "no" from the doctors. I'm only 5'2" but my husband/son's dad is 6'1" and my dad is 6'4" and I have two brothers who are ~6'. The docs kept telling me that son was destined to be short. (Now I wonder if I would be taller if I hadn't had undiagnosed celiac from age 15 or so.)

He was also not gaining weight - 92 pounds at age 12, 97 pounds at age 15. For most of his life to age 7, he was 75th percentile for height, 50th percentile for weight but had fallen off that.

My husband vetoed the endoscopy as too invasive and wanted son to go gluten-free. Son agreed to go gluten-free if he had the gene. So we had his genes tested and he was positive. Son also felt that he reacted to dairy too, so he went dairy free too. We started supplementing with Iron and Cod Liver Oil after I read a research paper on the efficacy of Vitamin A and Iron supplementation in starting puberty in boys with delayed puberty. See article: http://www.medscape.org/viewarticle/481326

He grew a little bit in the first 6 months but according to his doc, he was in puberty within 6 months. After that he took off. He also never gets sick but had been sick continuously for years - little things but they add up.

As you can see from my signature, he is now in college 18.5yo and 6'3", 165 pounds and size 12.5 feet. He still has trouble gaining weight and eats a lot.

The saddest thing is what he told me. About 6 months gluten-free, I asked him if he felt any different after going gluten-free, and he said "I didn't realize that eating wasn't supposed to hurt." So I feel really blessed that I was diagnosed so that he could be diagnosed early. There are worse things than being short, of course, but it is nice that he was able to achieve his destiny. He's smart, healthy and happy.

Anthony (nice name...my brother is also Anthony), I hope that your son has a similar journey and best of luck. I really recommend supplementation with Cod Liver Oil for Vitamin A and an iron supplement.(Carlson's Cod Liver Oil is gluten-free and it comes in capsuls that are taste-less.) You might have his iron level tested too, first.

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Btw, does he sleep alot? Growing occurs during sleep. DD was sleeping 13/14 hrs a dy during this summer's growth spurt.

Yes, he has always received about 9 hours of sleep per night.

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Anthony, our story is similar.

It took me a while after I was diagnosed with celiac to suspect that that was my son's problem too. The only problem was that his blood test was negative. My son was 15, not in puberty (zero testosterone via blood test) and had a bone age of 12.1 when I refused to take "no" from the doctors. I'm only 5'2" but my husband/son's dad is 6'1" and my dad is 6'4" and I have two brothers who are ~6'. The docs kept telling me that son was destined to be short. (Now I wonder if I would be taller if I hadn't had undiagnosed celiac from age 15 or so.)

He was also not gaining weight - 92 pounds at age 12, 97 pounds at age 15. For most of his life to age 7, he was 75th percentile for height, 50th percentile for weight but had fallen off that.

My husband vetoed the endoscopy as too invasive and wanted son to go gluten-free. Son agreed to go gluten-free if he had the gene. So we had his genes tested and he was positive. Son also felt that he reacted to dairy too, so he went dairy free too. We started supplementing with Iron and Cod Liver Oil after I read a research paper on the efficacy of Vitamin A and Iron supplementation in starting puberty in boys with delayed puberty. See article: http://www.medscape.org/viewarticle/481326

He grew a little bit in the first 6 months but according to his doc, he was in puberty within 6 months. After that he took off. He also never gets sick but had been sick continuously for years - little things but they add up.

As you can see from my signature, he is now in college 18.5yo and 6'3", 165 pounds and size 12.5 feet. He still has trouble gaining weight and eats a lot.

The saddest thing is what he told me. About 6 months gluten-free, I asked him if he felt any different after going gluten-free, and he said "I didn't realize that eating wasn't supposed to hurt." So I feel really blessed that I was diagnosed so that he could be diagnosed early. There are worse things than being short, of course, but it is nice that he was able to achieve his destiny. He's smart, healthy and happy.

Anthony (nice name...my brother is also Anthony), I hope that your son has a similar journey and best of luck. I really recommend supplementation with Cod Liver Oil for Vitamin A and an iron supplement.(Carlson's Cod Liver Oil is gluten-free and it comes in capsuls that are taste-less.) You might have his iron level tested too, first.

Thank you so much for sharing! My son was encouraged by hearing about another person who had similar characteristics.

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Thank you so much for sharing! My son was encouraged by hearing about another person who had similar characteristics.

Yes, they are very similar. We'll never know if going gluten-free caused all these changes in my son, but we believe it did.

Couple things: Studies say that adults take 2-5 years to heal their intestines to allow adequate absorption of vitamins/minerals, but children may heal in 6 months. So the fact that you haven't seen changes yet isn't bad. The body may have to receive signals that it is getting nutrients in order to grow. The good thing is that since he's not in puberty and has a low bone age that still gives him a window to grow before the bone age catches up, and maybe the natural process will be just delayed and will happen as he goes into puberty.

One other thing is that I remember reading that boys don't enter puberty until they weigh ~120 pounds. My son started puberty before that but maybe the body's internal system was kicked into gear with the added absorption of vitamins/minerals and that started puberty.

I was re-viewing what we did back then and it was:

Cod Liver Oil for Vit A and D (easily absorbed via damaged intestines)Carlson's is gluten-free

Vitamin B12 (sublingually for easier absorption) Trader Joe's or Source are gluten-free

Multi-vitamin w/iron (Nature Made is gluten-free)

Good diet with four meals a day as his appetite increased.

You might try upping his protein level and help weight gain. We tried dairy-free smoothies with rice protein but you could use whey powder and milk. I'd advise against soy supplements because of their anti-testosterone effects.

I hope you'll come back and tell us what happens. I have my fingers crossed for you all.

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When his growth spurt kicks in I am pretty sure he will sleep more than 9 hrs a day. He will need it.

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I was re-viewing what we did back then and it was:

Cod Liver Oil for Vit A and D (easily absorbed via damaged intestines)Carlson's is gluten-free

Vitamin B12 (sublingually for easier absorption) Trader Joe's or Source are gluten-free

Multi-vitamin w/iron (Nature Made is gluten-free)

Good diet with four meals a day as his appetite increased.

You might try upping his protein level and help weight gain. We tried dairy-free smoothies with rice protein but you could use whey powder and milk. I'd advise against soy supplements because of their anti-testosterone effects.

I hope you'll come back and tell us what happens. I have my fingers crossed for you all.

We stopped at the Natural Living Center store today and bought some Carlson Chelated Iron (27 mg) and Cod Liver Oil (2000 IU Vitamin A & 400 IU Vitamin D each soft gel) supplements today. I assume that he should take 1 Iron tablet and 2 Cod Liver Oil soft gels each day? He already has some gluten-free multivitamins that he's taking each day.

We have some EAS 100% Whey Protein powder to make protein shakes. The label says that it also contains milk and soy ingredients, but it says that 100% of its protein comes from whey. Is the soy in this shake mix likely to generate any anti-testosterone effects? I've never heard about this from soy products, so I'm not sure what to make of it in the case of this type of shake powder?

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When his growth spurt kicks in I am pretty sure he will sleep more than 9 hrs a day. He will need it.

He goes to bed whenever he feels tired, so I know that if his body starts growing and needs the extra sleep, he'll get more sleep. I'll pay attention to it and see if the gluten-free diet and supplements get his growth cycle started and results in him being more tired and wanting more sleep.

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