Hypotonia in children

Hypotonia is low tone in the muscles.  It can exist on a spectrum from mild to high.  Often children with low muscle are recommended for orthotics and therapies. Although I find therapies immensely helpful, they do not address underlying cause. Without pursuing and addressing biochemical underlying issues, the overall development and health of the child may not be complete.

Children with Hypotonia;

  • Fatigue quickly
  • Have poor posture.
  • Can have increased flexibility, increasing susceptibility to injuries.
  • Lack appropriate body awareness feedback.
  • Avoids chewy foods.
  • Preference to engage in sedentary activities.
  • Poor reflexes
  • Delayed speech
  • Head lag
  • Can appear floppy.

What are some treatable causes?

Mitochondrial dysfunction is very common.  Children tend to fatigue easily along with low muscle tone. Carnitine, creatine, B vitamin deficiencies are common with mitochondrial issues. Low thyroid function has to be ruled out.

What does the gut have to do with Muscle tone?

Mitochondria exist through the gut.   Impaired mitochondrial function can lead to constipation and fecal loading creating a vicious cycle.  Candida, bacteria start to grow that further release toxins impairing behavior.  Small / large bowel bacterial overgrowth is seen in most kids with ASD and low tone. Bacterial /fungal overgrowth can impair absorption of nutrients>> more behavioral issues and low tone.  B vitamin absorption primarily happens in the small bowel and as such it is critical to check for deficiencies in these kids.

What tests to do as a start?

Make sure that your provider understands functional testing and can provide comprehensive support to address underlying cause as possible. The following is not an exhaustive list but a place to start.

  • Organic Acid test
  • Free T3, Free T4, TSH, Reverse T3
  • Serum Homocysteine
  • Serum Creatinine
  • Blood amino acids

Other testing such as heavy metals, stool tests, ferritin, whole blood count etc may be necessary based on history and symptom picture individualized for each child.  Naturally lab results will guide treatment.

If you child has low muscle tone and need more support, give us a call or seek a functional medicine provider / naturopathic doctor trained in developmental disorders.


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