I'm looking for suggestions on how to help our youngest daughter who is now 8 and suffering from crushing fatigue. Our teen daughter and I didn't have the fatigue this bad at her young age. Any suggestions would be appreciated. In the last few months, she has missed a lot of school, stopped going over to most friends houses, and on days when she had activities including dance, church choir, and lacrosse - she no longer looks forward to going because she is so brutally exhausted and therefore has not been going. The school is fully aware and supportive of her time off for MitoD. Her recent blood test came back with the following issues: White blood cell count - Low - 4.2 (4.5-13.5) Red blood cell count - Low - 3.93 (4.0-5.2) Hematocrit - Low - 33.9% (35.0-45.0%) Absolute Neutrophils - Low - 1281 cells/uL (1500-1800) Alkaline Phosphate - Low - 144 (184-415) Vitamin B12 - High 1581 (250-1205) Vitamin D - Low 27 (30-100) In the last few months she has had a few bouts with illness (high fevers), but nothing unusual with this crazy flu season. Her eczema on her top lip keeps popping up (red crusty looking infected for a half inch above her top lip). Usually, a little cream helps this go away and stay away for months. Her toe the other day had an infection out of nowhere. Maybe these are due to her low absolute neutrophils. It's odd that her B12 is high when we do not supplement this and she tries to avoid meat at all cost and therefore eats only what we require. She would love for us to allow her to be a vegetarian (and she will likely go that direction when she is older). Her MitoD doctor sent a note that she often sees high B12 in MitoD kids stating that she "has frequently observed high B12 levels in other patients who are not on supplements either." But she didn't elaborate why. We have started increasing her D3 supplements to 2000 per day (per the doctor). Weak teeth and mineral issues is a big concern for all of us. This daughter will be going in for a root canal on her 6 year old molar and a tooth extraction in a month in the hospital. Due to tooth weakness, it works out best to be done in hospital. For example, during a tooth pull over a year ago, the tooth pull broke in her gum. They sent us to the Children's Hospital Emergency Room. They had to do emergency surgery right there due to complications. They want to avoid that from now on. While they take care of this most recent tooth issue, the Mito surgeon is also going to do a muscle biopsy at the same time. If there is anything you can think of which we have missed to help her with energy, please let me know. I hate to see our precious 8 year old so exhausted all the time. Usually we don't see this uptick in severe fatigue symptoms until around puberty in our family. Thanks!