Hypothyroidism is the most common kind of thyroid disorder in children. It occurs when the thyroid gland is underactive and doesn’t produce enough thyroid hormone to satisfy the needs of the body.
Thyroid function is essential for children and infants, whose bodies and brains rely on adequate levels of thyroid hormone. Hypothyroidism can result in disability and development failure. Congenital hypothyroidism, which is present at birth, and acquired hypothyroidism, which develops after birth, usually during late childhood or adolescence.
Congenital hypothyroidism affects 1 in 1,500-3,000 babies in the U.S. every year. Approximately, 10 to 20 percent of the time it is inherited, although the illness has been recorded to occur for no known reason.
The disease can result from insufficient maternal iodine consumption during pregnancy, but that is rare in the U.S., where dietary iodine is usually sufficient (iodine is added to table salt and can be present in seafood and milk). Rarely, medications for treating overactive thyroid may lead to congenital hypothyroidism, although the condition resolves without any effects. Still, it’s important for women to get their own thyroid function checked during pregnancy.
Congenital hypothyroidism is among the most common and preventable causes of cognitive disability. Since most newborns show no indications of it, the condition is normally detected during routine newborn screening, which will be mandatory at U.S. hospitals. Checks for congenital hypothyroidism and a number of other congenital disorders. Parents who choose home birth should be sure to secure the screening for their newborns.
Blood samples may show low levels of T4 (thyroxine), a hormone secreted from the thyroid, and/or high levels of TSH (thyroid stimulating hormone), which is released by the pituitary gland.
If the identification is supported through thyroid evaluations, teens have to be treated as rapidly as possible with synthetic thyroid gland, which should be provided as a pill. It should not be given with soy formula or calcium or iron supplements, which may decrease absorption of replacement hormone. Thyroid hormone replacement should also not be given in liquid form, which is unstable.
Most babies will have to take replacement hormone for the rest of their lives, but around 30 percent only require treatment for the first 3 decades of life and might have a transient form. In all cases, checkups and early treatment with a pediatric endocrinologist are important to help ensure normal growth and mind development. Children with congenital hypothyroidism are monitored during the first few years of existence.
Some data have revealed that the prevalence of congenital hypothyroidism is 100 percent higher in Hispanic newborns and 44 percent higher in Asians. The prevalence has also been proven to be 30 percent lower in newborns compared to whites. Infants with Down syndrome include a 10-fold increased incidence of congenital hypothyroidism.
Acquired hypothyroidism develops during late childhood or adolescence, typically after arrival. The condition is common, affecting 1 in 1,250 kids. About 4.6 percent of the U.S. population age 12 and older has hypothyroidism, as stated by the National Health and Nutrition Examination Survey (NHANES III).
Hormones produced by the thyroid perform several functions during youth including regulating metabolism and maintaining normal growth and bone growth.
Acquired hypothyroidism in children and teens’ usual cause is an autoimmune disorder called Hashimoto’s thyroiditis, in which the thyroid is attacked by the immune system, interfering with an gland’s ability and causing inflammation. (Hashimoto’s is also the chief cause of hypothyroidism in adults at the U.S.)
Less frequently, Candida can originate from the thyroid or from the pituitary, in case the gland fails to produce enough thyroid gland. Certain medications (like lithium) can decrease thyroid hormone production, and too much or too little iodine in the diet can lead to hypothyroidism, as can radiation exposure and infiltrative disease.
Some children are at greater risk for example those with disorders like Down syndrome of Hashimoto’s; people having other diseases like type 1 diabetes; and people who have received radiation for cancer therapy. Hashimoto’s runs in families and can be more prevalent in females than men.
The others appear only in kids while some symptoms of Hashimoto’s in older children and adolescents are similar to those in adults. These include slowed rate of growth, delayed puberty and delayed tooth development. Another common sign is an enlarged thyroid gland (goiter). Studies have shown that there is an obvious goiter found in nearly 40 percent of kids with autoimmune thyroiditis.
Hypothyroidism symptoms which children and adolescents have with adults in common include: fatigue, constipation, rough, dry skin and hair, and weight gain, even though the majority of weight gain experienced by adolescents and children isn’t due to thyroid disease.
Acquired hypothyroidism can be diagnosed with blood tests. Usually TSH levels are high and T4 levels are low. Both levels are low. Normal ranges for T4 and TSH are somewhat different in children than in adults, so it is important to speak with a pediatric endocrinologist.
Just like congenital hypothyroidism, obtained hypothyroidism is treated typically in the form of a once-daily pill. Side effects may include difficulty falling asleep, headache and restless sleep and result from overtreatment.
There’s no cure for either kind of hypothyroidism but hormone replacement is considered safe and effective. With appropriate use of drugs and intimate follow-up using a pediatric endocrinologist, children can expect to live a healthy life. Kids might be monitored more frequently if there are concerns about their adhering to the pill regimen.
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By Dr. Alex Jimenez
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