Hypothyroidism

What does Hypothyroidism mean?
Hypothyroidism refers to an underactive thyroid gland that does not produce enough of the active hormones T3 and T4. This condition can be present at birth or can be acquired at any time during childhood or adulthood. Hypothyroidism is very common and occurs in about 1 in 1250 children. In most cases, the condition is permanent and will require treatment for life.

What causes acquired hypothyroidism?
The most common cause of Hypothyroidism in children (other than newborns) is the autoimmune destruction of the thyroid gland by antibodies. This is also called Hashimoto’s Thyroiditis. This type of Hypothyroidism may be associated with other autoimmune diseases in a few cases and there may also be a history of Hypothyroidism in other family members too. Sometimes Iodine deficiency, past radiation, and very rarely, a defect in the pituitary gland may lead to Hypothyroidism. Certain children are at greater risk of hypothyroidism; this includes children with congenital syndromes, especially Down syndrome, children with type 1 diabetes and celiac disease, and children who have received radiation for cancer treatment.

What are the signs and symptoms of hypothyroidism?
The signs and symptoms of hypothyroidism include:
• Fatigue, tiredness
• Drowsiness
• Difficulty with learning
• Puffy face and generalized puffiness
• Dry, brittle nails and hair and dry itchy skin
• Constipation
• Poor linear growth and short height
• Modest weight gain
• Body aches
• Irregular/ Heavy periods in adolescent girls
• Swelling in the neck called Goitre

How is hypothyroidism diagnosed?
Simple blood tests are used to diagnose hypothyroidism. These include the measurement of hormones produced by the thyroid gland and pituitary. Free T4 (which is more accurate than just the total T4) and TSH are measured. The tests are inexpensive and widely available at most regular labs. Hypothyroidism is diagnosed when TSH is high and the free T4 is low. Normal ranges for free T4 and TSH are somewhat different in children than in adults, so the diagnosis should be made in consultation with a pediatric endocrinologist.

What is the treatment for hypothyroidism?
There is no cure for hypothyroidism; however, hormone replacement is safe and effective. With once-daily medication and close follow-ups with
your pediatric endocrinologist, your child can live a normal, healthy life.