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- What Is Thyroid?
- What Are the Types of Thyroid Disorder?
- What Is Hypothyroidism?
- Types of Hypothyroidism
- Who Should Be Screened for Hypothyroidism?
- Causes of Hypothyroidism in Kids
- Sign and Symptoms of Hypothyroidism in Childhood
- Diagnosis and Tests
- When to Treat Hypothyroidism
- The Course of Medical Treatment
- Monitoring of Hypothyroidism Disorder in a Child
- Hypothyroidism And Being Overweight
- Challenges for Parents
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The thyroid gland is one of the most important glands in the human body and plays a vital role in our overall development. Proper functioning of the thyroid is essential for the growth of a child, and a thyroid deficiency can lead to multiple disorders. Thyroid disease is a common problem, and people of any age, be it adults or kids can develop this condition. In this article, we have explained hypothyroidism in kids. Read on to learn more about this condition.
What Is Thyroid?
The thyroid is a butterfly-shaped, ductless gland which is located in the neck. The gland secretes hormones such as Thyroxine and Triiodothyronine, which are responsible for ensuring proper growth and development, maintaining a normal heart rate to control body weight, and regulating the body temperature.
What Are the Types of Thyroid Disorder?
At times, the thyroid gland might not function properly, resulting in an imbalance of hormone production, leading to a thyroid disorder. Thyroid disorders can be of two basic types:
This condition is caused by the dip in thyroid hormones in the blood. Hypothyroidism is known to affect women more than men and can get severe with age.
This refers to an increase of thyroid hormone in the blood because of an overactive thyroid gland.
What Is Hypothyroidism?
As discussed, hypothyroidism is an endocrine disorder where the thyroid gland is underactive and does not produce enough hormones required for the proper functioning of the body.
Types of Hypothyroidism
The condition can, in turn, be divided into two types. These include:
1. Congenital Hypothyroidism
This is a thyroid disorder that occurs when the thyroid gland does not develop or function properly prior to birth. This is a common problem that can be diagnosed during the newborn screening process. The doctor will determine the course and length of treatment for this disorder based on factors like the child’s health and history of this disorder in the family.
2. Autoimmune Hypothyroidism: Chronic Lymphocytic Thyroiditis
This condition is caused by an autoimmune disorder known as chronic lymphocytic thyroiditis and occurs when the child’s thyroid gland is attacked by the immune system. This results in damage and decreased functioning of the thyroid gland.
3. Iatrogenic Hypothyroidism
This occurs when the thyroid gland stops producing thyroid hormones in children after being medically destroyed or removed surgically.
4. Central Hypothyroidism
This is a condition where the brain does not make the thyroid-stimulating hormone (the signal that tells the thyroid gland to work). The abnormal development of the hypothalamus or pituitary glands can cause central hypothyroidism.
Who Should Be Screened for Hypothyroidism?
Thyroid screening should be performed in the following cases:
- Children who fail the thyroid tests in the newborn screening.
- Children who have poor linear growth.
- Children with a history of abnormal development or brain injury.
- Children who have undergone cranial irradiation as a part of treatment for cancer.
- Children with symptoms of hypothyroidism such as fatigue or weight gain.
- Pregnant women who have had a family history of thyroid disease.
Causes of Hypothyroidism in Kids
In children, the condition can be congenital or acquired after birth. It can also be caused due to autoimmune diseases, radiation therapies, removal of the thyroid gland, or the side effects of medication. Although such cases are rare, the disease can also be caused due to the treatment received for hyperthyroidism.
Sign and Symptoms of Hypothyroidism in Childhood
The symptoms are usually subtle and resemble symptoms of other medical conditions. The condition can go undetected for many years because of its non-specific nature.
Following are the symptoms of hypothyroidism:
- Weight gain
- Slower reaction time
- Frequent instances of cold
- Dull facial expression
- Swollen and puffy face
- Droopy, tired eye-lids
- Sparse, dry and coarse hair
- Slow pulse and heart rate
- Frequent muscle cramping
- Poor growth
Since these symptoms can be associated with a large number of medical conditions, a doctor should be consulted to find out the real cause of these symptoms in children before opting for treatment for hypothyroidism.
Diagnosis and Tests
Here are some of the tests available to identify hypothyroidism in children:
- Thyroid functioning screening
- Anti-thyroid antibody level studies
- Nuclear medicine uptake and scan
- Thyroid ultrasound
It is important to rectify this disorder in the child as it can hinder the growth and development of the child and have an adverse effect on the quality of life.
Hypothyroidism can be treated by hormone replacement therapy, where the deficient thyroid hormones are replenished by administering levothyroxine, a chemical that is identical to thyroxine.
The doctor might also prescribe medication to cure this condition in some cases.
When to Treat Hypothyroidism
Treatment in case of congenital hypothyroidism should be started immediately after the child is born and should be monitored closely. Most cases of congenital hypothyroidism will require lifelong hormone replacement.
In the case of acquired hypothyroidism, the start of treatment and the necessary dosage of medicine is dependent on the age and weight of the child with this condition.
The Course of Medical Treatment
If a child is diagnosed with the condition, L-thyroxin is administered as a remedy. Here is a guideline of the recommended dosage. Do remember, however, that a doctor must be consulted before the medicine is offered to the child.
1. For Acquired Hypothyroidism
The course of administering L-thyroxine for acquired hypothyroidism is as follows:
- For the age group of 1 to 3 years: 4 to 6 mcg/kg once a day
- For the age group of 3 to 10 years: 3 to 5 mcg/kg once a day
- For the age group of 10 to 16 years: 2 to 4 mcg/kg once a day
- For the age group higher than 17 years: 1.6 mcg/kg once a day
2. For Congenital Hypothyroidism
For treatment of congenital hypothyroidism, the dosage of L-thyroxine should be 10 to 15 mcg/kg, administered once a day. The medication should start immediately and should be monitored closely.
Monitoring of Hypothyroidism Disorder in a Child
Children who suffer from the disorder need to be monitored frequently during the first few years of their life. The monitoring frequency of the disorder is as follows:
- First 6 months after birth: Child to be monitored every one to two months
- Between 6 months to 3 years from birth: To be monitored every three to four months
- From 3 years to end of growth: To be monitored every six to twelve months
Hypothyroidism And Being Overweight
Thyroid hormones are closely related to body composition as they regulate basal metabolism, lipid metabolism, glucose metabolism, food intake and fat oxidation. Thyroid dysfunction can lead to changes in body weight and composition.
This disorder leads to decreased thermogenesis, decreased metabolic rate, higher body mass index and obesity. Even subclinical hypothyroidism can lead to significant changes in body weight, resulting in an increased risk of obesity.
Challenges for Parents
The effects of hypothyroidism in a child can be severe and may last a lifetime. This condition poses a severe challenge for the parents as they need to closely monitor the development of their child, and ensure timely and effective treatment of the disorder and its symptoms.
The treatment is a slow process which can even last a lifetime. In such situations, it becomes extremely important for parents to be patient and support their child throughout.
Hypothyroidism is a complex disorder which has a direct effect on the growth and development of a child. It is important to take necessary treatment immediately and continuously so that the child can have a chance to lead a normal life. Proper medication and monitoring can reduce the impact of this condition significantly.