Thyroid Disorders in Children
by Douglas J. Pucci
We normally associate thyroid problems with adults, but children suffer with thyroid , too. The signs and symptoms in children can sometimes be harder to recognize, misperceived or misdiagnosed, especially when the child is extremely young. But the fact is that more children from infancy through the teen years are being diagnosed with thyroid issues than ever before. A review in JAMA Pediatrics estimates the number has increased to two or three out of every 100 children. The question remains of why is this happening and what can be done about it.
Hypothyroidism describes a sluggish thyroid and is currently the most prevalent form of thyroid disease in children; this includes acquired hypothyroidism, which is typically caused by autoimmune thyroiditis. When a baby is born with hypothyroidism, it’s believed to have been inherited or because the baby’s mother wasn’t treated for the condition during pregnancy. A baby can also be born without a thyroid gland or with an underdeveloped gland. Infants may exhibit signs within the first few weeks of life which might be hard to recognize. Some of the symptoms to look for are cold skin, not eating well, constipation, increased sleep, lower activity level and yellowish tone to skin and eyes.
From the toddler years on, hypothyroidism can occur due to heredity as, well as a lack of iodine or pituitary gland abnormalities. Symptoms during these ages can include brittle hair, sluggishness, headaches, constipation, dry skin, delayed puberty, shorter than average stature and limbs and slower heart rate.
Autoimmune thyroid problems, such as Graves’ disease or Hashimoto’s, occur more frequently in girls, and usually show up from puberty through the teen years. A child with Down syndrome is more likely to suffer from an autoimmune thyroid problem, as are children with celiac disease or a family history of Graves, Hashimoto’s or Type 1 diabetes. There’s another possibility for the increase in childhood autoimmune thyroiditis; the JAMA Pediatrics review stated the possibility that our unnaturally antiseptic environments may be throwing our immune systems off, which is referred to as the hygiene hypothesis”.
Symptoms of autoimmune thyroiditis, which may be subtle during the teen years, also include weight gain, facial puffiness stiffness or pain in muscles or joints, difficulties in concentrating or learning, mood/behavioral problems, brittle nails, forgetfulness, menstrual periods that are heavy or irregular and depression.
When observed, these symptoms are commonly misdiagnosed as ADD or anxiety, and sometimes even brushed off as just part of growing up or the consequences of everyday life, which delays diagnosis. An untreated thyroid condition in children can impact both brain and physical development.
The earlier a diagnosis can be determined, the faster a child can begin to lead a healthy, active life. Unfortunately, routine blood tests don’t always show the presence of a thyroid condition, which may lead to a misdiagnosis or a wait-and-see approach. But once diagnosed, the answer lies not in a lifetime of medications that may or may not work and could possibly lead to even more prescriptions to counter side effects or new conditions created by these drugs. We just don’t know how these medications might negatively affect a developing brain and body.
The only way to determine how to treat a thyroid condition is through comprehensive testing that goes far beyond TSH, T3 and T4 numbers. These numbers alone don’t give a full picture of potential underlying causes, but when all the pieces of a person’s health are looked at together, a complete picture can emerge and a solution can then address the root cause, rather than just the symptoms.
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