A prevalent thyroid anomaly observed in children is hypothyroidism, wherein the thyroid gland generates an insufficient quantity of thyroid hormones.
Delving into the categories of hypothyroidism, insights from Dr. Nihar Parekh, a pediatrician and Founder of Cheers Child Care and SOCC (Second Opinion & Online Consultation For Children), reveal, “Hypothyroidism in children manifests in two forms—one occurring at birth, known as congenital hypothyroidism (CH), and the other arising secondary to an autoimmune phenomenon termed autoimmune Hashimoto thyroiditis, triggering hypothyroidism in teenagers or young children.”
“As standard protocol, the cord blood sample of the mother during delivery undergoes testing for Thyroid Stimulating Hormone (TSH) as a screening measure to rule out congenital hypothyroidism in newborns. If TSH levels are elevated at birth and persistently high over the subsequent days to a week, immediate testing for T3 and T4, the other two thyroid hormones, ensues to confirm the diagnosis of CH. Rectifying the condition necessitates precise medication dosage and continual monitoring of thyroid levels to avert developmental delays and cognitive issues in the child,” he further explicates.
Hyperthyroidism, a less common occurrence in children, is expounded upon by Dr. Ashok Kumar Jhingan, Senior Director – Centre for Diabetes, Thyroid, Obesity & Endocrinology at BLK-Max Super Speciality Hospital, Delhi. “Hyperthyroidism ensues when a child’s thyroid gland overproduces thyroid hormones. An excessively active thyroid gland may manifest as a palpable lump in the throat, particularly noticeable during swallowing.”
“The surplus release of thyroid hormone accelerates a child’s metabolism, giving rise to issues such as restlessness, weight loss, and tremors. Growth and development can also be adversely affected. However, it’s essential to note that pediatric hyperthyroidism is treatable and comparatively rare in contrast to hypothyroidism,” he adds.
Highlighting the imperative nature of treatment, Dr. Jhingan asserts, “Addressing hyperthyroidism is crucial since it can lead to cognitive delays in children under three years old, impacting their cognitive faculties. In newborns, a lack of timely diagnosis can be life-threatening. Unchecked hyperthyroidism may induce rapid initial growth, followed by premature cessation, resulting in diminished stature.”
The causative factors of pediatric hyperthyroidism, as delineated by Dr. Ashok Kumar Jhingan, encompass:
- Graves’ Disease: The foremost contributor to hyperthyroidism in children, Graves’ disease is an autoimmune disorder wherein the immune system mistakenly targets the thyroid gland. This leads to the release of excess thyroid hormone. Graves’ disease is also referred to as autoimmune hyperthyroidism.
- Excessive Thyroid Hormone Medication: Overconsumption of thyroid hormone medicine intended for treating low thyroid levels can precipitate hyperthyroidism in children.
- Dietary Iodine Overconsumption: While iodine is crucial for thyroid hormone production, excessive dietary intake can contribute to hyperthyroidism. Foods rich in iodine, including certain thyroid nodules, necessitate caution and, if present, biopsy.
- Thyroiditis: Inflammation of the thyroid gland, resulting in the release of extra hormones into the bloodstream, characterizes thyroiditis. Typically a self-limiting condition, it may cease on its own or arise during the early stages of autoimmune diseases like Hashimoto’s thyroiditis, thyroid gland injury, or infection.
Parents, entrusted with recognizing warning signs, receive guidance from Shivani Bajwa, CEO and Founder of YogaSutra Holistic Living and Functional Medicine and Health Expert. She notes, “Hypothyroidism may manifest subtly, posing challenges for early detection. Vigilant parents should be attuned to indicators such as unexplained fatigue, weight gain, and a slower-than-expected growth rate in their children. Constipation, dry skin, and sensitivity to cold also merit attention as potential signs of an underactive thyroid. Conversely, hyperthyroidism, characterized by thyroid overactivity, presents challenges as well. Parents may observe sudden weight loss, increased appetite, and restlessness in their children.”
She further emphasizes the importance of recognizing subtle changes in a child’s behavior and physical well-being, including symptoms like accelerated heart rate, palpitations, irregular menstrual cycles in adolescent girls, difficulty concentrating, anxiety, mood swings, unexplained sweating, and heat intolerance—typical manifestations of hyperthyroidism.
Augmenting this perspective, Dr. Richa Chaturvedi underscores the significance of blood tests and scans in identifying the cause of a child’s thyroid dysfunction. The treatment, contingent upon the diagnosis, may involve medications or, in rare instances, surgery. The overarching goal is early intervention to facilitate normal growth and learning in affected children.
Dr. Pawan Kumar, a General Pediatrician at Madhukar Rainbow Children’s Hospital, delineates factors indicating a child’s susceptibility to thyroid disorders:
- Genetic History: A familial predisposition to thyroid disorders elevates a child’s vulnerability.
- Weight Changes: Abrupt weight fluctuations, be it gains or losses, signal a potential thyroid imbalance. Neck swelling may indicate a goiter or an enlarged thyroid gland.
- Skin & Hair Changes: Dry skin, altered hair texture, and bristliness may result from thyroid problems, warranting regular evaluation for early detection and preventative measures.
- Mood Swings and Behavioral Changes: Emotional well-being may be impacted, leading to behavioral changes, irritability, or mood swings. Active monitoring of emotional health is essential, with timely professional advice sought.
Additionally, a cautionary note is extended regarding nutrients and substances that may impact hyperthyroidism, including iodine, calcium, and vitamin D. A list of low-iodine foods is provided, with the disclaimer that the information offered is for general informational purposes only and not a substitute for professional medical advice.
In conclusion, the intricate landscape of thyroid disorders in children necessitates astute parental observation, timely medical intervention, and adherence to prescribed treatments to ensure the well-being and normal development of affected children.
