Definition

Hypothyroidism is a condition characterized by insufficient production of thyroid hormone by the thyroid gland. The thyroid is a little, butterfly-shaped gland situated at the anterior part of the neck. The gland generates thyroid hormone to regulate the body's metabolism and other vital activities.

Hypothyroidism can affect individuals of all ages, including infants and children. Hypothyroidism in infants and children can lead to significant issues such as cognitive impairments, growth retardation, and auditory deficits. This disorder requires prompt treatment to minimize the risk of complications.

The estimated incidence rate of hypothyroidism in newborns is 1:3000–4000, with a further increase to 1:300-400 in iodine-deficient regions such as the highlands and mountains.

Causes

Hypothyroidism in children can manifest either belatedly at delivery (referred to as "congenital hypothyroidism") or occur during later stages of childhood. Nevertheless, "acquired hypothyroidism" refers to a situation in which the thyroid gland ceases to function correctly despite the kid being born with a healthy thyroid.

Hashimoto's thyroiditis is prevalent among neonates and children and is the leading etiology of hypothyroidism. Hashimoto's thyroiditis is an autoimmune disorder characterized by inflammation of the thyroid gland due to an erroneous immune system attack. Despite the immune system's intended function of safeguarding the body against exogenous pathogens and infections, it erroneously identifies and attacks the thyroid gland.

Additional factors include:

• Thyroiditis is inflammation of the thyroid gland that can result from a viral infection
• Thyroidectomy is performed to treat thyroid cancer or Graves' disease
• Radiation therapy is used to treat cancer, Hodgkin's disease, or Graves' disease, which can harm the thyroid gland
• Medications like lithium and amiodarone can disrupt the function of the thyroid gland
• Damage to the pituitary gland affects the regulation of the thyroid gland in the brain

Risk Factor

Several factors can elevate the chance of a child or baby developing hypothyroidism, including:

• Experiencing a chromosomal anomaly like Down syndrome, Williams syndrome, or Turner syndrome
• Suffer from an autoimmune condition like type 1 diabetes or celiac disease
• Suffering from a thyroid gland injury

Read more: Hypothyroidism - Definition, Causes, Symptoms, And Management | AI Care (ai-care.id)

Symptoms

The symptoms of hypothyroidism are not specific and may develop gradually over several years, leading parents to ignore the condition in their child often.

Two critical indicators require the attention of children:

• An infant who is underweight relative to his peers or has stunted growth is an early indicator that he or she has hypothyroidism
• Delay or postponement of the onset of puberty in adolescents

Other symptoms consist of:

• Fatigue
• Constipation
• Cold intolerance
• Xeroderma
• Dry and fragile hair
• Depression
• Menstrual irregularities or excessive bleeding
• Weight gain

Parents should consult a doctor for further assessment if their infant or baby displays various and non-specific symptoms.

Diagnosis

The doctor will do a comprehensive interview with you to gather information about the symptoms, complaints, and medical history of the child and the family.

The doctor will conduct a physical examination of the neck and body to check for thyroid gland enlargement or indicators of growth and development issues in the children.

Next, the doctor will recommend supporting examinations like blood tests or radiology. Blood tests are carried out to see several hormones associated with hypothyroidism, such as:

• TSH (Thyroid Stimulating Hormone). If TSH levels show high levels, it indicates that the thyroid gland is underactive (hypothyroidism)
• T4 levels: to measure the levels of the hormone thyroxine (T4) in the blood, usually the doctor will check the levels of free T4 (free T4 or FT4). Low FT4 levels can indicate an underactive thyroid gland (hypothyroidism)

During a radiological checkup, a doctor may conduct a thyroid ultrasound to provide a clearer view of the size and condition of a baby's or child's thyroid. A thyroid biopsy may be conducted in certain instances to confirm the diagnosis of hypothyroidism.

Read more: TSH Screening - Indications, Procedures, and Examination Results | AI Care (ai-care.id)

Management

Treating hypothyroidism in infants and children involves providing the necessary thyroid hormones. The objective is to restore T4, TSH levels, and bodily functions to their normal state.

The doctor will recommend a daily dosage of synthetic thyroid hormone, specifically levothyroxine. The dosage will be tailored according to the thyroid hormone levels in the infant or child. It is best to take this medication on an empty stomach or 30 minutes before mealtime.

Daily, Levothyroxine medication must be consumed as prescribed. In the event of forgetfulness, administer the medication to your child immediately. Levothyroxine should not be combined with some medications, including iron and calcium supplements.

The following factors must be taken into account when managing hypothyroidism in young children and infants:

1. Adequate dosage: The dosage of thyroid hormone for infants or children should be modified following their thyroid hormone levels to maintain normal thyroid hormone levels
2. Monitoring levels of thyroid hormone: Regular monitoring of the thyroid hormone levels in infants and children is necessary to ensure that the administered dosage is suitable
3. Consult a doctor: Infants and children with hypothyroidism should visit the doctor frequently to ensure that their treatment is proceeding as planned
4. Consume nutritious foods: For effective treatment of hypothyroidism in infants and children, a balanced and healthy nutritional intake is essential
5. To relieve stress, infants and young children should be provided with positive stimulation and gentle treatment

Supervision by a doctor is necessary to manage hypothyroidism in babies and children and maintain appropriate thyroid hormone levels for their overall health.

Complications 

Hypothyroidism can impact the growth, development, and sexual maturation of a child or infant. Untreated hypothyroidism can lead to several diseases, such as:

• Anemia
• A low body temperature can cause hypothermia
• Heart failure

Prevention

Prevention of hypothyroidism is not possible. There are various measures you can take to lower the risk of hypothyroidism in children or infants, such as:

• Pregnant women should have routine prenatal examinations to prevent hypothyroidism in the fetus
• Screening tests should be conducted on newborns to detect hypothyroidism
• Ensure children and newborns receive adequate iodine without exceeding recommended levels or avoiding it altogether
• Monitor a baby or child who has undergone thyroid surgery to prevent the occurrence of hypothyroidism

When to see a doctor?

It is advisable to promptly have your child or newborn examined if they exhibit the signs of hypothyroidism indicated above. Children and infants who promptly receive therapy can prevent severe problems. Adhere to the doctor's suggestions for managing your child's hypothyroidism treatment.

Accurate diagnosis and treatment are crucial to promoting the optimal health and development of the baby or child.

If you need medical advice or consultation, you can either visit a doctor or use the consultation features available in the Ai Care application by downloading the Ai Care application from the App Store or Play Store.

Looking for more information about other diseases? Click here!