Does your child have thyroid problems?

By Drum Digital
15 April 2014

Does your child seem hyperactive? Or are they constantly tired and constipated? Or perhaps they’ve lost an abnormal amount of weight? All of these could be symptoms of a thyroid problem.

The thyroid gland develops at the base of the tongue and descends before birth to the front of the neck.

“The thyroid gland produces hormones that regulate the speed at which processes happen in the body; like a thermostat it helps regulate the heart rate, body temperature and metabolic rate,” says Dr David Segal, a paediatric endocrine specialist in Johannesburg.

So although only about 1 in 300 children could have thyroid problems, considering its function, these problems could potentially be disastrous.

Problems and symptoms

Dr Segal says the thyroid gland can either become underactive or overactive during childhood, or it may just swell – a condition known as goitre. “An underactive thyroid slows the metabolism, causing tiredness, lethargy, constipation. It can cause a child to feel cold when others are warm. It can also slow growth and cause short stature, and has been associated with weight gain.”

But be careful not to assume your overweight child has thyroid problems, says Dr Segal. “Less than one percent of overweight children have a thyroid problem and thyroid tests done in overweight and obese children might suggest a thyroid abnormality, but usually [functionality returns] to normal with weight loss and [does] not require therapy.”

“An overactive thyroid speeds up the metabolism. Children could have hyperactivity, frequent stooling, frequent urination, difficulty sleeping, restlessness, feeling hot, increased appetite and sometimes weight loss. The thyroid can swell and the eyes can bulge. There could also be a tremor and reports of palpitations,” says Dr Segal.

Because of these symptoms, he recommends children with ADHD and ADD have their thyroid checked before starting stimulant medications.

A separate but very important thyroid disorder is called congenital hypothyroidism, which means it’s present from birth. “This is the most common preventable cause of brain damage and for this reason all newborn babies should have their thyroid screened. Parents should insist on it.”  Thyroid cancers are rare in children.

Diagnosis and treatment

Thyroid problems are diagnosed by symptoms, a physical exam and blood tests in 90 per cent of cases. “If thyroid problems are suspected, blood tests will need to be performed to assess the functionality of the thyroid to see if it is either over or under functioning. Antibodies against the thyroid are also measured to look for the most common cause, which is an autoimmune thyroid attack.” Dr Segal explains this is when the immune system reacts against the thyroid gland for some reason. “Ultrasounds should not be routinely ordered, neither should uptake scans. It is better to be referred to a specialist before these expensive tests are ordered.”

He says once diagnosed appropriate medication will be prescribed in tablet form and regular blood tests will be used to make minor adjustments to the dose over time. Unfortunately, “there are no home remedies for thyroid disorders”.

Causes

“The most common cause of thyroid problems is autoimmunity. This is when the person’s immune system is activated to either stimulate or destroy the thyroid gland. In these cases there is usually a family history of thyroid disorders, most often from the mother’s side of the family.”

Do symptoms differ between adults and children?

“Not much. The biggest difference in symptoms is that children with underactive thyroids can grow slowly. Adults have finished growing so this symptom won’t affect them.”

- Dalena Theron

Source: Dr David Segal, paediatric endocrinologist, Johannesburg (011-726-0016)

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