Hypothyroidism

Overview
Hypothyroidism is a condition in which the body lacks enough thyroid hormone. The thyroid gland is located in the neck and produces thyroid hormones. These hormones are important for many of our body’s functions and the proper development and growth of cells in the body. The production of thyroid hormones is also affected by the functioning of certain parts of the brain (hypothalamus and pituitary).

Normal thyroid hormone levels are important for proper growth and development. For infants and young children, untreated hypothyroidism can lead to serious, sometimes permanent developmental problems. If hypothyroidism develops when a child is older, there is less chance of permanent damage to the child.
Because the thyroid hormone is so important to a child’s growth, many countries have routine newborn screening to detect congenital hypothyroidism early. In Singapore, when babies are born, blood is taken from the umbilical cord to screen for hypothyroidism.

The diagnosis of hypothyroidism is made through blood testing. Specialised scans and additional blood tests are usually needed to determine the cause of hypothyroidism.

Causes
Causes include abnormal thyroid gland development, abnormal thyroid hormone production, abnormal development of the brain, the temporary effect of substances that crossed from mother to baby in utero and certain medications.

Symptoms
Symptoms of hypothyroidism vary according to the age of the child. Some babies are born with hypothyroidism (congenital hypothyroidism).

Babies with hypothyroidism may have prolonged jaundice, poor feeding, constipation, cool skin, increased sleepiness, decreased crying, a large tongue and an umbilical hernia.

Over time, if untreated, hypothyroidism can result in poor growth, delayed dentition, delayed development and mental retardation. Hypothyroidism can develop in children and adults of any age. In older children and adults, hypothyroidism can cause a variety of symptoms including tiredness, being more sensitive to cold, mental fatigue, difficulty with learning, poor memory, dry skin and constipation.

Risk Factors
A family history of thyroid disease may increase your child’s risk of getting hypothyroidism. Insufficient iodine in your child’s diet could also cause thyroid problems.

Prevention
Congenital hypothyroidism cannot be prevented.

When To Seek Help
Parents should seek medical advice if their children show signs of prolonged jaundice, poor feeding, constipation, cool skin and increased fatigue. Early detection of hypothyroidism and prompt treatment can prevent any irreversible problems.

Treatment Options
The treatment for hypothyroidism is simple. Your doctor will prescribe synthetic thyroid hormone that is taken orally. Your child will need to have his blood checked regularly for his or her thyroid hormone level so that the dosage can be tailored accordingly. For some children, thyroid hormone treatment may be required for life.