Hypothyroid 101:Could My Child Have Chronic Hashimoto’s Thyroiditis CHT and Subclinical Hypothyroidism?

Hypothyroid 101:Could My Child Have Chronic Hashimoto’s Thyroiditis CHT and Subclinical Hypothyroidism?

Hypothyroid 101:Could My Child Have Chronic Hashimoto’s Thyroiditis CHT and Subclinical Hypothyroidism?

Could My Child Have Hashimoto’s Thyroiditis and Subclinical Hypothyroidism?

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DR.Guttler’s opinion:

  1. The most important for your child is to find out if there is autoimmune thyroid disease in the first degree relatives. Also if there are other autoimmune diseases such as Lupus,Diabetes, RA, etc.
  2. The leading cause of childhood hypothyroidism is CHT.
  3. It is a disease of families starting with the mother.
  4. If you have family members with autoimmune diseases of the thyroid CHT or Graves’ disease the children need thyroid tests including antibodies by age 4-7 even without symptoms.
  5. CHT is a slow onset disease. Antibodies are abnormal before the child in clinically hypothyroid.
  6. TSH is slowly increasing for years before they are symptomatic.
  7. TSH rise causes stimulation of growth of the thyroid and formation of nodules.
  8. Failure to diagnose CHT in children in the subclinical phase can result in nodule growth.
  9. One 8 year old who had positive antibodies and borderline TSH at 4 years old was not treated and developed hypothyroidism and a nodule was papillary thyroid cancer.
  10. Symptoms are the last thing that develops.
  11. The child is at risk for nodules and cancer if you wait until they have TSH >10-20 and they have symptoms.
  12. Pediatric endocrinologist may not wish to treat the subclinical hypothyroid child with CHT, but should do an ultrasound first before not treating.
  13. An enlarged thyroid or one with small nodules should prompt treatment now.
  14. The main cause of acquired hypothyroidism is Hashimoto’s thyroiditis, in which the immune system mistakenly attacks cells in the thyroid gland and weakens it.
  15. Hashimoto’s affects up to 1 in 100 children.
  16. Your pediatrician will take a family history, because when another family member has hypothyroidism, a child’s risk increases.
  17. He or she will also examine your child, because an enlarged thyroid gland is another clue pointing to hypothyroidism. The pediatrician may then order a blood test to confirm or rule out a problem with the thyroid. A firm feeling thyroid even if it is only mildly enlarged should prompt an ultrasound examination for nodules.
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  19. Hashimoto’s usually requires lifelong treatment.
  20. Checking  child with a family history of thyroid autoimmune diseases is not screening but is actual case finding because you have an indication to look at the child’s thyroid status contrary to a screening pap smear done on every female.kl
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