By law, children born in the United States are screened for hypothyroidism (low thyroid) shortly after birth. Unless parents or physicians have specific concerns, relatively few children undergo thyroid testing again until they reach adulthood. Thyroid stimulating hormone (TSH), a hormone your pituitary makes to communicate with your thyroid gland, is the most sensitive indicator of how well your thyroid is doing its job—which is to synthesize and secrete thyroid hormones. Since TSH levels change significantly during early childhood, baseline thyroid tests should probably not be done until a youngster starts elementary school, when TSH levels begin to stabilize.
If your pediatrician balks at ordering thyroid tests for a healthy-appearing child, a number of independent laboratories allow you to order the test(s) yourself, after which you simply take your child to an affiliated lab to have the blood drawn. Examples of such services include LabTestPortal.com, MDLabTests.com, and Health One Labs; availability varies according to state. The results are sent directly to you, so you may have to ask your physician to interpret them.
Thyroid disease is uncommon in prepubescent children. With the onset of puberty, thyroid disorders become more prevalent, particularly in children with a family history of thyroid disease. Multiple factors undoubtedly play a role in the upsurge in adolescent thyroid disease, including dramatic shifts in metabolism, accelerating growth, genetics, and increased exposure to environmental agents that trigger autoimmune responses.
Another uptick in autoimmune thyroid disease (both Hashimoto’s thyroiditis and Graves’ disease) is seen in young adult women, and older women are at risk for hypothyroidism. At all stages of life, thyroid disease is more prevalent in females than males.
The most common form of thyroid disease in children and adolescents is autoimmune (Hashimoto’s) hypothyroiditis. Few children with autoimmune thyroiditis develop hyperthyroidism; a significant number have normal thyroid hormone levels at the time of diagnosis, and many are hypothyroid as a result of “burned out” disease—indicating the condition has been present (and undiagnosed) for several years.
A review published in the February 2012 issue of Journal of Thyroid Research reveals that more than 20 genes are involved in the genesis of autoimmune thyroid disease (either Graves’ or Hashimoto’s). The interactions of these genes—and the interplay of environmental factors—differ from patient to patient and from population to population. For reasons that are not clear, this interplay leads to autoimmune thyroiditis in most affected teens, regardless of what types of thyroid disease have been diagnosed in other family members.
TF Davies, R Latif, X Yin. New genetic insights from autoimmune thyroid disease. J Thyroid Res. 2012:623852
About the Author
Steve Christensen, MD – “Doom” to his close friends – was trained at the University of Utah School of Medicine. Since his premature retirement from medicine in 2003, Dr. Christensen has expanded his knowledge of alternative medicine: he is a certified herbalist; he has dabbled at the edges of Ayurvedism, shared ideas with Chinese physicians, rubbed shoulders with Native American healers and contemplated the healing powers of channeled energy.
This blog post was originally published by AutoimmuneMom.com, written by Steve Christensen, MD, and first published on May 6, 2012.