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Underactive thyroid in children and adolescents - medication often unnecessary
An underactive thyroid usually occurs at an advanced age, but it can also appear at a very young age and immensely affect the development of children and adolescents. However, in many cases, no medication is needed for treatment.
Women affected more often than men
According to the Professional Association of German Internists (BDI), at least two percent of all women, but only around 0.1 to 0.2 percent of men, suffer from an underactive thyroid. According to the experts, this is usually discovered between the ages of 40 and 60. The disease rate increases with age. However, an underactive thyroid gland can also be congenital and immensely impair the development of children and adolescents - after all, the small organ is an important hormone producer. However, it is often not necessary to use medication for treatment.
Fatigue, listlessness or being overweight - there are very unspecific symptoms, which are by no means rare in other contexts, with which an underactive thyroid gland is noticeable in children and adolescents, the German Diabetes Society (DDG) explains in a message.
This is why doctors often feel compelled to check the thyroid values of their young patients.
"These tests are also justified out of concern for the development of the children," said Professor Dr. med. Heiko Krude, Director of the Institute for Experimental Pediatric Endocrinology at the Charité – Universitätsmedizin Berlin.
After all, hypothyroidism is a serious danger for children and adolescents: if the hormone disorder occurs in childhood, mental and linguistic development and physical growth can be delayed.
With teenage illness, memory and concentration disorders often develop.
Blood analysis can provide information
A lack of thyroid hormones can, however, be recognized early by a blood analysis and compensated for by the administration of the development-relevant hormone LT4.
It is therefore gratifying at first glance that children and adolescents are being examined more and more for abnormal thyroid values.
However, the tests are also increasingly leading to children receiving the hormones incorrectly - for example, because the function of their thyroid gland is only temporary or only slightly impaired.
Body tries to counteract this
The most important blood value for determining an underactive thyroid is the so-called TSH value. TSH stands for Thyroid Stimulating Hormone or Thyrotropin.
"This hormone stimulates the formation of LT4 and LT3 in the thyroid gland," explains Professor Matthias M. Weber, media spokesman for the German Society for Endocrinology (DGE).
Only when the thyroid gland produces these important hormones in sufficient quantities will TSH production be throttled via a feedback mechanism.
If the thyroid gland does not work properly and produces too little LT4 and LT3, the body tries to counteract this by increasing TSH production.
However, not every elevated TSH value indicates a real hypothyroidism. The TSH acts on the thyroid gland with the aim of stimulating the formation of T4 and T3.
Often, the actually disease-relevant values for LT4 and LT3 are often in the reference range - despite conspicuous TSH. Hormone treatment is then unnecessary.
"Nevertheless, therapy with LT4 is usually initiated solely on the basis of the increased TSH value," criticizes Krude.
According to the experts, this is harmful for the young patients in several ways. On the one hand, they would have to plan the daily intake of tablets in their daily routine, on the other hand, the health awareness of the adolescents would be disturbed.
In an already difficult phase of self-awareness, they feel sick, although there is no reason for it. Last but not least, there is also the risk of causing an overactive thyroid gland through the use of hormones.
Therefore, Krude pleads to check a slightly higher TSH value after three months and a significantly higher value after six weeks - initially without initiating treatment.
If the values do not increase further during this time, the experienced pediatrician only recommends a further check.
"However, large studies show that the TSH value is now spontaneously back in the reference range," said the expert. (ad)