Thyroid Disorder
Thyroid disorder is not uncommon in the young. The thyroid gland begins development at the back of the primitive tongue early in pregnancy and has moved down to its position in the front of the neck at the end of the twelfth week. The function of the thyroid gland is to join iodine to a protein called tyrosine, to produce thyroxine or tri-iodothyronine, the active hormones responsible for controlling our metabolic rate. The activity of the thyroid gland is governed by the level of thyroid stimulating hormone (TSH) secreted by the pituitary gland in the brain: this also measures the amount of thyroid hormone in the blood and adjusts the TSH level accordingly.
Thyroid failure - or hypothyroidism - in the infant can result from complete failure of development (called agenesis) of the thyroid, or, more rarely, inborn errors of metabolism of the hormone, or the use of anti-thyroid drugs by the mother during pregnancy. It can also be caused by severe iodine deficiency - which is why most table salt has small amounts of added iodide. In the infant thyroid failure causes a syndrome of small stature, mental retardation, rough skin and coarse features, called Cretinism. It’s in order to prevent this that all babies in the UK are tested for TSH shortly after birth. Thyroid failure developing during childhood or adolescence, causing multiple symptoms involving all major systems: weight gain, hair loss, coldness, slow heart rate, hoarse voice, fatigue, muscle pain and weakness, menstrual irregularity in post-pubertal girls, constipation - is most commonly due to autoimmune attack on the thyroid, causing thyroid inflammation - a condition called Hashimoto’s thyroiditis. Hypothyroidism is eminently treatable using thyroid replacement therapy. Thyroid over-activity, called hyperthyroidism (hypo means low, while hyper means high) can occur in children and adolescents, usually as a result of a condition called Grave's disease, where there is production of antibodies that stimulate the thyroid gland and produce high levels of thyroid hormones. As with hypothyroidism there are symptoms affecting all major systems: weight loss, tremor, palpitations, bulging eyes, anxiety and possibly panic attacks. There are effective treatments both to block the effects of the thyroid hormones and to reduce the activity of the gland. Both surgery and radiotherapy may play a part.
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