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What Causes Thyroid Problems In Newborns

How Can I Help My Child

Cause of miscarriage/thyroid in pregnancy in Bengali/Conceiving Baby in Thyroid Problem in Bengali

If your child has hypothyroidism, it’s very important to give the thyroid hormone as instructed by your doctor.

If your child is too young to chew or swallow the pill, crush it and mix it with a small amount of water, non-soy baby formula, or breast milk. Make sure your child drinks all the liquid. Some thyroid hormone pills dissolve more easily in liquids than others, so talk to your doctor if you’re having trouble with this.

Some infant formulas , medicines, and mineral supplements may block the thyroid medicine from being absorbed. Check with your doctor about how and when to give other medicines or supplements while your child takes thyroid hormone.

Screening In Special Categories Of Neonates At Risk Of Ch

Special categories of neonates with CH can be missed at screening performed at usual time, particularly preterm babies and neonates with serious illnesses and multiple births. Drugs used in neonatal intensive care , immaturity of hypothalamic-pituitary thyroid axis, decreased hepatic production of thyroid binding globulin, reduced transfer of maternal T4, reduced intake of iodine or excess iodine exposure, fetal blood mixing in multiple births can affect the first sample, and in many center a second specimen is required to rule out CH. .

Preterm babies have a higher incidence of a unique form of hypothyroidism, characterized by a delayed elevation of TSH. These babies can later develop low T4 and elevated TSH concentrations. This pattern has been termed atypical congenital hypothyroidism or delayed TSH. Preterm babies with a birth weight of less than 1500 gr. have an incidence of congenital hypothyroidism of 1:300. Survival of even extremely premature babies is around 90% in developed countries, and the incidence of prematurity is around 11.5 % in US and 11.8 % worldwide. So, an increasing subpopulation of preterm babies and high risk newborns deserves a special sight about screening and follow up of CH.

What Is The Thyroid Gland And What Is Its Function

The thyroid gland is a small, butterfly-shaped gland located in the anterior part of the neck. It produces the hormones thyroxine and triiodothyronine .

These hormones have a major impact on the following functions:

  • Growth, puberty and fertility
  • Use of vitamins, proteins, carbohydrates, fats, electrolytes and water

The secretion of these hormones is controlled by the thyroid stimulating hormone , which is produced by the pituitary gland. The pituitary gland is located at the base of the brain and produces hormones which control the other glands.

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Is It Safe To Breastfeed While Im Taking Beta

Certain beta-blockers are safe to use while youre breastfeeding because only a small amount shows up in breast milk. The lowest possible dose to relieve your symptoms is best. Only a small amount of thyroid hormone medicine reaches your baby through breast milk, so its safe to take while youre breastfeeding. However, in the case of antithyroid drugs, your doctor will most likely limit your dose to no more than 20 milligrams of methimazole or, less commonly, 400 mg of PTU.

What Are The Symptoms Of Hyperthyroidism

Congenital Hypothyroidism: What is it? Causes, Symptoms ...

Thyroid hormone has important effect on almost every organ in the body, including the brain, heart, bone, skin, and intestinal tract. In hyperthyroidism, excessive amounts of thyroid hormone can cause symptoms from any of these organs. Excess thyroid hormone increases metabolism and can cause weight loss, sweating, and a rapid heartbeat. It can also affect your childs mood and ability to concentrate, making them nervous, irritable, and anxious. In infants, too much thyroid hormone can result in developmental delay.

Signs and symptoms of hyperthyroidism may include:

  • difficulty gaining weight
  • always feeling hot
  • trembling of the hand

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How Is Hypothyroidism Diagnosed

Because the signs and symptoms can be subtle, our pediatric endocrinologist will be very thorough at your initial visit. The doctor gets the medical history, does an exam and decides if a blood test is needed.

  • History and physical examination: The doctor takes a careful history of the child and family. Have family members had an autoimmune condition? The doctor feels around the neck, carefully checking the thyroid gland. Is it swollen ? Are there nodules? Signs and symptoms that could be due to a thyroid disorder are noted and considered.
  • Blood test: We measure the levels of thyroid hormones in a sample of blood. The amounts of thyroid-stimulating hormone and free T4 in the blood are important to learn. Testing for antithyroid antibodies is often helpful as well.

What Causes Congenital Hypothyroidism

Most cases of congenital hypothyroidism happen because the thyroid doesn’t form correctly in the baby during pregnancy. At birth, the baby may have no thyroid gland at all, or have a small, partially developed gland. Why this happens is often unknown, but in some cases it is genetic.

Less commonly, a baby’s thyroid did fully develop, but can’t make normal amounts of thyroid hormone. This is usually due to a genetic problem. Other children born to the same parents have a 1 in 4 chance of having the same thyroid problem.

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Autoimmune Hypothyroidism: Chronic Lymphocytic Thyroiditis

Acquired hypothyroidism is most frequently caused by an autoimmune disorder called chronic lymphocytic thyroiditis . In this disorder your childs immune system attacks the thyroid gland, leading to damage and decreased function. The disorder was originally described by Japanese physician Hakaru Hashimoto and thus is often referred to by his name: Hashimotos thyroiditis.

CLT is more common in girls than in boys, and in adolescents more than pre-adolescents. Patients with other forms of autoimmune disease, most commonly insulin-dependent diabetes, are at increased risk of developing CLT. Overall, about 20 to 30 percent of diabetics will develop CLT. Because of this, annual screening for CLT is a routine part of diabetic care.;

How Does Hyperthyroidism Affect Pregnancy

Thyroid Disease | Hypothyroidism – Causes, Symptoms, Treatment, In English

Uncontrolled hyperthyroidism has many effects. It may lead to preterm birth and low birth weight for the baby. Some studies have shown an increase in pregnancy-induced hypertension in women with hyperthyroidism.

A severe, life-threatening form of hyperthyroidism, called thyroid storm, may complicate pregnancy. This is a condition in which there are extremely high levels of thyroid hormone that can cause high fever, dehydration, diarrhea, rapid and irregular heart rate, shock and death, if not treated.

It is always best to plan for pregnancy and to consult with your physician to ensure your thyroid status and treatment are optimized prior to becoming pregnant and monitored throughout your pregnancy. However, if this does not happen and you find out you are pregnant, you should contact your physician immediately to arrange for increased testing of your thyroid functions and a potential change in your medication.

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Signs And Symptoms Of Hypothyroidism

Symptoms of hypothyroidism are usually subtle and gradual, and may resemble those of other conditions or medical problems. Many symptoms are non-specific and may be ignored as normal parts of our everyday lives. Because of this, the condition may go undetected for years.

Symptoms may include:

  • Slower reaction time
  • Weight gain
  • Sparse, coarse and dry hair
  • Coarse, dry and thickened skin
  • Slow pulse
  • Sides of eyebrows thin or fall out
  • Dull facial expression
  • Enlarged thyroid, producing a goiter-like growth on the neck
  • Increased menstrual flow and cramping in girls and young women

If you have concerns about your child’s health, talk to your childs physician.

How Often Are Blood Levels Checked

An important part of treatment involves monitoring of blood thyroid hormone levels to make sure that the amount of medication is adjusted to keep up with how fast the baby is growing. Generally, blood tests are checked every 1 to 2 months up to 6 months of age and then every 2 to 3 months thereafter. In general, it is recommended that babies with congenital hypothyroidism be managed in consultation with a pediatric endocrine specialist. The primary care provider or the pediatric endocrine specialist will give instructions for how often the blood tests are monitored.

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Low T4 And Normal Tsh

Normal TSH levels with low T4 values occurs in about 3 to 5 percent of neonates and may indicate thyroid insufficiency. It is more common among preterm or ill infants. Possible causes are hypothalamic immaturity , protein-binding disturbances such as TBG deficiency, central hypothyroidism, or primary hypothyroidism with delayed TSH elevation. Constant infusions of dopamine or high-dose glucocorticoids can inhibit TSH, causing low T4 concentrations. Midline facial abnormalities, hypoglycemia, microphallus, or visual abnormalities should suggest hypothalamic-pituitary abnormality. Septooptic dysplasia should be suspected in infants with clinical symptoms of hypopituitarism and blindness or midline defects of the brain.

The optimal follow-up is unclear. Options include no further testing, follow-up filter-paper testing until T4 levels are normal, and measurement of FT4 and TSH concentrations on a second blood sample. However, FT4 values and thyroid function test results usually are normal.

Treatment with LT4 has no proven benefit except in infants with central hypothyroidism or delayed TSH elevation. When deciding whether to pursue further testing, physicians should weigh the benefits of detecting rare conditions against the cost and psychological impact on the family.

Thyroid Disease Increases Birth Defects

Understanding Congenital Hypothyroidism in Your Baby

Jan. 18, 2002 — Women with thyroid disease are more likely to have a child with birth defects — even if thyroid tests taken during pregnancy are normal. A researcher at the Society for Maternal-Fetal Medicine meeting in New Orleans is recommending testing before getting pregnant.

Babies born to women with thyroid disease are at increased risk of heart, brain, and kidney defects, says lead author David Nagey, MD, PhD, in a news release. Nagey is associate professor of gynecology and obstetrics at Johns Hopkins Medical School.

The infants are also at risk for physical abnormalities like cleft lip or palate or extra fingers, he reports.

The risk for heart defects was seen in women with an underactive thyroid but not in women with an overactive thyroid. And this was true even if the women were taking medication to bring their thyroid levels back to normal.

“We already knew that there was an increased risk of problems, mostly intellectual or developmental … but the link with birth defects is new and unexpected,” Nagey says.

If the study results are confirmed, it could lead to routine testing of women for thyroid disease prior to pregnancy. If the test indicates a woman has an underactive thyroid, a fetal ultrasound of the heart — called an “echocardiogram” — during the 20th week of pregnancy might be necessary, he says.

Overall, there were 108 pregnancies with 114 fetuses.

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Can Other Members Of The Family Have Ch

Having CHIf they are healthy and developing normally, older brothers and sisters of a baby with CH are unlikely to have the condition. Talk to your doctor if you have questions about your other children.

Future pregnanciesAll 50 US states offer newborn;screening;for CH. However, when a previous child in the family has had CH, newborn screeningA screening test that looks for different disorders using a small sample of blood taken from a newborns heel. A positive or abnormal newborn screening result means that there are slight differences that were found in the babys blood, and further testing is needed to figure out if the baby has a metabolic disorder. results may not be sufficient to rule out the condition in a newborn baby. In this case, special diagnostic testing may be advised in addition to newborn screeningThe process of testing for disease in a person who does not show signs of having the disease . The goal of screening is to catch the disease in its early stages..

Does The Treatment Have Any Side Effects

Because thyroxine medicine is simply replacing a normal chemical produced by the body, giving the correct dose every day should not have any side effects. However, if given too little thyroxine, the child will develop the symptoms of hypothyroidism outlined earlier, and over a long period, may grow more slowly than usual. If the child has too much thyroxine, he or she may develop mild diarrhoea, not put on weight, may be more restless than usual and over a long period may grow more quickly than usual. But, as described above, the correct dose for the child will be calculated on a regular basis, so these effects are unlikely to occur.

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Predictors Of Transient Congenital Hypothyroidism

Children who had the lower increases in their blood levels of thyroid stimulating hormone which controls thyroid gland activitywhen diagnosis at birth, were more likely to outgrow the condition,1 the researchers found.

TSH tells the thyroid gland how much hormone to produce so if levels are high, it is an indication of hypothyroidism. Those who no longer had the hypothyroidism were also more likely to need lower doses of levothyroxine initially and again at 6 and 12 months.1 These babies were also less likely to have a hereditary or genetic form of this hypothyroid condition

While the usual routine generally is to treat children until they reach 3 years of age because the time to that point is very important for brain development, Dr. Saba says her findings suggest that it may not be necessary to continue treatment out that long in every baby, and that treatment may often be safely stopped at six months, based on the blood test results for the thyroid levels. She cites the benefits of potential cost savings in being able to stop the levothyroxine sooner whenever possible.

Luiz Gonzalez-Mendoza, MD, pediatric endocrinologist and director of the division of endocrinology at Nicklaus Children’s Hospital in Miami, Florida who was not involved, reviewed the study findings for EndocrineWeb, and recommended a bit of caution.

How Do Doctors Treat Postpartum Thyroiditis

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The hyperthyroid stage of postpartum thyroiditis rarely needs treatment. If your symptoms are bothering you, your doctor may prescribe a beta-blocker, a medicine that slows your heart rate. Antithyroid medicines are not useful in postpartum thyroiditis, but if you have Graves disease, it may worsen after your baby is born and you may need antithyroid medicines.

Youre more likely to have symptoms during the hypothyroid stage. Your doctor may prescribe thyroid hormone medicine to help with your symptoms. If your hypothyroidism doesnt go away, you will need to take thyroid hormone medicine for the rest of your life.

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Development Of Thyroid Function

During fetal life, the thyroid gland develops with production of thyroxine and triiodothyronine and secretion into the serum from about 12 weeks gestation, the levels of which increase to term. Throughout gestation, maternal T4 crosses the placenta in limited amounts, but in the first trimester, this plays a critical role in central nervous system development, as exemplified by the fetal neurological impairment seen in fetomaternal Pit-1 deficiency and severe iodine deficiency. In both situations there is severe maternal and fetal hypothyroidism. In areas of endemic iodine deficiency, iodine supplementation to women before pregnancy or up to the end of the second trimester protects the fetal brain from the effects of iodine deficiency whereas third trimester or neonatal supplementation does not improve neurological outcome.

T3 and T4 are also inactivated to sulphated analogues by sulphotransferase in fetal liver. Sulphated iodothyronines are major thyroid hormone metabolites in the fetus, and sulphate conjugation of the iodothyronines accelerates deiodination.

What Causes Thyroid Problems Among Women

According to the American Thyroid Association, women are five to eight times more likely than men to have thyroid problems. And of the women who develop a thyroid dysfunction during their life, 1 in 5 has it as a result of genetic mutation of the TSHB gene.

The following thyroid-related diseases affect more women than men:

  • Disorders that cause hypothyroidism
  • Thyroid nodules
  • Thyroid cancer

Because women are more likely than men to have a thyroid condition, there are several symptoms that exclusively affect women and child-bearing individuals with thyroid disease. For example, pregnant women with undiagnosed or inadequately treated hypothyroidism have an increased risk of miscarriage, preterm delivery, and severe developmental problems in their children.

Additionally, women with thyroid disorders may experience problems with their menstrual cycles, fertility issues, and problems during pregnancy.

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Does This Hypothyroxinaemia Matter

In preterm infants, almost all reports document an association between adverse outcome and hypothyroxinaemia. Severe hypothyroxinaemia, as measured on blood spots in newborn screening programmes that utilise T4 , has been associated with an increase in perinatal mortality and morbidity, with prolonged oxygen supplementation, mechanical ventilation, and hospital stay, an increased incidence of intraventricular haemorrhage, and a greater risk of echolucencies in cerebral white matter on ultrasonography. In the survivors, an increased risk of neurodevelopmental problems, reduced intelligence quotient ,, and disabling cerebral palsy has been reported, even when corrected for potential confounders including gestation, fetal growth, and illness severity. A British cohort in which T3 was measured twice in the first week and weekly thereafter in babies of less than 1850 g has shown an association between a T3 level less than 0.3 nmol/l and a reduction on the Bayley mental developmental index score, and the Bayley psychomotor index score of 8.3 points and 7.4 points respectively at 18 months, even with adjustment for confounding variables known to affect outcome. When reassessed between 7.5 and 8 years, overall IQ was 6.6 points lower in those whose lowest T3 had been < 0.3 nmol/l.

Management Of Babies At Risk Of Neonatal Thyrotoxicosis

Cyst On Thyroid

Figure 1 shows a suggested scheme for the management of a baby at risk of neonatal thyrotoxicosis. This will include all babies of mothers with a current or past history of Graves disease , and those rare families with a family history of neonatal thyrotoxicosis secondary to TSH receptor mutations. The diagnosis of euthyroid, hypothyroid, or hyperthyroid has to be made in the light of expected TSH and T4 levels for postnatal age, as the huge surge in both after delivery will necessarily mean that the usual normal ranges for adults and older children are inappropriate.

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