Hypothyroidism

Male1: Doctor, sometimes babies are born and the parents get a call about a week or ten days later that they found something wrong in this thing called newborn screening—they say, “oh you might have problem with the thyroid,” and they look up the internet and hyperthyroidism can lead to a big problem what is that all about?
Male2: Newborn screening was one of the greatest inventions over the last few decades in the United States and globally. New born screening was designed to detect children with serious medical conditions that would otherwise go undetected until irreversible damage was done, however as a result of the testing deemed to be extremely sensitive, that means, not allow any children who may potentially have a disease to go undetected most of the time, the reports that come in are borderline cases that are ultimately normal, however, when the family or pediatrician gets a call from the state in reference to a new born screening, it can result in a lot of anxiety until things are sorted through. It is important that the parents do get a call that they speak to their pediatrician and most of the time will get the reassurance that they are looking for and only find out later that in fact the results are normal.
Male1: But it turns out in this particular case, a thing called TSH and was elevated and they confirmed that it was true. What does that mean?
Male2: Again, as a result of a new born screening being in place in every state in the United States and in many countries around the world, a condition called congenital hypothyroidism which occurs in one in 5000 live births has been able to be detected in enough time to prevent that child from developing any complications from being hypothyroid or from having an under active thyroid gland. Typically, these children will have a condition where the thyroid gland has not formed or has formed impartially and as a result of that, they have just borderline function of the thyroid gland. If this is detected early enough, then the pediatrician or the pediatric endocrinologist can institute treatment and the child can be spared any problems going forward. So the new born screening program works and in the rare case, in one in 5000, when the child in fact does have a disease, if in fact the child is detected early enough as is done by newborn screening and appropriately treated that child has a bright future.
Male1: So in other words, you read about a kid that has hypothyroidism in the newborn period, and they get treated, they do not end up with things like retardation and Cretinism and things like that.
Male2: Fortunately, cretinism which was undetected hypothyroidism resulting in devastating neurological complications is a thing of the past today in the United States and this is because of how successful newborn screening is. So today, with treatment starting within a couple of weeks after birth, most of the children are in fact spared any neurological problems going forward.
Male1: And the treatment is actually rather simple, is it not?
Male2: Of all the endocrine problems in the world that happened, in fact, of all the problems that a child can have, having new born hypothyroidism is probably the easiest and simplest to treat. Simply administering a replacement dose of thyroid hormone is sufficient enough to take care of that child and with frequent visits to the pediatrician or the pediatric endocrinologist where a routine blood testing and monitoring can be done, that child looks towards a very, very bright future.
Male1: Does that mean that my kid can never get hypothyroidism that the newborn screening is okay, can you devolve that later in life?
Male2: There are many forms of hypothyroidism. We have just now spoken about congenital hypothyroidism, again, a condition where the gland is partially formed or not formed at all. There are other forms of hypothyroidism, one of the most common causes is where the body recognizes the thyroid gland as being a foreign protein or a foreign structure and begins to destroy it. It is so-called autoimmune disease and when this happens, thyroid function goes down, thyroid hormone production goes down, TSH levels rise and the baby or child now will develop hypothyroidism. This can occur in childhood and it occurs primarily during two times in the child’s life around the ages of six to nine and then again in the teen years, more commonly seen in girls than in boys and again, very readily treatable by replacement does of thyroid hormone and the thing for parents to always remember in treating hypothyroidism is that all we are doing is replacing back to the body what the body is no longer capable of making, unlike the treatment by antibiotics where we are treating a disease, here we are simply replacing back to the body in a way that is most natural what the body is no longer capable of making.
Male1 : If the kid is in school and seems to be performing well and seem to gain weight and someone picked up the cholesterol and it is a little elevated, is that a sign of hypothyroidism?
Male2: An elevated cholesterol in particular the triglyceride levels can very often times be associated with abnormal thyroid function, however, it is important to always remember that in most cases of overweight, we do not find an abnormality in the thyroid.



Transcription by: Scribe4you Transcription Services