Male Speaker: Dr. Anhalt, sometimes babies who are born and their parents get a call about a week to 10 days later, they found something wrong and this thing called newborn screening, they say “Oh! he might have a problem with the thyroid” and they say “Oh! And look up the internet and hypothyroid can lead to a big problem. What’s that all about?
Dr. Henry Anhalt: Newborn screening was one of the greatest inventions of the last few decades in the United States and globally. Newborn screening was designed to detect the children with serious medical conditions that would otherwise go undetected until irreversible damage was done. However, as a result of the testing leading to be extremely sensitive, that means not allow any children who may potentially have a disease to go undetected most of the time, most of the time the reports that come in are borderline cases that are ultimately normal.
However, when a family or pediatrician gets a call from the state and reference to newborn screening it can result in a lot of anxiety until things were sorted through. It’s important that if 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.
Male Speaker: But it turned out in this particular case the kid had a thing called TSH and was elevated and they confirmed it was true. What does that mean?
Dr. Henry Anhalt: Again as a result of newborn 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 1 in 5,000 life 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 underactive thyroid gland.
Typically, these children will have a condition where their 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 pediatric endocrinologist can institute treatment and a child can be spared any problems going forward. So, the newborn screening program works and in the rare case in 1 in 5,000 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.
Male Speaker: So, in other words when you read about a kid that has hypothyroidism in newborn period and they get treated they don’t end up with things like retardation and cretinism and things like that?
Dr. Henry Anhalt: 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 or infants spared any neurological problems going forward.
Male Speaker: And the treatment is actually pretty simple isn’t it?
Dr. Henry Anhalt: Of all the endocrine problems in the world that have in fact of all the problems that a child can have, having newborn 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 routine blood testing and monitoring can be done that child looks towards a very, very bright future.
Male Speaker: Is that mean my kid can never get hypothyroidism with the newborn screening is okay, can he develop it later in life?
Dr. Henry Anhalt: 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 cause is where the body recognizes the thyroid gland as being a foreign protein or foreign structure and begins to destroy it, a so called autoimmune disease, and when this happens thyroid function goes down, thyroid hormone production goes down, TSH levels raise, and the baby or child now will develop hypothyroidism.
This can occur in childhood and occurs primarily during two times in a child’s life around the ages of 6 to 9 and then again in the teen years more commonly seen in girls than in boys. And again, very readily treatable by replacement doses of thyroid hormone and I think 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 a treatment like antibiotics where we are treating a disease here we are simply replacing back to the body in a way that's most natural what the body is no longer capable of making.
Male Speaker: If a kid is in school, she in fact performing well and seems to gain weight and so I picked up the cholesterol is elevated is that a sign of hypothyroidism?
Dr. Henry Anhalt: In elevated cholesterol in particular the triglyceride levels can very oftentimes 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. It is a common myth and common misconception that thyroid problems are the result or the cause of overweight in many children. In fact, the incidents of thyroid abnormalities in overweight children is no more common than it is in the background population and therefore oftentimes not the cause of abnormalities and cholesterol.
Male Speaker: Thank you very much.
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