Hypothyroidism

Thyroid hormones are essential for brain and body development in children, therefore it's important to check thyroid function in any child with neurodevelopmental and growth problems.

Congenital

N.B. Most common endocrinopathy affecting newborns.

This is commonly due to an underdeveloped thyroid (dysgenesis), or a fully developed thyroid that doesn’t produce enough hormone (dyshormonogenesis).

It's screened for during the newborn blood spot screening test.

Acquired

It's most commonly caused by Hashimoto’s Thyroiditis, which is where there's autoimmune inflammation and subsequent gland underactivity. It's associated with Anti-TPO.

Other causes include Antithyroid meds e.g. Lithium, Amiodarone, and Hyperthyroid meds etc.

Presentation

• Slow growth and development

• Poor feeding and growth

• Fatigue, Increased sleeping, Reduced activity

• Constipation, Infrequent changing of nappies

• Dry, thin hair and skin

Investigations

• TFTs – Low T3 and T4, High TSH (if primary, which is the most common)

• Anti-TPO – to identify cause i.e. Hashimoto’s

Management

• Levothyroxine