Hypothyroidism

Thyroid function is essential to growth and to all aspects of development. Hypothyroidism is not preventable, however, early detection and immediate treatment can prevent deleterious and irreversible effects on the growing child. Newborn screening is mandated in all fifty states and it is critical to the early detection of congenital hypothyroidism and the institution of treatment in the first weeks of life. Awareness of acquired hypothyroidism in school-aged children and adolescents is important to the detection of this often subtle condition that usually first presents as deceleration of growth. Lymphocytic thyroiditis is the most common cause of acquired thyroid deficiency in children and adolescents. Hypothyroidism may also develop years after radiation treatment for cancer directed at the area of the thyroid gland or the cranium. Replacement therapy with thyroxine is generally well tolerated. The use of lithium carbonate and other medications, as well as conditions of starvation and chronic malnutrition may be associated with disturbed thyroid function. Persons with the rare disorder of generalized resistance to thyroid hormone are at significant risk for attention deficit hyperactivity disorder. However, the reverse is not the case.