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Author Spotlight: In Vivo Assessment of Thyroid Hormone Disruption Using the THAI Mouse Model
Published on: October 6, 2023
Treatment of hypothyroidism in infants, children and adolescents
Luisa Rodriguez1, Catherine Dinauer2, Gary Francis3
1Assistant Professor of Pediatrics, Division of Endocrinology and Diabetes, University of Texas Health Science Center San Antonio, San Antonio, TX, USA.
Insights
Levothyroxine (LT4) is standard for hypothyroidism, but diagnosing and treating certain pediatric groups like those with congenital hypothyroidism (CH) remains challenging. This review examines progress and remaining issues in these specific populations.
Area of Science:
- Pediatric Endocrinology
- Thyroid Disorders
- Clinical Review
Background:
- The 2014 American Thyroid Association guidelines recommend levothyroxine (LT4) for hypothyroidism, targeting normal thyrotropin (TSH) levels.
- While generally effective, standard treatment approaches present challenges in specific pediatric subgroups.
Purpose of the Study:
- To review advancements in the diagnosis and treatment of hypothyroidism in problematic pediatric populations.
- To identify persistent challenges and areas for future research in pediatric hypothyroidism management.
Main Methods:
- Literature review focusing on recent studies and guidelines.
- Analysis of diagnostic and therapeutic strategies for specific pediatric groups.
Main Results:
- Levothyroxine (LT4) remains the cornerstone of treatment, with TSH normalization as the primary goal.
- Specific challenges persist in diagnosing and treating hypothyroidism in congenital hypothyroidism (CH), low birth weight (LBW), very low birth weight (VLBW), Down syndrome (DS), subclinical hypothyroidism, and obesity.
Conclusions:
- Despite established guidelines, tailored approaches are crucial for managing hypothyroidism in vulnerable pediatric populations.
- Further research is needed to address diagnostic and therapeutic complexities in these specific groups to optimize outcomes.
Abstract:
In 2014, treatment guidelines from the American Thyroid Association reflected the general consensus that levothyroxine (LT4), adjusted to maintain a normal thyrotropin (TSH) level, is the preferred method for treatment of hypothyroidism. Although this is generally applicable to children, there are subsets of children for whom the diagnosis and treatment of hypothyroidism are problematic. These include children with congenital hypothyroidism (CH), low birth weight (LBW) and very low birth weight (VLBW), Down syndrome (DS), subclinical hypothyroidism, and obesity. In this Review, we focus on the progress and remaining pitfalls in diagnosis and treatment of hypothyroidism in these and other groups.
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