Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Concept Videos

Synthesis and Regulation of Thyroid Hormones01:20

Synthesis and Regulation of Thyroid Hormones

4.3K
Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
4.3K
Functions of Thyroid Hormones01:18

Functions of Thyroid Hormones

2.6K
The thyroid hormone (TH) plays a pivotal role in the intricate orchestration of physiological processes, exerting profound effects on development, metabolism, and homeostasis throughout different life stages.
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...
2.6K
The Thyroid Gland01:23

The Thyroid Gland

3.7K
The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...
3.7K
Diabetes Mellitus: Overview and Type I Subtype01:22

Diabetes Mellitus: Overview and Type I Subtype

2.5K
Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
2.5K
Attention-Deficit/Hyperactivity Disorder01:30

Attention-Deficit/Hyperactivity Disorder

50
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by persistent inattention, hyperactivity, and impulsivity. It affects approximately 5-8% of children globally, with around 60-70% of cases persisting into adulthood. ADHD has significant implications for educational attainment, social interactions, and occupational success.
Diagnostic Criteria and Symptoms
To diagnose ADHD, symptoms must manifest before age 12 and be evident across multiple settings....
50
Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

217
Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
217

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Overview of Endocrine Dysfunction in Children with Turner Syndrome.

Turkish archives of pediatrics·2026
Same author

Graves' Disease in Children: An Update.

Clinical medicine insights. Endocrinology and diabetes·2023
Same author

Subclinical hyperthyroidism in children.

Journal of pediatric endocrinology & metabolism : JPEM·2022
Same author

Midkine: Utility as a Predictor of Early Diabetic Nephropathy in Children with Type 1 Diabetes Mellitus

Journal of clinical research in pediatric endocrinology·2021
Same author

Soluble CD40 Ligand Levels in Children with Newly Diagnosed Graves’ Disease

Journal of clinical research in pediatric endocrinology·2019
Same author

Epicardial Fat Thickness in Children with Classic Congenital Adrenal Hyperplasia

Journal of clinical research in pediatric endocrinology·2018

Related Experiment Video

Updated: Jun 14, 2025

Author Spotlight: Integrating Ultrasound Imaging with Biochemical Markers for Thyroid Disease Diagnosis
05:41

Author Spotlight: Integrating Ultrasound Imaging with Biochemical Markers for Thyroid Disease Diagnosis

Published on: February 9, 2024

557

Refractory hypothyroidism in children: an overview.

Kotb Abbass Metwalley1, Hekma Saad Farghaly1

  • 1Pediatric Endocrinology Unit, Department of Pediatrics, Faculty of Medicine, 68796 Assiut University , Assiut, Egypt.

Journal of Pediatric Endocrinology & Metabolism : JPEM
|September 6, 2024
PubMed
Summary

Refractory hypothyroidism (RH) in children is often due to poor compliance or malabsorption issues. Early identification and addressing the root cause are crucial to prevent over-treatment with l-thyroxine (LT4).

Keywords:
change of brand of LT4l-thyroxine malabsorptionpoor storage of LT4refractory hypothyroidismweight gain

More Related Videos

Generation of Hypoparathyroid Rats via Carbon-Nanoparticle-Assisted Parathyroidectomy
03:57

Generation of Hypoparathyroid Rats via Carbon-Nanoparticle-Assisted Parathyroidectomy

Published on: July 14, 2023

1.8K
Generation of a Mouse Spontaneous Autoimmune Thyroiditis Model
04:39

Generation of a Mouse Spontaneous Autoimmune Thyroiditis Model

Published on: March 17, 2023

1.6K

Related Experiment Videos

Last Updated: Jun 14, 2025

Author Spotlight: Integrating Ultrasound Imaging with Biochemical Markers for Thyroid Disease Diagnosis
05:41

Author Spotlight: Integrating Ultrasound Imaging with Biochemical Markers for Thyroid Disease Diagnosis

Published on: February 9, 2024

557
Generation of Hypoparathyroid Rats via Carbon-Nanoparticle-Assisted Parathyroidectomy
03:57

Generation of Hypoparathyroid Rats via Carbon-Nanoparticle-Assisted Parathyroidectomy

Published on: July 14, 2023

1.8K
Generation of a Mouse Spontaneous Autoimmune Thyroiditis Model
04:39

Generation of a Mouse Spontaneous Autoimmune Thyroiditis Model

Published on: March 17, 2023

1.6K

Area of Science:

  • Pediatric Endocrinology
  • Thyroid Disorders
  • Internal Medicine

Background:

  • Refractory hypothyroidism (RH) is characterized by elevated thyroid-stimulating hormone (TSH) levels despite adequate l-thyroxine (LT4) dosage.
  • Common causes include non-compliance, LT4 malabsorption due to diet, medications, or gastrointestinal conditions.
  • In children, RH can be linked to weight gain, brand switching, poor LT4 storage, and other underlying diseases.

Purpose of the Study:

  • To review the causes, clinical features, diagnostic approaches, and management strategies for refractory hypothyroidism in pediatric patients.
  • To provide endocrinologists with a methodical approach to diagnosing and treating RH in children.
  • To emphasize the importance of identifying underlying causes to avoid excessive LT4 treatment.

Main Methods:

  • Extensive literature search on refractory hypothyroidism in children.
  • Analysis of clinical experience in managing pediatric RH cases.
  • Review of diagnostic investigations and treatment protocols.

Main Results:

  • Inadequate compliance is the most frequent cause of RH.
  • Gastrointestinal issues, dietary factors, and drug interactions can impair LT4 absorption.
  • RH in children is often asymptomatic or presents with mild hypothyroid symptoms.

Conclusions:

  • Early and accurate diagnosis of RH in children is essential.
  • Addressing underlying causes like non-compliance and malabsorption is key to effective management.
  • Appropriate treatment prevents LT4 overuse and associated complications such as cardiac and bone issues.