Patient's question:
I am the mother of a child with a disease. I myself am a hypothyroidism patient. The doctor considered that I might have Hashimoto's thyroiditis with hypothyroidism and have been taking (Levothyroxine) ever since. After my thyroid function was regulated to normal, I got pregnant (I was very surprised at the time, as I had been trying to conceive for two years without success, and the doctor also said that hypothyroidism makes it difficult to get pregnant). After consulting the doctor, I continued to take Levothyroxine during pregnancy and had my thyroid function checked every month. My thyroid function has always been maintained within the normal range.When the child was three years old, a follow-up thyroid function test showed normal results. At that time, I thought that since the child was already three, everything should be fine. However, a few days ago, the child had a cold and discomfort in the neck, and I noticed that her neck was a bit swollen. I had an ultrasound done, which indicated: diffuse thyroid lesions -- possible Hashimoto's thyroiditis with hyperthyroidism. I then had a comprehensive thyroid function test, with the results as mentioned above.
The child has been experiencing irritability and excessive sweating, which I initially thought were due to a change in her temperament or calcium deficiency. This condition has lasted for about half a year. My child is now 5 years and 3 months old, weighing 17 kg and measuring 110 cm.
Doctor's answer:
Hello!Your child's thyroid function can be normal at the age of three, but it doesn't necessarily mean it will remain normal.
If the mother has Hashimoto's thyroiditis, she may have thyroid globulin antibodies (TGAb) and thyroid microsomal antibodies (TMAb) in her body. These two antibodies can pass through the placenta to the fetus or be inherited by the fetus, meaning they can damage the thyroid gland and lead to hypothyroidism or hyperthyroidism.
The timing of onset depends on when these two antibodies cause thyroid damage. Most children develop symptoms during puberty, but it can occur earlier, even in school-age or preschool-age children!
Your child's two key indicators were not checked. I recommend retesting them next time you have blood drawn.
Hyperthyroidism requires treatment. Currently, your child should reduce the dosage: 5mg per dose, three times a day. After two weeks, retest the thyroid function. Once it returns to normal, adjust the dosage to 5mg per dose, twice a day, and retest the thyroid function again after one month.
Regular follow-ups are necessary, and the dosage should be adjusted based on the thyroid function results. If the dosage is not appropriate, it can lead to hypothyroidism or hyperthyroidism, or cause alternating cycles of both.
Regarding how long the medication for hyperthyroidism should be taken, it depends on the individual. Typically, it is used for 2-3 years. If it recurs after stopping the medication, longer treatment may be needed. The younger the child, the harder it is to control hyperthyroidism!