Understanding Hashimoto’s in Children


Understanding Hashimoto’s in Children


What is Hashimoto’s? 

Hashimoto’s, or Hashimoto’s Thyroiditis, is an autoimmune disorder involving the thyroid gland. It is the most common cause of hypothyroidism or an underactive thyroid in adults and children. 

While the condition is increasingly common among adults it is considered less of a risk for children.

The thyroid gland is a butterfly-shaped gland just below your Adam’s apple. It plays a very important role in the body by making a hormone called thyroxine. This hormone travels to endless areas of the body and signals each and every cell to produce energy and promote growth and development so that we can go about our normal everyday activities. 

In Hashimoto’s, the thyroid gland comes under attack by our own body’s immune system. The attack leaves the thyroid gland inflamed and battered. It is left unable to function at 100% and produce enough thyroid hormones to keep us energised. Without enough thyroid hormones, we start to slow down and feel sluggish.

What are the signs and symptoms?

Signs and symptoms may not be overtly obvious at the beginning. There may be some unusual fatigue, sluggishness, an onset of constipation, dry skin and weakness. Or a child’s only symptom may be an enlarged thyroid known as a goitre. Symptoms can range from mild to more severe. 

If you have concerns that your child might be suffering with a sluggish thyroid and there are thyroid disorders or other autoimmune conditions in the family, it is worth talking to your health professional to rule out Hashimoto’s as the cause.  If it is caught early, children can avoid having to take medication.

Common things to look out for in your child:

  • Fatigue and ‘sluggish’ demeanor
  • Sensitivity to the cold
  • Increased sleepiness and afternoon napping
  • Signs of depression and low mood

You may also notice:

  • Dry skin
  • Constipation 
  • Unexplained weight gain 
  • Slowed or stalled growth and development
  • Problems with memory and concentration, issues at school
  • Tantrums and meltdowns
  • Violence and aggression
  • Sensory issues
  • Muscle weakness
  • Muscle aches, tenderness and stiffness 
  • Joint pain and stiffness
  • Recurrent illnesses
  • Irregular or excessive menstrual bleeding 
  • A puffy face
  • An enlarged tongue 
  • Hair loss
  • Brittle nails 
  • A goiter (swelling of the thyroid) 
  • Feeling cold all the time

Why do our bodies attack our thyroid gland? 

While it may be hard to believe, in Hashimoto’s, the body is not attacking the thyroid gland on purpose. Being an autoimmune disorder, the immune system has become confused and it thinks that the thyroid gland (or parts of it) is a threat or enemy to be dealt with. The immune system produces its ammunition, called antibodies, that it normally uses to deal with and protect us from viruses and bacteria. For reasons yet to be concretely understood, the immune system makes anti-thyroid antibodies that attack the thyroid gland causing inflammation, destruction of the thyroid and a reduced ability to produce thyroid hormones. 

The exact cause of the misinformed attack is not clearly understood. A combination of genetic and environmental risk factors as well as immune dysfunction is believed to be at the bottom of the disorder. 

Hashimoto has a genetic factor, so a family history of it and/or other autoimmune conditions is a strong risk factor.  Hashimoto’s is also significantly more common in females: at least 10:1.

Like most autoimmune disorders, development is triggered by environmental factors in genetically susceptible people. 

Environmental triggers for Hashimotos:

  • Bacterial and viral infections
  • Exposure to cigarette smoke
  • Exposure to chemicals such as flame retardants and phthalates
  • Negative changes in gut microflora 
  • Excessive iodine intake (usually through supplementation) 
  • Stress or trauma
  • Nutrient deficiencies

How do you know if you or your child have Hashimoto’s? 

Hashimoto’s is diagnosed based on blood tests that look for thyroid antibodies and assess thyroid function. 

90% of people with Hashimoto’s will have antithyroid peroxidase antibodies in the serum. Children and adolescents may also be positive for another antibody called Antinuclear factor (ANF). 

The thyroid function tests check the hormones relevant in the loop involved in producing thyroid hormones and keeping levels in the blood within a normal healthy range. These include results for thyroid stimulating hormone (TSH), and thyroid hormones T3 and T4. 

In suspected or confirmed cases of Hashimoto’s in children, it is recommended to screen for Coeliac Disease as well, as the two can coexist. Looking for more information on the signs and symptoms of Coeliac Disease? Have a read of this recent blog here.

If you suspect your child may have a thyroid issue, get in touch to discuss how we might be able to improve your child’s quality of life, restore their thyroid function and control the disease.

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