Endocrinology for Mainz: Thyroid medication often unnecessary
Endocrinology specialist from Mainz advises: first check children, then treat them
MAINZ: Should thyroid medication be used in children and adolescents? Endocrinology specialist Prof Dr med Dr h. c. Christian Wüster advocates a wait-and-see approach to treatment in the case of elevated TSH levels in children. TSH stands for thyroid-stimulating hormone. ‘Not every elevated TSH value is a reliable indication of an underactive thyroid. The task of TSH is to stimulate the formation of T4 and T3. If the disease-relevant values for LT4 and LT3 are within the reference range and the TSH value is elevated at the same time, hormone treatment is not indicated for the time being,’ emphasises the endocrinologist.
Endocrinology specialist from Mainz: Thyroid hormone therapy too early can be harmful
For young patients, premature treatment with LT4 based on an elevated TSH value can sometimes be harmful. Children have to schedule the intake of tablets into their daily routine. In addition, their health awareness is disturbed because they feel ill for no reason during the emotionally turbulent pubertal development phase. In addition, premature thyroid therapy creates the risk of hyperthyroidism. If a TSH value is conspicuous during an examination, the endocrinology specialist from Mainz initially favours control. After a period of three months, a slightly elevated value should be checked again.
If the value is significantly elevated, a check-up is carried out after six weeks. If the values remain unchanged during this period, further check-ups should be carried out. This is because the TSH value is often back in the normal range in the meantime. Large studies have confirmed this. This is because if the thyroid gland is not working properly, the body tries to compensate for LT4 and LT3 production by producing more TSH.
Do not counteract too quickly with thyroid preparations, recommends an endocrinology specialist
Tiredness, listlessness and obesity can be signs of an underactive thyroid in children and adolescents. Doctors then often advise checking the thyroid levels. This is because a lack of thyroid hormones can have a negative impact on mental and linguistic development as well as physical growth. The ability to concentrate and memory can also be impaired if the TSH value is permanently elevated. A blood analysis can provide clues here. ‘However, these tests often lead to the prescription of thyroid preparations, which are sometimes unnecessary,’ warns the endocrinology specialist from Mainz.
