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January 21, 2005

Thyroid

Question from Texas, USA:

My daughter is five and has had diabetes since the age of 18 months old. Recently, a goiter significant in size appeared within a few weeks time. Her laboratory results are as follows: TSH 80.65; Thyroglobulin 24; T3 242; and T4 0.6. Diagnosed as hypothyroid with goiter, she has been placed on Synthroid, 50 mg. I am satisfied with her doctors diagnosis and advice. I do have so many questions as to why this happened to her. Is it reversible? Is it common at such a young age? What other autoimmune disorders will be linked to this so I can request further testing on a regular basis to keep her as healthy as possible?

Answer:

Thyroid disorders are commonly associated with type 1 diabetes since both are autoimmune diseases of the endocrine system. Celiac disease should be screened using transglutaminase antibody. Some would also do gastroparietal and adrenal antibodies. There is an old article of Diabetes Forecast that describes this association. Many pediatric endocrinologists routinely check for thyroid antibodies, celiac antibodies and thyroid functions because of how common this is.

It sounds like the correct treatment is being undertaken with thyroid hormone replacement. Hypothyroidism is usually very easy to treat with a single thyroid hormone pill each day aiming to normalize the T4 and TSH levels. Sometimes, T3 is also needed in addition to T4 and this is decided based upon actual thyroid blood results.

SB