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May 30, 2005

Other Illnesses, Thyroid

Question from Cumming, Georgia, USA:

My son is 13 and has had type 1 since age four. In the last two years, he has put on 40 pounds and now weighs 172 pounds. He has been diagnosed with hypothyroidism and, now, growth hormone deficiency. Is there a correlation between all these hormone issues? What else do I need to be looking for? Will we need to watch for other hormone problems? I feel we were late diagnosing the thyroid and late diagnosing the growth hormone problem. I am frustrated and don't want to miss anything else.

Answer:

It is very unusual to have growth hormone deficiency and type 1 diabetes. They are not likely related diagnoses. Thyroid problems related to Hashimoto’s thyroiditis (goiters, hypothyroidism and hyperthyroidism) are autoimmune problems that are seen in type 1 diabetes about 20 to 40% of the time in children/adolescents. If the thyroid deficiency is from TSH deficiency, this would suggest that the growth hormone and thyroid deficiencies are related to hypopituitarism. This could be a very rare type of pituitary autoimmune problem called hypophysitis. If the pituitary gland is underactive, then evaluation of the posterior pituitary for diabetes insipidus is important; also, evaluation for gonadal deficiency of LH (luteinizing hormone) and FSH (follicle-stimulating hormone) would be more likely as might adrenal insufficiency from ACTH (adrenocorticotropic hormone) deficiency. Please go back and ask this question to your endocrinologists since they will be able to give you best answer looking at all the facts.

SB