July 14, 2006
Diagnosis and Symptoms, Thyroid
Question from Culpeper, Virginia, USA:
My 16 month old daughter has become fairly yellow in skin color. Her eyes are perfectly white, so the doctors have always said that it was not jaundice, but was just carotenemia from eating a lot of “yellow” fruits and vegetables. However, after her last well-baby visit, her doctor called me back to schedule an appointment for her to come have blood drawn to check her thyroid function because my daughter wasn’t gaining weight at her usual rate, which could result from thyroid dysfunction, another possible cause for the carotenemia. However, when I looked this up, it appeared to me that HYPOthyroidism is what causes carotenemia, but HYPERthyroidism is what causes decrease in weight. Maybe that’s not always the case? But, I also noticed that diabetes can be another cause for carotenemia. Diabetes runs rampant in my family, but I believe it has always been type 2. In thinking about the symptoms, my daughter has been increasingly hungry and thirsty recently. She still gets up in the middle of the night to nurse. And, she currently weighs 19 pounds, 1 ounce, which they said dropped her into the third percentile, while she was in the fifth percentile at her previous visit. I really don’t want to question what the doctor is thinking if it’s not necessary, but this does somewhat concern me. Does this sound like she could possibly be developing type 1 diabetes? Would there even be an increased risk of type 1 with a high familial incidence of type 2?
Answer:
The yellowish skin tones that accompany carotenemia and hypothyroidism are similar. Cause and effect? I’ve never thought of it that way. And while I do not mean to scare you, persons with some kidney diseases can get that tint also.
So, in an infant an toddler, with the history of large consumption of yellow/orange vegetables, etc., then carotenemia, a very benign, non-worrisome issue, is probably the cause. But, add to that issues of irregular growth, or other more systemic symptoms, it seems prudent for the child to be more formally assessed.
Yes, poor weight is more common in HYPERthyroidism, but nothing is always 100%.
Children with diabetes typically have obviously profound increases in urination and thirst and sometime appetite, also.
Simply based on the symptoms you describe, I would anticipate that your doctor will want to check the child’s blood count (“CBC”), general blood chemistries (to check glucose and kidney functions –this could also screen for liver function), and thyroid levels.
DS
