Yesterday, my 11 year old daughter, who has type 1 diabetes, was told she was borderline for thyroid disease, which the doctors say is common with people with type 1 diabetes. Is that true? I see that she is starting to get greasy hair and skin and acne, so I think that perhaps her thyroid gland is working hard because her body is changing, but the doctor doesn’t seem to think so. Doesn’t the thyroid gland produce hormones? We will have her tested again in three months, but with everything else this poor kid is going through, she really doesn’t need to worry about taking a pill for the rest of her life. I am a very worried mother.

Your worry is understandable, and hopefully, your daughter’s pediatrician/pediatric endocrinologist was reassuring to you. Thyroid disease is common in people with type 1 diabetes — perhaps near 20% of the time! This usually manifests as an underactive thyroid (hypothyroidism) but can be an overactive thyroid (hyperthyroidism). Both conditions are treatable, but hypothyroidism is easier to manage.

The root cause of thyroid disease in patients with type 1 diabetes is similar as to what causes type 1diabetes, which your daughter’s doctor likely commented to you. When someone has type 1 diabetes, the body’s immune system gets “confused” and begins producing immune proteins (antibodies) that “attack” normal organs. In type 1 diabetes, they attack the insulin producing cells of the pancreas, in rheumatoid arthritis, they attack the joints and, in thyroid disease, the thyroid gland is the target. There are other autoimmune diseases which have less frequent associations with type 1 diabetes.

As for puberty, it is absolutely normal for girls to have signs of puberty after age eight years, although most girls don’t start until age 10 or 11. The average age of first menstrual bleeding in this country is about age 12 1/2 years.

Please discuss this with your daughter’s doctor. Thyroid problems occur most often and are generally the easiest to treat. If her levels were “borderline” and she had few, if any, symptoms of a thyroid problem, it seems very appropriate to observe matters over time.

DS
Additional comments from Dr. Larry Deeb:

Twenty percent of children with diabetes have thyroid disease and take a thyroid pill for life. Get follow up, and do what is needed.

LD