Congenital (congenital) hypothyroidism seen in newborn babies is the most common endocrinological problem. Untreated congenital hypothyroidism, which can pose a great risk for the health of babies, can cause very serious diseases, especially mental retardation.
TREATMENT IS EXTREMELY IMPORTANT
Each baby is given a series of tests within the first 72 hours of birth. These tests with blood taken from the heel are vital for babies. Congenital hypothyroidism is one of the diseases tested under the Newborn Screening Program of the Ministry of Health. Congenital hypothyroidism, which can cause mental retardation if not treated, is a problem that should not be neglected.
The symptoms of congenital hypothyroidism, the treatment process and the health problems it can cause, Dr. Behçet Uz and Prof. Dr. Behzat Özkan told TRT Haber.
THE MOST COMMON ENDOCRINOLOGICAL PROBLEM IN THE NEWBORN
Stating that congenital hypothyroidism is the most common endocrinological hormone disorder problem in the newborn period, Prof. Dr. Özkan said, “When we collect permanent and temporary cases together, it is seen in approximately one in 800 to 200 thousand live births. If we evaluate the permanent cases alone, it appears to be one in 3 thousand live births. So it’s a common problem in society,” he says.
MAY CAUSE IRREVERSIBLE RESULTS
Thyroid hormones play a very important role in the formation of neural development. Since the growth rate of the brain increases very much in early childhood, especially in the first two years, these hormones are very important for the development of nerves. Congenital thyroid hormone deficiency is a serious problem that should not be neglected. Because thyroid hormone deficiency can lead to irreversible consequences, especially in newborns. prof. Dr. Özkan explains the importance of thyroid hormone as follows:
“Thyroid hormones play a very important role in the formation of neural development. Since the growth rate of the brain increases very much in early childhood, especially in the first two years, these hormones are very important for the development of nerves. It is obvious that a newborn baby who is deficient in these hormones will fall behind in terms of both mental and intellectual, motor functions and somatic functions in this process.”
IT CAN BE PERMANENT AS IT CAN ALSO BE TEMPORARY
The thyroid gland is located in the front of the neck. Its size is almost as big as the tip of a human’s thumb. It completes its development along with other organs in the body. Congenital hypothyroidism occurs as a result of the absence of the thyroid gland, its underdevelopment or problems in the synthesis of the thyroid gland. Expressing that in addition to all these, there is also temporary hypothyroidism, Prof. Dr. Ozkan continues:
“They sometimes use iodized solutions to remove the infection around the baby’s navel during the newborn period. The deficiency of this iodine can cause hypothyroidism, and its excess can block thyroid hormone biosynthesis. So this can lead to hypothyroidism. This can damage the development of their nerves, as the child will be deficient in thyroid hormone. On the other hand, some medications taken by the mother can also cause temporary hypothyroidism. This can be detected early. Treatment is started, but then the drug can be stopped in a controlled manner by observing the suppression of the TSH level.”
THE NEWBORN GENERALLY DON’T SYMPTOMS
Congenital hypothyroidism usually does not give any specific symptoms in the first month when the baby, called a newborn, is born. In this period, as little as 5-10 percent of the cases cannot be detected. Stating that this screening program was started throughout the country in 2006, Prof. Dr. Özkan said, “When newborn babies are born, blood is taken from their heels within a few days. This blood is sent to the relevant laboratories through the ministry. Results come within a week. Here, the TSH result is checked. If the TSH level is above 20, they are referred directly to endocrinology clinics. However, if the result is between 5 and 20, blood is taken from the heel again or the analysis is done again in the endocrine laboratory. If the TSH value is below 5, it is considered normal,” he says.
TREATMENT CONTINUES BY LOOKING AT TSH LEVEL
So, what kind of treatment is applied to a baby with a high TSH result? First of all, it is necessary to apply to the endocrinology clinic regarding the issue. Here, the baby with a high result is evaluated by performing additional tests. prof. Dr. Özkan describes the path they followed in this process as follows:
“We look at free T4, free T3 and TSH together. We consider all three together. After starting the treatment, we closely monitor the child’s compliance with the treatment by monitoring the thyroid hormones for one week, then for fifteen days, then every one and a half months and every three months. By the way, is the thyroid gland in place or missing? Or does it exist but does not synthesize hormones? We are also attempting some imaging modalities to detect it.”
PHYSICIAN’S ADVICE MUST BE FOLLOWED
At this point, the duty of the families is to give the medicine in the time interval and dose that the physicians deem appropriate. At this point, Prof. Dr. Özkan gives an important warning:
“Some families will be used for life? They may think that I will use this medicine for three days and then stop it after four or five days. It is necessary to continue the drug until the doctor says for sure. If they stop the treatment without their doctor’s permission, they may face mental retardation and somatic motor developmental delay in their children. Especially until the age of three, they must use this medicine under the supervision of a doctor. Compliance with treatment is very important here.”
ATTENTION TO SYMPTOMS
Congenital hypothyroidism does not give any clinical findings in newborns. However, if it is overlooked in the scan, prolonged jaundice, constipation, umbilical hernia, constant sleepiness, inability to gain weight, edema; In the later stages, it progresses with symptoms such as crying with a rough voice, lumps in the fingers, and enlargement in the tongue.
The development of babies who receive proper and adequate treatment continues just like their peers. After the baby reaches the age of three, the thyroid hormone is reduced and stopped in a controlled manner by looking at the situation. If there is an increase in the TSH level again, the treatment is now planned to be lifelong.
