We looked into the growing concern of iodine deficiency hypothyroidism among children in the United States. This condition, which can lead to cognitive and physical impairments, was thought to be largely eliminated thanks to universal salt iodization started in the 1920s. However, recent trends suggest that iodine deficiency could be reappearing due to increased use of noniodized salts, lower iodine levels in dairy, and dietary restrictions like veganism or food allergies.
Over an 18-month period, we documented a series of cases where three children were diagnosed with iodine deficiency hypothyroidism despite having no underlying thyroid dysfunction. Their clinical presentations varied significantly—some had large goiters while others showed mild or no goiter at all. The results of their biochemical tests also highlighted a range of thyroid-stimulating hormone elevations.
Importantly, all patients returned to normal thyroid function following iodine supplementation. We propose that measuring spot urine iodine levels alongside elevated serum thyroglobulin could serve as a simpler and effective diagnostic approach, moving away from the more complex 24-hour urinary iodine tests. Our findings shine a light on the necessity of addressing iodine deficiency in today’s dietary landscape.
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Iodine treatment for hypothyroidismLong lasting effect of intramuscular iodine injection in the treatment of goiter in an intestinal failure patient with complete entero-colectomy.
Moderate relevance to thyroid effects
We explored the impact of iodine treatment on hypothyroidism, particularly focusing on a unique case involving a patient who had undergone total entero-colectomy. In this situation, standard methods of administering iodine, such as oral supplements, proved ineffective due to absorption challenges. Our approach utilized ethiodized oil, an iodine-rich contrast agent, which we injected intramuscularly.
We observed that this method not only addressed the patient's goiter but also sustained normal thyroid function for more than five years. The long half-life of ethiodized oil made it an ideal option for patients reliant on parenteral nutrition, who often struggle with iodine deficiency.
This study highlights a promising alternative for individuals facing similar nutritional challenges due to severe digestive issues. Overall, our findings suggest that tailored iodine administration could offer a viable solution for hypothyroidism linked to dietary deficiencies.
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We assessed how effective radioactive iodine (RAI) treatment is for inducing hypothyroidism in adolescents with Graves' disease (GD). This treatment is often considered when initial therapies, like antithyroid drugs, do not yield lasting results.
In our examination, we reviewed the medical records of teenagers under 18 years old who received RAI treatment from January 2007 to December 2022. We identified 14 cases and noted their ages ranged from 9.8 to 17.3 years, with I131 doses varying between 5.8 and 15.0 mCi.
Remarkably, almost all patients responded positively within six months after treatment, with a cure rate of 86%. Most experienced hypothyroidism within three months, reinforcing the necessity of monitoring thyroid function early on. We did observe one case of temporary salivary gland inflammation.
Throughout the follow-up period of up to 13 years, there were no relapses, which speaks to the effectiveness and safety of RAI as an option for these young patients with GD.
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We explored the impacts of levothyroxine sodium on a 7-year-old Toy Poodle diagnosed with hypothyroidism. The dog was experiencing several issues, such as exercise intolerance, weight gain, and skin problems, including patches of hair loss.
After starting treatment with levothyroxine sodium, we noticed a significant increase in scaling of the skin after one month. This scaling primarily appeared on the trunk, particularly in areas where hair loss was present. Remarkably, as we reduced the levothyroxine dosage over the following three months, the scales vanished and hair regrowth became evident.
Our observations suggest that while levothyroxine sodium helps to trigger hair regrowth, it may also affect how the skin renews itself, leading to temporary scaling. It's important for pet clinicians to recognize that when such scales appear, they often don’t accompany other skin conditions like itchiness or redness, and typically resolve on their own as hair grows back. Hence, further treatment may not be necessary in these situations.
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We explored a unique case involving a 2-year and 7-month-old girl diagnosed with congenital hypothyroidism (CH) alongside alpha thalassemia. This child presented with symptoms that included severe anemia and elevated muscle enzymes, which made her appear dispirited and caused growth delays. Such combined conditions are rare, and this study sheds light on the importance of recognizing them promptly to prevent missed diagnoses.
In addressing her condition, we treated her with levothyroxine sodium, a standard therapy for hypothyroidism, along with interventions to correct her anemia. Remarkably, we observed significant improvement after the treatment. The child's energy, appetite, physical development, and overall well-being were reported to be better than those of her peers.
Our findings emphasize that both hypothyroidism and alpha thalassemia can lead to vague symptoms, potentially leading to misdiagnoses. Therefore, we recommend that children exhibiting anemia and elevated muscle enzymes undergo regular thyroid function testing. Early detection and treatment can significantly enhance their quality of life and health outcomes.
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