A week ago (on May 25th) we celebrated the World Thyroid Day which is dedicated to thyroid patients and to all who are committed to the study and treatment of thyroid diseases worldwide. It was established in 2008 by the European Thyroid Association (ETA). The main purpose is to increase public awareness concerning prevention, diagnosis and treatment of thyroid diseases.
The thyroid gland is located on the front of the neck. It consists of two lobes which are connected by a thin band of tissue called the thyroid isthmus. The thyroid gland produces hormones which regulate many metabolic processes such oxygen consumption in tissues, thermoregulation, immune response and others. The adequate functioning of this small organ plays a key role in development and growth of a child beginning from the embryonic development at the fifth week of pregnancy to puberty age. Thyroid hormones are very important for puberty, initiating and maintaining reproductive function. The thyroid gland affects not only vital activity but even appearance and mood.
Since thyroid hormones directly or indirectly affect almost all processes in the child’s body, the clinical manifestations of thyroid diseases may be rather diverse. Often, the pathology of the thyroid gland can disguise itself as other diseases. A child with an underactive thyroid (hypothyroidism) may experience unmotivated weight gain, weakness, drowsiness, increased fatigue, depressed emotional state, swelling, dry skin, brittle nails, and constipation.
The symptoms of overactive thyroid (hyperthyroidism) may include disturbance of the general sense of well-being, nervousness and anxiety, changes in behavior and academic performance, insomnia, sweating, tremor, rapid heart rate, palpitations, headaches, impaired vision, weight loss.
Algorithm for diagnosis of thyroid disease includes ultrasound investigation, blood test that measures the levels of thyroid hormones and consultation of endocrinologist.
In the Republic of Belarus the prevalence of thyroid disorders is rather high and accounts to almost 70% of total endocrine disorders in childhood. According to the official reports, endemic diffuse goiter (simple nontoxic goiter) prevailed in the structure of thyroid diseases in children at the beginning of 2020.
The National Program for the Elimination of Iodine Deficiency Disorders has been successfully implemented in our country. The Republic of Belarus has chosen the concept of universal salt iodization which entails the iodization of all food-grade salt (i.e. salt used in both households and during food processing). Salt was chosen because it is consumed by the entire population of the country throughout life and salt iodization is technically easy process. Thanks to such a simple solution, by 2013 the iodine deficiency in the Republic of Belarus was completely eliminated.
An important result of the National Strategy for the Elimination of Iodine Deficiency is a decrease in the primary incidence of endemic goiter per 100 thousand children (from 195.33 in 2015 to 158.76 in 2019). Another significant criterion for adequate iodine supply is the incidence of congenital hypothyroidism (according to neonatal screening). In recent years, there has been a decrease in the primary incidence of congenital hypothyroidism per 100 thousand children (from 1.41 in 2015 to 1.13 in 2019) in our country.
What can be done to decrease the risk of development of thyroid diseases in children? As in the case of any other disease we must focus on prevention, which begins with a healthy lifestyle including a balanced diet and adequate physical activity.
Thyroid hormones are partially composed of iodine and we naturally get iodine with food. So that, your child’s healthy diet must include foods high in iodine such as sea fish (salmon, tuna), seaweed, vegetables and greens (spinach, arugula, parsley, asparagus, cauliflower, onion), nuts (walnuts, hazelnuts) and berries. A spoon of fish oil also contains a daily dose of iodine. Healthy diet in combination with physical activities will help to improve thyroid gland functioning of a child, and also give a charge of vivacity and optimism.
Angelica Solntseva, doctor of medical sciences, professor of the 1st Department of Pediatric Diseases of the Belarusian State Medical University, Chief non-staff pediatric endocrinologist of the Ministry of Health of the Republic of Belarus
Ekaterina Belyaeva, junior physician
Photo: Dmitry Zelenkovsky
Translation: Varvara Boika