This is a post no mother-slash-blogger ever wants to sit down to write.
My 10 year old daughter was diagnosed with a hypothyroid last year and we’ve been watching it closely since. With having managed her diet and lifestyle factors the best we could given that we don’t have 100% oversight of these things, we were sad to learn that she just received a diagnosis for Hashimoto’s thyroiditis. While this was difficult to hear, I found it interesting to learn that the majority of autoimmune hypothyroid cases develop in early to mid-puberty (source). So here we go into this new world of both mother and daughter navigating an autoimmune condition together.
Sitting here now, contemplating how the heck I’m going to integrate an anti-inflammatory lifestyle for my 5th grader, I’ve decided to create a five-part series on the matter. Of course, I’m no Ph.D… I’m not a certified medical expert in any of this stuff. But I read a lot. A. LOT. And I’ve been managing my own hypothyroid for 18 years and Hashimoto’s for two years. It was one of the leading reasons I turned to Paleo…
So as a sufferer, as a mother, and as someone who has the opportunity to maybe make this a little easier for someone else out there, here’s my take on how to respond to a Hashimoto’s diagnosis with your child.
How does Hashimoto’s thyroiditis develop?
First thing to cover is understanding the difference between hypothyroidism and Hashimoto’s. Everyone has a thyroid. It’s a gland located front and center of your throat and it regulates the most basic of your body’s functions, primarily metabolism. Most of the time we associate weight management with the word metabolism, but its scope is actually quite broad. Metabolism is a chemical process that regulates breathing, the circulatory system, body temperature, contracting muscles, digesting food (nutrients), waste elimination, and brain and nerve function… no big deal 😉 Hashimoto’s thyroiditis is also called autoimmune hypothyroid/thyroiditis and chronic lymphocytic thyroiditis (CLT).
When a thyroid starts to poop out, it becomes hypothyroid (as opposed to one that is overactive, hyperthyroid). A basic blood test can assess the rate at which your child’s thyroid is performing and indicate if he or she is within a healthy range. Since most of our thyroids function just fine through childhood and early adulthood, this isn’t something that will be on your pediatrician’s radar during well child check-ups and routine sports physicals. Your child will need to present symptoms that perk your doc’s curiosity. It’s worth addressing too that hypothyroidism is often misdiagnosed in children. Symptoms like tiredness, emotional instability/mood swings or weight gain are often passed off as normal or the cause of something environmental. It is also frequently mistaken for ADHD (source).
Let’s say you’ve crossed that line and like us last year found that the explanation for your child’s lethargy, school struggles, emotional instability, and digestive issues are due to a poorly functioning thyroid gland. Let’s say that you’ve found the right dose of thyroid hormone replacement medication and they are taking their meds consistently. Now what?
As Sarah Ballantyne, Ph.D., explained in her presentation at Ancestral Health Symposium this summer, genetic disposition, a trigger and a leaky gut are the trifecta for developing autoimmune thyroiditis. If your child has already been diagnosed with hypothyroidism, be on your guard mom and dad! Now’s the time to take some steps in the direction of prevention.
The Leap from Hypothyroid to Hashimoto’s
Fatigue, brain-fog, weight gain are just a few symptoms that come with a hypothyroid. While these are typically mitigated with thyroid replacement hormones, for some the symptoms persist. That was my first indication that there might be something more going on than just incorrect dosing. My daughter had stable labs for over a year and yet after experiencing classic autoimmune triggers such as gluten, lack of sleep, and situations that caused her emotional stress, she would respond with behaviors and digestive issues that were exactly what we dealt with prior to getting her on thyroid replacement hormones.
If you find that your hypothyroid kiddo goes through something similar, you might want to do a quick survey to see if there may be more going on. Thyroid expert and patient advocate, Mary Shomon has a checklist of symptoms related to autoimmune disease. Remember, after completing this bring it to your doctor. It’s NOT intended for self-interpretation.
Unfortunately Hashimoto’s can look almost identical to hypothyroidism, which makes it extra fun to diagnose. It’s essential that thyroid replacement hormone be taken properly (on an empty stomach, not within 4 hours of a multi-vitamin containing iron and at the same time each day), so that improper dosing/absorption can be easily ruled out. If symptoms persist, it may be time to request additional testing.
Since Hashimoto’s typically develops once hypothyroidism has been established, you’ve likely observed common symptoms in your child. Hypothyroidism affects kids differently depending on where they are at in development… or, basically, how old they are. In infants symptoms of hypothyroidism looks like prolonged jaundice, hoarse sounding cry, poor appetite and feeding, constipation, bulging navel, sleepiness, not kicking vigorously and an unusually large tongue (source). Unfortunately in order to diagnose the condition a prick to the heel is in order. Blood work will diagnose if your infant has an underperforming thyroid gland.
For kids and adolescents the symptoms of hypothyroidism matures right along with them and begins to mimic the symptoms of an adult. Children who complain of being cold frequently (this was a big one for my daughter!), who have delayed tooth development or who seem to be growing slowly, or even not at all, may have an underactive thyroid. If your child is hitting that tween age, keep this (long) list of symptoms on your radar:
- growth delays
- cold intolerance
- fatigue or excessive sleepiness
- poor appetite
- slow speech
- slow pulse
- slow reaction times (sports, a new driver, etc)
- dull facial expression
- droopy eyelids
- puffy face
- hoarse voice
- a swollen thyroid gland
- muscle cramps, weakness
- heavy, painful menstrual cycles
- dry skin
- dry hair and/or hair loss
- generally an increase in body and facial hair (a real irony… we lose it on our heads and grow more on our bodies… it’s a tough one ladies, hang in there)
- delayed puberty
- moderate weight gain
- struggles with school work
I know for me personally, I was diagnosed at 15 years old and fatigue, weight gain, dry skin and a complete collapse at school were my primary symptoms. I went from a 4.0 student my sophomore year to failing my first class by junior year. Chemistry was my favorite subject and suddenly I forgot the periodic table of elements. It was devastating for me at the time. Be sensitive if suddenly symptoms like this become a part of your child’s life; often it is out of the blue for them and hard to cope with.
This post on autoimmune diseases in children may also be a helpful resource for you. Also, keep in the back of your mind that autoimmune conditions are the kind of misery that love company, so it is all too common for multiple conditions to develop over a person’s life. Diabetes, lupus, vitiligo, celiac disease, pernicius anemia, rheumatoid arthritis, multiple sclerosis, and Addison disease are all common autoimmune diseases that can develop during your child’s lifetime.
What you’re looking for is the presence of thyroid antibodies. Since I’m a patient, a mom, an advocate not a doc, I’ll explain this concept like a non-technical person. Antibodies are protein cells that your immune system makes when it’s fighting off germs and stuff that make you sick. Because autoimmune diseases happen when the immune system can’t figure out the good guys from the bad guys, it starts attacking your body by mistake. Yep, that’s right. Your own personal mutiny happening right there at your thyroid gland. Good times.
Thyroid antibodies are the specific “fighters” that show up when the body decides to wage war against this particular gland. (For some reason I always picture a bunch of confused Minions running around in circles when I think about antibodies). So if your immune system isn’t attacking your thyroid, it won’t create thyroid-specific antibodies. Easy enough!
The tests you’ll hear your doc order are for anti-TPO (Anti-thyroid peroxidase antibody) and TgAb (Antithyroglobulin antibody). Those are the culprits that are causing the Hashimoto’s ruckus. (source)
The first thing you can do right now: Find a doctor who gets it.
Sounds like a straight forward proposition: get sick, go to the doc. Problem is, not all physicians are created equal these days. For example, when I was investigating my own hypothyroid condition, I asked my primary care provider to run several tests to check for the levels of various forms of thyroid hormone in my body and also to rule out autoimmunity. She responded with a there, there, wee patient tone and informed me that the tests I was requesting were reserved for those undergoing radiation for their thyroid (e.g. a cancerous gland) and all I really needed was some anti-depressants (never mind that depression wasn’t even a principle symptom I was complaining about, but whatever… she’s a doctor, right?).
With your child, it is even more imperative that your practitioner have a solid and current grasp on the disease. Your kids can’t advocate for themselves and the wrong doc will likely misinterpret your concern. Find a partner, find a subject-matter expert, find someone who is able to take a minute to talk, listen and think. And for the love, find a doc who understands the role of gluten in the digestive system and its implication with autoimmunity!
TIP: Paleo Physicians Network and Primal Docs are two awesome places that you can locate a practitioner in your area (or who offers consultations remotely) to help answer your questions and possibly treat your child’s Hashimoto’s!
This post is the beginning of the 5 part series I’ve written on how to adjust to your child’s Hashimoto’s diagnosis. Though this information is absolutely applicable to anyone with an autoimmune thyroid, adults included!
What I’ll be covering next:
- The One Thing: this one thing holds the key to managing your autoimmune condition. And it’s so basic!
- Soup’s On: the key to nutrient-dense, anti-inflammatory foods
- Sleep Tight: essential lifestyle factors that help or hinder managing autoimmune triggers
- Moving Forward: equip yourself with easy swap outs for inflammation causing foods, my top 5 favorite books on thyroid health and nutrition, plus a wrap up of the top 10 things to remember as you move forward managing your own or your child’s autoimmune thyroiditis
Because this is a lot of focused information, I’m offering it via email as opposed to blog posts. Each week, I will send you the next segment, which you can read at your convenience.
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