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Doctor in Training

THYROID DYSFUNCTION & AUTISM

First Published Saturday, 3rd May, 2008.


I wrote the following piece a couple of years ago when the following questions were posed within the community. Another acquaintance has recently been diagnosed with Graves Disease, so it appears a good time to revisit older work. The information remains valid, and I hope, perhaps useful to others.


Parent asked:

“I’ve just been told that there’s a link between thyroid problems and autism. Do you have any literature on this? Is it true? I have never heard of this before and hope you can enlighten me. I have just been diagnosed with “Graves Disease” which is an advancement of over active thyroid.”

 

My response:
The possibility of thyroid dysfunction among the autistic population has been considered and studied. Despite investigations, no abnormalities could be demonstrated. The following is an excerpt from one study undertaken by Cohen DJ, Young JG, Lowe TL & Harcherik D.:

Thyroid Hormone in Autistic Children

 

Thyroid hormone plays an important role in the pre and postnatal development & function of the central nervous system. Disturbances in thyroid regulation have been hypothesized in childhood autism. We evaluated blood indices of thyroid function, including serum thyroxine, triiodothyronine, and thyroid-stimulating hormone, in a large number of autistic children. No differences were found between autistic and NT children.

 

However, immunological studies of the autistic population have revealed features also found in those with autoimmune diseases. Autoimmune diseases, including Grave’s thyroid disease, rheumatoid arthritis, and insulin-dependant diabetes, show some genetic predisposition. Similarly, autism is higher among identical twins than in the usual population.



There is a high prevalence(1 in 4000 births) of congenital hypothyroidism, the most common in pediatric med. Naturally, it may be included as part of newborn screening. If undetected it can lead to deafness or mental retardation. Because of the central role of thyroid hormones in brain development in the fetus & neonate, and in growth, what’s known as hypothyroxinemia in the first years of life has profound and irreversible consequences. Early detection and treatment usually allows a normal life for the child in question.

 

The following are interesting links for Newborn screening and Hypothyroidism in infants and children.
(*note condition profiles):
http://www.newbornscreening.com/
http://www.thyroid-info.com/articles/hypokids.htm

 

Additional info. On Graves…No single gene causes Graves. It’s thought to be triggered by both genetics and environmental factors, such as stress. Heredity along with other characteristics seem to play a role in determining susceptibility. Studies show for example, that if one identical twin contracts Graves, there’s a 20% likelihood of the other twin contracting it. Women are more likely than men to develop it. As many as 1 in 8 women have a thyroid condition. Smokers with Graves are more likely to develop eye problems than non smokers.

 

What’s important to note is that most autoimmune diseases such as Graves, are associated with several sequence variants. For example, the link between celiac disease and thyroid disease is well established. It’s been shown in studies that the prevalence of celiac disease in patients with autoimmune thyroid disease is 4-15 times greater than in the general population. About 30% of subjects with Grave’s have a member of the immediate family who has also had an autoimmune condition.

 

There is an autism/thyroid internet based group for brainstorming and support purposes:
http://health.groups.yahoo.com/group/Autism-Thyroid/

 

Further information…

 

Treatment is more complex for overactive than underactive. A scan will determine the type(be it Grave’s, thyroid nodules or the self-limiting form-subacute). There are three main treatments to choose from. Betablockers are commonly prescribed. Propranolol tablets are more frequently used. Thyroxine tablets may be prescribed to balance the anti-thyroid meds.

 

Symptoms tend to improve quite rapidly. 1 patient in 50 has side effects on anti-thyroid meds(mild skin rash or joint pains). Getting the dose right can be tricky. These meds can make thyroid activity swing the other way, running too slowly. If you’re given radioactive iodine, your neck may feel a little sore in the first few days(the small amount of radioactivity used has been shown not to cause harm).

 

Thyroid function should be checked via blood test every 12 months for the rest of your life. Prominence and discomfort of eyes, even if not present at the time of diagnosis, can occasionally occur during or after treatment. Your Doc should be informed if your eye sight is affected in any way.

 

Risk of relapse is between 50 & 80% over a 10 year period. Best to avoid iodine, along with a number of other foods and drugs. The condition can be triggered by dietary additives or drugs and certainly from interaction between certain meds.

 

For further reading…
Book:”How to cope successfully with thyroid problems”:

Thyroid Problems (How to Cope Successfully): Tom Smith: 9781903784013: Amazon.com: Books

 

“Basic Causes of Thryoid Dysfunction”:
http://www.suite101.com/article.cfm/hypothyroidism/109402

 

“Thyroid Research – Thyroid information from the past and present…for the future”

The aim of the site is to put extracts from thyroid-related medical research online and to trace the development of diagnosis and treatment. Patients will find it useful for an in depth exploration of their conditions. Doctors and medical students will discover a wealth of information, much of it previously not available except from specialist libraries with restricted access. Medical historians will be saved long trips to libraries and can obtain articles dating back more than a century.
http://www.thyroidhistory.net/

Related Articles

 

NYTimes  “Hypothyroidism – When to Treat a Sluggish Thyroid”

http://health.nytimes.com/ref/health/healthguide/esn-hypothyroidism-ess.html?ref=health

Missy Elliot Graves’ disease: ‘I couldn’t even use a pen’:

http://www.dailymail.co.uk/tvshowbiz/article-2007566/Missy-Elliott-Graves-disease-I-use-pen.html

“Baywatch actress Gena Lee Nolin tells how her diagnosis took ten years: I battled thyroid illness in a Baywatch bathing suit”:

http://www.dailymail.co.uk/health/article-2020557/Baywatch-actress-Gena-Lee-Nolin-tells-diagnosis-took-years-I-battled-thyroid-illness-Baywatch-bathing-suit.html

“I thought it was a heart attack – but my thyroid had gone on the blink”:

http://www.dailymail.co.uk/health/article-2034158/I-thought-heart-attack–thyroid-gone-blink.html