GuidelinesPEML (Paeds Hospital STG)
Hypothyroidism in Older Children and Adolescents
Hypothyroidism in Older Children and Adolescents
ICD-10 Code: E03.9
DESCRIPTION
Acquired hypothyroidism in childhood and adolescents may be due to:
- auto-immune thyroiditis,
- goitrogen induced,
- iodine deficiency,
- post surgery,
- radioactive iodine,
- infiltrations,
- medicines.
DIAGNOSTIC CRITERIA
Clinical
- Low growth velocity or short stature with short limbs associated with a normal or elevated BMI.
- Subtle features with cold intolerance, dry skin, brittle hair, pallor and myxoedema.
- Elevated TSH and low thyroxine levels.
MEDICINE TREATMENT
- Levothyroxine, oral, once daily on an empty stomach.
| Age | Dose |
| 1–6 months | 8–10 μg/kg |
| 6–12 months | 6–8 μg/kg |
| 1–5 years | 5–6 μg/kg |
| 6–12 years | 4–5 μg/kg |
| Over 12 years | 2–3 μg/kg |
REFERRAL
- All cases for investigation and initiation of therapy.
Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Paediatrics, 2023 Edition
Chapter 7: Endocrine, 7.13 Hypothyroidism In Older Children And Adolescents