Hormonal disorders in children can have significant physical, emotional, and social impacts. These conditions can affect growth, development, and overall well-being, making early diagnosis and treatment essential. Understanding these issues can help parents and caregivers take proactive steps to support their child’s health and development, says Dr Riaz I, Professor, Paediatric and Adolescent Endocrine Clinic, Government TD Medical College, Alappuzha, in an interview with Unnikrishnan S. Edited excerpts:
Q: What are the most common hormonal disorders in children?
The most important endocrine disorder in children is hypothyroidism, especially congenital hypothyroidism, a condition present at birth, where the thyroid gland doesn’t produce enough hormones, often due to gland maldevelopment. It’s the most common preventable cause of intellectual disability. Early diagnosis and treatment at birth can ensure normal growth and brain development.
Other common hormonal disorders include type-1 diabetes mellitus, acquired hypothyroidism, growth hormone deficiency, precocious puberty, delayed puberty, congenital adrenal hyperplasia, obesity & metabolic syndrome, hyperthyroidism (Graves’ Disease)
Q: What early signs should parents watch for?
Abnormal growth patterns: It is important to record the height and weight of every child in a growth chart at periodic intervals. Slowing down or accelerated height or weight gain, falling off, or jumping across growth percentiles on a growth chart are all signs of an endocrine disease.
Signs of diabetes: Frequent urination, excessive thirst, weight loss, bedwetting, or genital fungal infections.
Puberty issues: Early signs (before 8 years in girls, 9 years in boys) or delayed signs (after 13 in girls, 14 in boys).
Hypothyroidism: Fatigue, sleepiness, constipation, cold intolerance, jaundice, poor activity in newborns.
Hyperthyroidism: Heat intolerance, sweating, unexplained weight loss, diarrhoea, irritability.
Unusual hair growth or acne: Could indicate excess adrenal hormones or polycystic ovary syndrome (PCOS) in girls.
Skin changes: Dark, velvety skin in folds (acanthosis nigricans) may suggest insulin resistance.
Menstrual irregularities: Absent, delayed, or irregular periods in adolescents can point to hormonal imbalances.
Q: Are there any preventive measures parents can take to avoid hormonal disorders in children?
While not all hormonal disorders can be prevented, early detection and a healthy lifestyle play a key role. For example, congenital hypothyroidism can be silent at birth, so it is essential to check thyroid levels in all newborns. Early treatment can prevent intellectual and physical delays.
Encouraging a balanced diet rich in fruits, vegetables, whole grains, and lean proteins is also important. Limiting sugar, salt, fats, and junk foods can help prevent obesity and insulin resistance, which are linked to various hormonal issues.
Ensuring that children get at least an hour of physical activity or play each day is crucial for maintaining a healthy weight and supporting hormone balance.
Lastly, regular paediatric checkups to monitor growth and development are important. Early identification of any deviations allows for timely treatment of potential endocrine disorders.
Q: What are the current treatment options for children diagnosed with hormonal diseases?
Treatment for hormonal disorders in children varies based on the condition but generally focuses on restoring normal hormone levels and supporting growth and development. Common treatments include:
Type-1 diabetes: Managed with insulin therapy (injections or pump), regular blood glucose monitoring, dietary adjustments, and self-care education
Hypothyroidism: Treated with oral levothyroxine (synthetic thyroid hormone), with regular thyroid function tests to adjust dosage
Hyperthyroidism: Treated with antithyroid medications and beta-blockers for symptom relief. In some cases, radioiodine therapy or surgery may be needed
Growth hormone deficiency: Managed with recombinant human growth hormone injections, growth tracking, and periodic IGF-1 testing
Precocious puberty: Treated with GnRH analogs to delay puberty. Further evaluation for underlying causes, such as CNS lesions or adrenal disorders, is also necessary
Delayed Puberty: Often requires watchful waiting for constitutional delays, but hormone therapy (testosterone or estrogen) may be used if a pathological cause is found or if puberty is significantly delayed
Congenital adrenal hyperplasia: Managed with glucocorticoids and sometimes mineralocorticoids, along with salt supplementation in salt-wasting forms. Growth, puberty, and adrenal crisis prevention are closely monitored
Q: How do hormonal imbalances affect children socially and emotionally? How can we support them?
Hormonal imbalances can lead to low self-esteem and body image issues in children due to delayed growth, early or late puberty, weight gain, or excessive hair growth. This may cause social withdrawal, embarrassment, and bullying. To support them, it’s important to address the underlying condition with prompt treatment, provide proper counselling, and create a supportive, understanding family environment.
