ABOUT CONGENITAL HYPOTHYROIDISM
FREQUENTLY ASKED QUESTIONS ON CH
What is the thyroid
gland?
Ano ang thyroid gland?
The thyroid gland is a small,
butterfly shaped gland located in the anterior part of neck. It takes up iodine
from the food we eat to make thyroid hormones (Thyroxine, T4 and Triiodothyronine, T3). It stores thyroid hormone and releases them into the bloodstream as needed
by the body.
Ang thyroid gland ay isang maliit, hugis paruparong "endocrine gland"
sa harapang bahagi ng leeg. Ito ang gumagawa ng thyroid hormones (Thyroxine
T4 at Triiodothyronine T3) mula sa iodine na nanggagaling sa ating pagkain.
Ang thyroid gland ay nag-iimbak at naglalabas ng thyroid hormones ayon sa pangangailangan ng ating katawan.
Hypothalmic – Pituitary – Thyroid Axis
Thyroid hormone synthesis
and secretion are under the control of hormones produced by 2 other glands:
Ang pituitary at hypothalamus ay dalawang endocrine gland na nagkokontrol
sa paggawa at paglabas ng thyroid hormones:
1. The pituitary gland,
located at the base of the brain, produces Thyroid Stimulating Hormone (TSH)
; and
2. The hypothalamus, a small part of the brain above the pituitary, produces
Thyrotropin Releasing Hormone (TRH).
1. Ang pituitary gland na matatagpuan sa utak ay gumagawa ng Thyroid Stimulating
Hormone (TSH)
2. Ang hypothalamus na nasa ibabaw ng pituitary gland ay gumagawa ng Thyrotropin
Releasing Hormone (TRH).
The hypothalamus and the pituitary respond to low levels of thyroid hormones
by releasing TRH, which in turn stimulates the pituitary to release TSH. Increased
levels of TSH, in turn, stimulate the thyroid to produce more thyroid hormone,
thereby restoring the level of thyroid hormone in the blood back to normal.
Kapag mababa ang thyroid hormones, ang hypothalamus ay gumagawa ng Thyrotropin
Releasing Hormone (TRH) na nagbibigay hudyat sa pituitary upang maglabas naman
ng TSH. Ang mataas na TSH ay isang hudyat sa thyroid gland na gumawa ng mas
maraming thyroid hormone nang sa gayon ay mapanumbalik ang normal na dami ng
thyroid hormone sa ating dugo.
Why is thyroid hormone
important?
Bakit mahalaga ang thyroid hormone?
Thyroid hormone is important because it affects the general function of the
body. In the first two years of life, thyroid hormone plays a vital role in
ensuring normal growth and development of the brain, the bones and nervous system.
Ang thyroid hormone ay mahalaga para sa pagtangkad at maayos na paglaki
ng ating utak, mga buto at nervous system mula sa pagkapanganak ng sanggol hanggang
ika-dalawang taon ng bata.
Thyroid hormones affect all organs and every cell of the body.
• Regulate
the rate at which calories are burned, thereby affecting weight loss or weight
gain
• Can slow down or speed up the heartbeat
• Can raise or lower body temperature
• Can affect level of alertness and sleep requirements
• Can affect skin texture
• Influence the rate at which food moves through the digestive tract
• Control the way muscles contract
Ang thyroid hormone
ay may epekto rin sa:
• metabolismo at timbang ng katawan
• pagtibok ng puso
• temperatura ng katawan
• paggalaw ng mga bituka
What is Congenital
Hypothyroidism (CH)?
Ano ang Congenital Hypothyroidism (CH)?
Congenital refers to a condition that is present at birth. Hypo means not enough.
Congenital hypothyroidism is a condition in which the thyroid gland does not
produce enough thyroid hormone to meet the needs of the body. Absence or lack
of development of the thyroid gland is the most common defect. Some babies are
born with the gland in the wrong place, or with one that doesn't function or
grow correctly.
The thyroid gland cannot produce enough T4 and the pituitary works
very hard to stimulate the thyroid gland by producing high levels of TSH. Babies
with primary congenital hypothyroidism have low levels of T4 and high levels
of TSH.
Ang congenital ay nangangahulugan na ang kalagayan ay mula pa sa pagkapanganak.
Ang ibig sabihin ng Hypo ay hindi sapat. Samakatuwid, ang congenital hypothyroidism
ay isang kalagayan na kung saan ang thyroid gland ay hindi makagawa ng sapt
na thyroid hormone upang matugunan and pangangailangan ng katawan.
Ang karaniwang dahilan ng congenital hypothyroidism ay kawalan ng thyroid gland.
Ang ilang mga sanggol ay may thyroid gland subalit wala naman sa tamang lugar,
o hindi naman makabuo ng thyroid hormone.
What signs will make me suspect that my child has congenital hypothyroidism?
Anu-ano ang mga palatandaan na maaaring ang isang bata ay may Congenital
Hypothyroidism?
The signs of hypothyroidism
are often not obvious and difficult to identify in a newborn infant.
Some of the common signs of hypothyroidism are:
Ang mga palatandaan ay karaniwang bahagya lamang o hindi agad mapapansin
sa simula. Mahirap malaman kung sino sa mga bagong panganak na sanggol ang may
congenital hypothyroidism. Ang ilan sa mga palatandaan ng congenital hypothyroidism
ay ang mga sumusunod:
• a puffy-appearing face (Mamintog ang mukha)
• a dull look (Malamlam tingnan)
• a large tongue that protrudes from the mouth (which is usually kept
open) (Malaki ang dila at kadalasan at nakalabas ito sa bibig)
• dry brittle hair (Tuyot ang buhok at hindi madulas)
• prolonged jaundice (usually longer than 2 weeks) (Matagal ang paninilaw
ng balat ng sanggol kadalasang higit sa 2 linggo)
• poor feeding (poor suck) (Hirap sa pagsuso ng gatas dahil sa malimit
na pagkabilaok)
•constipation or difficulty of defecation (Tinitibi and sanggol)
• sluggish body movements (Matamlay at hindi gumagalaw)
• muscle tone is usually decreased (Malambot ang mga kalamnan)
• appearance of teeth may be delayed (Matagal ang paglabas ng ngipin)
• growth failure (Mabagal ang paglaki)
Unless detected and treated early, hypothyroidism results in delayed
development and mental retardation.
Ang sanggol na may congenital hypothyroidism ay nagkakaroon ng mental retardation
kung hindi agad nabigyan ng karampatang gamot.
Is it possible to
identify newborns with congenital hypothyroidism?
Maari bang malaman kung sino sa mga kapapanganak pa lamang ang may
Congenital Hypothyroidism?
Newborn Screening identifies babies who may have congenital hypothyroidism even
before there are any signs or symptoms of hypothyroidism.
If the screening for congenital hypothyroidism is positive, the health care
provider caring for the infant is informed immediately so that the baby can
be further evaluated. There are a few causes, which may not be picked up by
newborn screening.
Sa pamamagitan ng Newborn
Screening, maaaring malaman kung sino sa mga kapapanganak pa lamang ang may
congenital hypothyroidism bago pa man lumabas ang mga palatandaan o simtomas
nito.
Kung positibo ang newborn screening sa CH, ipinaaalam agad ito sa manggagamot
ng sanggol upang agad itong masuri.
What tests confirm
the diagnosis of Congenital Hypothyroidism?
Anu-ano ang mga pagsusuri na kinakailangan upang mapatunayang may
Congenital Hypothyroidism?
To confirm CH, blood is collected from your baby to measure levels of T4 and
TSH. If the TSH is high and the T4 is low, your baby most likely has CH. Your
doctor may consult with or send you to a pediatric endocrinologist. A pediatric
endocrinologist is a specialist in conditions with hormonal problems such as
hypothyroidism.
Upang malaman kung may Congenital Hypothyroidism, pinapasuri ang dugo ng
sanggol at sinusukat ang T4 at TSH. Kung ang TSH ay mataas at ang T4 ay mababa,
malamang na may CH ang sanggol. Maaaring makipag-ugnayan ang manggagamot o di
kaya ay ipakonsulta sa isang pediatric endocrinologist. Ang Pediatric Endocrinologist
ay isang espesyalista sa bata (Pediatrician) na nagpakadalubhasa sa mga kalagayang
sanhi ng mga suliranin na dulot ng hormones gaya ng congenital hypothyroidism.
What is the treatment
for congenital hypothyroidism?
Ano ang gamot sa Congenital Hypothyroidism?
The treatment is daily replacement of the missing thyroid hormone with thyroid
hormone tablets (also called L-thyroxine). The synthetic thyroid hormone acts
exactly like the hormone produced by the thyroid gland. When given at the proper
dosage, there are no side effects.
Ang Congenital Hypothyroidism
ay ginagamot sa pamamagitan ng araw-araw na pagpapa-inom ng tableta na thyroid
hormone (L-thyroxine). Ito ay katulad din ng thyroid hormone na mula sa thyroid
gland. Walang dapat ikabahala kapag ang tableta ng thyrid hormone ay nasa tamang
dosage.
How will I give
the thyroid hormone tablet to my baby?
Paano binibigay ang tableta ng thyroid hormone sa isang sanggol?
Thyroid hormone tablets are very small. They can be crushed and dissolved in
a 1/2 to 1 teaspoon of water. Do not mix the crushed thyroid tablet into a bottle
of milk formula or other liquids, because the full dose will not be taken in
if your baby does not consume the bottle. Older babies can simply chew up and
swallow the tablet. It should be given 30 minutes to 1 hour before the first
morning milk feeding or food intake.
Ang tableta ng thyroid hormone ay maliliit. Maaari itong durugin, pulbusin at
tunawin sa kalahati hanggang kutsaritang (1/2 - 1 tsp) tubig. Huwag ihalo ang
dinurog o pinulbos na tableta sa bote ng gatas sapagkat hindi maiinom lahat
ng sanggol ang gamot kapag hindi naubos and kanyang gatas, bukod pa rito ay
maaaring dumikit sa bote ng gatas ang pinulbos na gamot. Maaaring nguyain at
lunukin na lamang ng mga mas malalaking mga bata ang tableta ng thyroid hormone.
Ipinaiinom ang tableta ng thyroid hormone mula 30 minuto hanggang isang oras
bago kumain o sumuso ng gatas.
How will I know
how much thyroid hormone to give my baby?
Paano malalaman kung gaano karaming thyroid hormone ang dapat ibigay
sa sanggol?
Your doctor will prescribe the appropriate dosage of thyroid hormone for your
baby. Regular clinic visits are essential to ensure that your baby (child) continues
to receive enough thyroid hormone for normal growth and development. In addition,
periodic monitoring of thyroid function tests must be performed every few months
in order to ensure proper dosing of medications.
Ang inyong pediatric endocrinologist and siyang magrereseta ng nararapat na
dami o dosage ng thyroid hormone.
Mahalagang patingnan at ikunsulta ang inyong sanggol upang ma-monitor ang paghaba
at paglaki nito at upang malaman kung sapat ang dosage na natatanggap ng sanggol.
Maaaring ipasuri muli ang dugo para sa thyroid hormone upang maging gabay sa
paggamot ng inyong anak.
Reference:
Philippine Society of Pediatric Metabolism and Endocrinology
For more information,
please get in touch with Section of Pediatric Endocrinology and Metabolism,
Ward 9, Philippine General Hospital, Taft Avenue, Ermita, Manila. Tel. No. (+632)
5218450 loc 2109
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