The short and long-term potential negative effects of thyroxine therapy in children and adolescents

Ashraf Soliman; Nada Alaaraj; Noor Hamed; Shayma Mohamed; Fawzia Alyafei

doi:10.1530/endoabs.99.EP1271

Introduction: This review aims to systematically analyze and summarize the findings from research articles regarding the potential short-term and long-term side effects of L-thyroxine therapy in children and adolescents. The selection criteria for the studies included their focus on the negative effects of thyroxine therapy related to thyroid health, cognitive function, cardiovascular health, bone health, and cancer risk in pediatric populations.

Results of the Review: Summary of Research Findings on Thyroxine Therapy, Thyroid Health, and Associated Risks in Children and Adolescents


Study Focus	Findings	Authors	Year
Neurocognitive Function in Hypothyroidism	Short-term thyroxine therapy did not significantly affect neuropsychological function in children with compensated hypothyroidism.	Aijaz et al.	2006
Cardiovascular Side Effects of Thyroxine Therapy	Potential adverse effects include shortening of systolic time intervals, increased frequency of atrial premature beats, and possible left ventricular hypertrophy, manageable with appropriate dosage adjustments.	Bartalena, Bogazzi, & Martino	1996
Bone Health in Long-term Thyroxine Therapy	Long-term use of thyroxine can affect bone density and mass, mitigable with careful monitoring.	Bartalena, Bogazzi, & Martino	1996
Thyroxine Therapy in Down Syndrome	Thyroxine treatment improved growth and potentially development in Down syndrome children with congenital hypothyroidism.	van Trotsenburg et al.	2005
Cognitive and Behavioral Outcomes in Juvenile Hypothyroidism	Mild behavioral symptoms and poorer school achievement may occur in children treated with L-thyroxine for juvenile acquired hypothyroidism.	Rovet, Daneman, & Bailey	1993
Autoimmune Hyperthyroidism Characteristics	Prepubertal children are more severely affected at presentation and require longer therapy for remission.	Shulman et al.	1997
Thyroid Cancer Outcome after Chernobyl	Favorable responses to radioiodine therapy in Chernobyl-exposed Belarusian children and adolescents with thyroid cancer.	Reiners et al.	2013
Thyroid Cancer Risk and Serum TSH	Increased thyroid cancer risk in children especially vulnerable to ionizing radiation.	Ron et al.	1995
Neurocognitive Functions in Subclinical Hypothyroidism	Impacts on attention in children and adolescents with subclinical hypothyroidism.	Ergür et al.	2012
Thyroxine Therapy in Nodular Goiter	L-thyroxine treatment associated with decreased frequency of papillary thyroid cancer in nodular goiter patients.	Fiore et al.	2010

Conclusions: The review highlights that while thyroxine therapy is crucial for the management of hypothyroidism and associated conditions in pediatric populations, careful consideration is necessary to mitigate potential adverse effects. These include, but are not limited to, cardiovascular side effects, impacts on bone health, cognitive function, and growth. The findings underscore the importance of tailored and monitored thyroxine therapy in children and adolescents to balance therapeutic benefits against potential risks.

Endocrine Abstracts

EP1271