THE COLOUR IS GRAY: Thyroid testing not the key to fighting obesity: study

THE COLOUR IS GRAY

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Thyroid pills shouldn't be prescribed to overweight children for weight loss, according to researchers who say parents of heavy children are asking for thyroid tests hoping pills will solve the problem.

If anything, children with hypothyroidism actually gain weight after treatment, according to a study published in this month's Pediatrics journal.

While an underactive thyroid gland - the butterfly shaped, hormone-secreting gland at the base of the neck - can cause slight weight gain, it doesn't make children fat, Lomenick says.

"There's this thought that has trickled down to physicians and patients alike that not only does hypothyroidism cause a lot of weight gain, it causes obesity, and that's just crazy."

After following 68 children with hypothyroidism, his team found the entire group actually gained weight at the first follow-up visit after starting treatment.

Only children with "extraordinary" cases of underactive thyroids lost weight between the first and second visit. The average weight loss was a little more than two kilograms.

"It's not like they lost 50 pounds or something," Lomenick said in an interview. "They basically lost the fluid they had accumulated, and that's about five pounds or so."

Testing leads to many unnecessary referrals to specialists and it ignores the real issue at hand, Lomenick says - "that there are too many calories consumed and not enough exercise being done."

The researchers say doctors frequently prescribe thyroid medication for mild cases of hypothyroidism in hopes of causing weight loss.

If a child were put on an unnecessarily high dose, it could make him or her "hyperthyroid", when there's too much of the thyroid hormone, causing symptoms such as high blood pressure, diarrhea, mood changes, insomnia and faster heart rate.

In Canada, 26 per cent of children under 18 are overweight or obese, according to Statistics Canada.

Overweight children are at risk of diabetes, high blood pressure, high cholesterol, abnormal blood clotting, hardening of the arteries, sleep apnea, asthma and "non-alcoholic" fatty liver disease.

Thyroid hormones play a key role in regulating a person's metabolic rate, including how quickly calories are burned. If not enough hormones are produced, the body's functioning slows down, making people feel mentally and physically sluggish.

In the new study, researchers followed children with hypothyroidism seen at the Kentucky Children's Hospital from 1995 to 2006.

Over that time, weight and body mass index scores didn't change significantly after treatment with levo-thyroxine, a thyroid hormone that normalizes thyroid levels, even in children who were overweight or obese.

"In fact, on average, they actually gained a kilogram," Lomenick says.

Lomenick says little is written about whether overweight children should be screened for hypothyroidism. He says there's no need to do a thyroid test if there are no classic symptoms of a problem, such as failing to grow, constipation, dry skin, dull hair and intolerance to cold.

Geoff Ball, director of the pediatric centre for weight and health at Edmonton's Stollery Children's Hospital, says parents of overweight children often think there must be something hormonally wrong, especially if only one child in the family is overweight.

"In a lot of families minds they think, 'we've tried this, tried that, it must be something metabolically going on,'" says Ball.

He says the answer, in most cases, "comes down to the choices families are making" and the need to make healthy changes.

THE COLOUR IS GRAY

Sharon Kirkey, CanWest News Service