(8 minute read)
I found taking Seren to gymnastics squad three times a week really inconvenient. I had to rush when picking up my three children from school and nursery, get home, get them fed and then race to gymnastics only to have the hassle of either my husband or I having to go back out again a couple of hours later. Not ideal in the winter when all you want to do is relax after work and avoid going out in the dark and cold. We used to breathe a sigh of relief on Wednesdays and Thursdays when we knew we didn’t have to do the gymnastics run. That’s the problem with us modern humans who are thoroughly stressed and as a consequence driven by convenience. Your child being healthy and well enough to enjoy basic hobbies get forgotten for what they really are – a tremendous gift. We are so lost in what needs to be done at work; worrying about when we’ll get around to dealing with the state of the bathroom; what Bob down the road said this morning to annoy us; the appointments that need changing; the parcels that need posting; the breakfast club that needs booking; someone who had the cheek to send an email with just an attachment and no message; Sharon’s birthday that you mustn’t miss because you know she gets mad if she doesn’t get a card… And although some of those things really do have to be done, at least some of thosethings get forgotten for what they really are – tremendous trivia. Sorry Sharon.
Seren had a six-pack and took massive delight in going to gymnastics squad three times a week. She literally loved it and loved the friends she made there. It was her thing. She’s always been a healthy child, nothing remarkable certainly. Then on the day of her 10th birthday, her life changed, just like that. It was the 8th January 2022 and my husband, Chris and I both had Covid. Seren and our 7-year-old daughter Betsy were testing negative and so my best friend came to the rescue and took them both out bowling to give Seren a little celebration for her birthday. When they returned, Seren fell through the front door crying with a stomach ache and pain all up and down her legs. You don’t think much of these things, do you. Your kids are bound to get stomach aches now and then and maybe the pain in the legs is just growing pains. It’s probably a good thing that you don’t know in that moment that your future is staring you in the face. And for how long, no one can tell you. I didn’t know then that what was happening with Seren would alter the trajectory of our lives – in both small and big ways.
The doctors didn’t expect anything significant. Why would they? Seren did catch Covid in the days after her 10th birthday and so the GP understandably thought her symptoms and swollen lymph nodes might be a post-viral thing. She was ordered to go home and rest. About ten days later she was referred to the paediatric unit where after hours of waiting, the paediatrician confidently declared, ‘My impression is viral gastritis!’ And off we went with some Omeprazole. If some blood tests had been conducted there and then, it would have been discovered that Seren had a TSH (Thyroid Stimulating Hormone) of 138 mU/L when levels should be under 5 mU/L. This means her pituitary gland (at the base of your brain) was working extremely hard to ‘tell’ the thyroid gland to release thyroid hormones into her blood.
Dr Sargis, an Endocrinologist from the University of Chicago explains that your thyroid (originating from the Greek word ‘shield’) is a small, butterfly-shaped gland at the bottom of your throat, typically weighing less than an ounce. While in the womb it begins developing at the back of your tongue and gradually makes its way to the front of your neck before you’re born. But for such a small organ, it sure has a big role to play in how your body functions. According Dr Sargis, when instructed by the TSH, the thyroid gland uses iodine from the food we eat, then combines with the amino acid tyrosine to make and release hormones called T3 (Triiodothyronine) and T4 (Tetraiodothyronine or Thyroxine). There is a really useful short film by the British Thyroid Foundation (click here) that explains clearly how the thyroid works but in short, your thyroid gland controls the speed at which your body works. People actually talk about this all the time, for example, ‘I used to have a fast metabolism but since I hit 40 it has slowed down and now I’m as fat as anything’ – that kind of thing, I’m sure you’ve heard it. As Dr Sargis describes, your metabolism is your body’s ability to break down food and convert it into energy. Food is our source of energy and our bodies use this fuel at different rates, hence your ‘fast’ or annoyingly ‘slow’ metabolism. So the hormones T3 and T4 go about their business by travelling to all the cells and tissues in your body and serve as messengers. When you’ve not got enough of these hormones everything begins to slow down – for example, your metabolism, heartbeat, energy levels, digestion and so on. You might find you become very tired, gain weight, suffer with constipation, feel the cold more, and experience problems like muscle weakness or aches, low mood, and memory problems. The term for this is hypothyroidism. You can find out more about this as well as the other thyroid condition hyperthyroidism, which occurs when you produce too much T3 and T4 here.
The thyroid gland
Of course, we didn’t know that Seren had hypothyroidism. It’s not one of the first things that springs to mind for doctors when it comes to a 10-year-old child. Because she was presenting with stomach issues, I experimented and removed gluten from her diet. There were some improvements. But it wasn’t until five weeks after her 10th birthday that we discovered that she was indeed experiencing severe hypothyroidism as defined in Kucharska et al.’s (2020) study . The GP rang on a Tuesday morning, 20 minutes before I was due to give a lecture on Research Methods to my undergraduate students. I heard things like ‘very underactive thyroid’ and ‘very unusual for someone her age’ but I was just keen to know what caused or triggered it. I’m a researcher, after all. As I was setting up for the lecture there was one thought that kept creeping in.
Was it something I did?
According to the British Thyroid Foundation, there are various causes of hypothyroidism, the most common one being Hashimoto’s Thyroiditis which is an autoimmune disease. The immune system creates rogue antibodies that attack thyroid cells as if they were a virus, bacteria or foreign body. As the thyroid becomes damaged, it is unable to make enough thyroid hormone. The immune system continues to destruct the thyroid until it is completely dead. Sometimes hypothyroidism can be caused by nodules on the thyroid but they are rarely cancerous. It can be caused by iodine deficiency although this is more common in the developing world. It can be triggered after an infection (in fact I had hypothyroidism when I was 17 when I was recovering from Glandular Fever but it eventually corrected itself). Some people get it temporarily after pregnancy or after taking medications like Lithium or Amiodarone. Others may get hypothyroidism because of problems with the pituitary gland in the brain.
NICE (2021) suggests that it’s difficult to estimate just how common hypothyroidism is because it depends what definition has been used, the characteristics of the population being studied and in which geographical area. However, according to the British Thyroid Foundation, it affects around 5-10% of the population and the prevalence increases in women and with increasing age . A Scottish study in 2000 (the most recent one I could find), found that the prevalence of hypothyroidism in young people (age less than 22 years), is 0.135% with 66% of those cases caused by Hashimoto’s disease.
The name of this blog page kind of gives away what the cause of Seren’s hypothyroidism is. I really knew very little about autoimmune disease except that on my mother’s side of the family there seems to be a bit of tendency for us to produce rogue antibodies. Something I’d never paid much attention to before. Anyway, thank god for medicine and in this case, Levothyroxine, a manufactured form of thyroid hormone. Now we knew what it was we could start the treatment and things would improve greatly. Thank God we have medication that can essentially fix the problem and get those thyroid levels back to normal. Knowing we could fix it would mean life would get back to normal too and although she’d missed some gymnastics it didn’t matter because she’d be back in a few weeks. Wouldn’t she?
 Kucharska A. M,, Witkowska-Sȩdek, E., Labochka, D. and Rumińska, M. (2020) ‘Clinical and Biochemical Characteristics of Severe Hypothyroidism Due to Autoimmune Thyroiditis in Children’, Front Endocrinol (Lausanne), 8 (11) 364.
 Okosieme, O. (2015) ‘Management of primary hypothyroidism statement by the British Thyroid Association Executive Committee’, Clinical Endocrinology, 0, 1-10.
 Biondi, B., Cappola, A. R. and Cooper, D. S. (2019) ‘Subclinical hypothyroidism: a review’, JAMA, 322(2): 153-160.
 Pearce, S. (2013) ‘European Thyroid Association (ETA) Guideline: Management of subclinical hypothyroidism’, European Thyroid Journal, 2, 215-228.
 Hunter, I., Greene, S. A., MacDonald, T. M. et al. (2000) ‘Prevalence and aetiology of hypothyroidism in the young’, Archives of Disease in Childhood, 83: 207-210.