Background: There is high prevalence of Vitamin D deficiency (VDD) in Hashimotos thyroiditis (HT) as reported in literature. However, it is uncertain whether VDD is a cause or effect of HT. The effect L-thyroxine replacement on vitamin D levels in children with HT has not been studied.
Objective and hypotheses: To study vitamin D level of newly diagnosed children with HT and to observe the change in vitamin D level after L-thyroxine therapy.
Method: A prospective observational study was conducted on 35 consecutive children (less than 12 years old) who were newly diagnosed with HT, and not yet started on L-thyroxine, over a one year study period. Children with concomitant chronic kidney/liver disease, Celiac disease, on anti-tubercular therapy/antiepileptics or glucocorticoids and who received vitamin D supplements in last 6 months were excluded. Serum 25 (OH) D levels was estimated before starting L-thyroxine and on follow-up. Vitamin D levels were compared with historical controls (from a study from same centre on healthy children of similar age and epidemiological profile).
Results: The mean vitamin D level in cases at diagnosis was significantly low as compared to controls (33.34±16.93 nmol/L vs 65.13±30.57 nmol/L; P value<0.0001). Out of 22 Vitamin D deficient children with HT, who received vitamin D therapy, 7 (31.8%) remained deficient even at follow-up. Thirteen patients (with sufficient/insufficient vitamin D levels) who were not supplemented with vitamin D had a fall in vitamin D levels in follow-up. However, degree of fall in Vitamin D was not statistically significant.
Conclusion: Children with HT were observed to have low vitamin D levels at diagnosis and L-thyroxine therapy lead to further compromise in vitamin D levels.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology