Every day, children suffering from unusual fatigue, poor weight gain, stunted growth, and delayed mental development crowd the outpatient department of the Mother and Child Unit at Birdem General Hospital-2 in Segunbagicha, Dhaka. Medical examinations reveal that many of these children are affected by thyroid hormone disorders.
Once thought to affect mainly adults, thyroid disorders are now increasingly common in children, doctors warn. The condition can silently but severely hinder both physical and mental development if left undetected. Physicians caution that abnormalities in a child’s weight, height, or cognitive progress should not be attributed solely to malnutrition, as thyroid disorders may often be the underlying cause.
Dr Sabrina Jashim, resident medical officer and Child and Neonatal specialist at Birdem General Hospital-2, explained that thyroid disorders in children fall into two categories: congenital and acquired. “Congenital thyroid disorders can be detected through screening within seven days of birth. If treated early, children can lead completely normal lives,” she said.
Bangladesh, however does not yet have a government-run free neonatal thyroid screening program. Currently, parents must pay for private testing, which costs around Tk700—an expense many low-income families cannot afford. At Birdem, all newborns are screened within the first week, and treatment begins immediately if abnormalities are detected.
According to Sabrina, newborns with congenital thyroid hormone deficiency often show symptoms such as excessive sleepiness, feeding difficulties, constipation, and facial swelling. In older children, iodine deficiency is a major contributor, leading to reduced mental development, loss of appetite, and poor physical growth. “We often see children aged two to two-and-a-half years who appear no older than one year,” she noted. On average, 20 to 25 children with thyroid disorders seek treatment daily at Birdem’s pediatric department, most coming from outside Dhaka.
Four-year-nine-month-old Arwa is one such patient. She visits the endocrinology department at Birdem with her mother from Uttarkhan. Her mother recalls that Arwa developed jaundice at just 43 days old. Further tests revealed a thyroid hormone deficiency. Tests, including TSH and FT4, confirmed that her thyroid gland was underdeveloped and producing insufficient hormones. With regular treatment, Arwa now leads a normal life, though doctors recommend follow-up tests every two months.
Similarly, two-year-old Abdur Rahman from Barguna was diagnosed with thyroid hormone deficiency at one year old, though he appeared no older than a two- to three-month-old infant. After initial diagnosis at a local hospital, he was referred to Birdem for specialized care. Nearly 18 months of continuous treatment have significantly improved his growth.
Doctors emphasize that the first three years of life are critical for brain development, and thyroid hormones play a vital role in both physical growth and cognitive development during this period. A deficiency can result in lifelong physical and intellectual disability, a condition known as congenital hypothyroidism, caused by incomplete development of the thyroid gland or impaired hormone production.
A study by the Nuclear Medicine and Sciences department of Bangladesh Medical University (BMU) found that thyroid disorders are largely hereditary and not contagious. Genetically, one in every 2,300 children is born with a thyroid disorder. Around one in ten women suffers from thyroid-related diseases, and if both parents are affected, the risk of the child developing the condition rises to nearly 70%.
Iodine deficiency remains a major contributing factor. Iodine is essential for thyroid hormone production, and certain medications can reduce or block hormone secretion. Since thyroid hormones are also crucial for fetal growth, screening and treating thyroid disorders in pregnant women is essential. A recent BMU study found widespread iodine deficiency among school-going children and pregnant women in Bangladesh.
Sabrina said all forms of thyroid treatment are now available in the country. Birdem provides comprehensive thyroid care, while BMU’s Thyroid Clinic—operating for over 30 years—has treated thousands of patients. It remains the country’s only fully integrated thyroid clinic, offering services through nuclear medicine and surgical departments. Thyroid treatment is also available at Dhaka Medical College and most medical colleges and nuclear medicine centers nationwide.
Doctors urge parents to monitor their children’s growth and cognitive development closely and seek early thyroid screening if abnormalities appear, as timely treatment can ensure a healthy, normal life for affected children.
