Unawareness of the effects of soy intake on the management of congenital hypothyroidism

Abigail Fruzza, Carla Demeterco-Berggren, Kenneth Lee Jones

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

It has been established that soy products can interfere with thyroid hormone absorption resulting in continued hypothyroidism in individuals receiving recommended levothyroxine replacement. It has also been reported that achievement of euthyroidism in hypothyroid patients using soy products requires increased doses of levothyroxine. We have observed 2 patients with congenital hypothyroidism who continued to manifest clinical hypothyroidism while receiving recommended doses of hormone and ingesting soy products. The first patient was diagnosed by newborn screening (thyroid-stimulating hormone [TSH] = 169 μIU/mL) and treated with 50 μg of levothyroxine since 6 days of age while simultaneously starting soy formula. At 3 weeks of age, she was clinically and biochemically hypothyroid (thyroxine = 4.0 μg/dL, TSH = 216 μIU/mL). We stopped her soy formula and decreased her levothyroxine dose. Three weeks later signs of hypothyroidism were resolving, and, by 10 weeks of age, she was clinically and biochemically euthyroid. Another patient was diagnosed by newborn screening, received levothyroxine, and did well. She was lost to us for 2 years. During this interval she began consuming soy milk and became profoundly hypothyroid (free thyroxine <0.4 ng/dL, TSH = 248 μIU/mL), even though the primary care physician had increased her levothyroxine dose to 112 μg/day. She was switched to cow milk, and her thyroid function slowly normalized with decreasing doses of levothyroxine. These 2 patients reinforce the importance of remembering that soy products interfere with levothyroxine absorption and can endanger infants and young children with congenital hypothyroidism who are at risk for developmental and growth delay.

Original languageEnglish (US)
JournalPediatrics
Volume130
Issue number3
DOIs
StatePublished - Sep 2012

Fingerprint

Congenital Hypothyroidism
Thyroxine
Thyrotropin
Hypothyroidism
Soy Milk
Unawareness
Intake
Hormones
Dose
Newborn Infant
Primary Care Physicians
Thyroid Hormones
Thyroid Gland
Milk

Keywords

  • Levothyroxine
  • Soy
  • Thyroid disease

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Arts and Humanities (miscellaneous)

Cite this

Unawareness of the effects of soy intake on the management of congenital hypothyroidism. / Fruzza, Abigail; Demeterco-Berggren, Carla; Jones, Kenneth Lee.

In: Pediatrics, Vol. 130, No. 3, 09.2012.

Research output: Contribution to journalArticle

Fruzza, Abigail ; Demeterco-Berggren, Carla ; Jones, Kenneth Lee. / Unawareness of the effects of soy intake on the management of congenital hypothyroidism. In: Pediatrics. 2012 ; Vol. 130, No. 3.
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