Thyroxine and thyroid stimulating hormone levels in under-five severe malnourished children

Background In Indonesia, protein energy malnutrition (PEM) in children is still a health problem. Malnourished children will have growth and development disruption, which is not only caused by nutritional factor, but might be associated with endocrine system, such as thyroid hormone metabolism. Hypothyroidism or thyroid hypofunction could be happened in malnourished children. Objective The purpose of this study was to assess thyroxine (T4) and thyroid stimulating hormone (TSH) levels in under-five severe malnourished children. Methods This was a descriptive study with cross sectional design. Subjects were all under-five severe malnourished children based on nutritional evaluation in August 2001 done by local health care workers in Andir District, Bandung. Severe malnutrition was defined as weight for age less than -3SD (W/A <-3SD). Results There were 42 subjects who fulfilled inclusion criteria, aged 11-57 months, five of them showed clinical manifestation of marasmus. The T4 levels of the 41 subjects were still in normal limits and within the range of 4.5-11.2 mg/dl. Thirty-nine subjects had normal TSH levels, ranged from 0.9 to 5.0 mlU/ml, and 2 subjects showed increased TSH levels of 6.8 and 7.6 mlU/ml, respectively. Reduced T4 and TSH levels of 3.93 mg/dl and 0.2 mlU/ml, respectively were detected in one subject Conclusion In general, the T4 & TSH levels were still normal, with only one subject (2%) showed low levels of T4 & TSH