Tighter supervision of thyroid function

Oct 13, 2025 by thesweetdesigns.com 131 views

The Relationship Between the First Age of Valproic Acid Use and the Duration of Use with the Occurrence of Thyroid Function Disorders in Patients with Idiopathic Epilepsy

Introduction

Valproic acid (VPA) is a widely used medication for the treatment of idiopathic epilepsy in children. However, its long-term use has been associated with several side effects, including disorders of the endocrine system. One of the thyroid disorders that can occur in patients with idiopathic epilepsy who receive VPA therapy is subclinical hypothyroidism, characterized by increased thyroid-stimulating hormone (TSH) levels while thyroxine (T4) and triiodothyronine (T3) levels remain within normal limits. This study aims to explore the relationship between the age when VPA is first used and the duration of use with the occurrence of thyroid function disorders in children with idiopathic epilepsy.

Background

Valproic acid has been proven effective in controlling seizures in children with epilepsy, but its side effects, including disorders of the endocrine system, need to be a concern. Subclinical hypothyroidism is a form of thyroid disorder that can appear in patients with idiopathic epilepsy who receive VPA therapy. This phenomenon has been reported in several studies, highlighting the need for closer monitoring of thyroid function in these patients.

Research Purposes

This study aims to evaluate the relationship between the age when VPA is first used and the duration of use with the occurrence of thyroid function disorders among children with idiopathic epilepsy. The study also aims to identify the risk factors associated with the development of subclinical hypothyroidism in these patients.

Methodology

This study is a cross-sectional study conducted between October 2012 and May 2013. The research subjects consisted of children under 18 years who have been diagnosed with idiopathic epilepsy. The patients and their parents were asked to fill in a questionnaire, where information related to the first age of VPA use and the duration of use were recorded. In addition, blood samples were taken to measure T3, T4, and TSH levels. Data collected were analyzed using SPSS software version 15.0.

Research Results

A total of 49 children met the criteria for participating in this study. The findings show that the incidence of subclinical hypothyroidism in children who use VPA reaches 14.3%. The age when first used VPA that was less than or equal to 4 years was proven as a significant risk factor for developing subclinical hypothyroidism, with a value of P = 0.036 (95% Confidence Interval 1.22-36.6). However, no significant relationship was found between the length of use of VPA and thyroid function disorders.

Discussion

The results of this study suggest that the first age of using VPA under 4 years is related to an increased risk of thyroid function disorders, especially subclinical hypothyroidism. This finding is consistent with previous studies that have reported an association between early VPA use and thyroid dysfunction. However, the duration of VPA use does not show a significant relationship with the problem of thyroid function. This suggests that the risk of thyroid dysfunction is more closely related to the age when VPA is first used rather than the duration of use.

Conclusion

From the results of this study, it can be concluded that the first age of using VPA under 4 years is related to an increased risk of thyroid function disorders, especially subclinical hypothyroidism. However, the duration of VPA use does not show a significant relationship with the problem of thyroid function. Therefore, tighter supervision of thyroid function in children who start therapy with VPA at an early age is highly recommended. This knowledge is important to improve therapy management and minimize the risk of adverse side effects in epilepsy patients.

Recommendations

Based on the findings of this study, the following recommendations are made:

Tighter supervision of thyroid function: Children who start therapy with VPA at an early age should be closely monitored for thyroid function disorders.
Regular thyroid function tests: Regular thyroid function tests should be performed in children who use VPA, especially those who start therapy at an early age.
Early detection and treatment: Early detection and treatment of thyroid function disorders can prevent long-term complications and improve the quality of life of epilepsy patients.
Education and awareness: Healthcare providers and parents should be educated about the risks of thyroid dysfunction associated with VPA use and the importance of regular thyroid function tests.

Limitations

This study has several limitations, including:

Small sample size: The sample size of this study is relatively small, which may limit the generalizability of the findings.
Cross-sectional design: The cross-sectional design of this study may not allow for the identification of causal relationships between VPA use and thyroid function disorders.
Limited data: The data collected in this study may not be comprehensive, which may limit the interpretation of the findings.

Future Research Directions

Future research should aim to:

Confirm the findings: The findings of this study should be confirmed in larger and more diverse samples.
Investigate the mechanisms: The mechanisms underlying the association between VPA use and thyroid function disorders should be investigated.
Develop guidelines: Guidelines for the management of thyroid function disorders in epilepsy patients should be developed based on the findings of this study and other relevant research.

Conclusion

In conclusion, this study highlights the importance of monitoring thyroid function in children with idiopathic epilepsy who use VPA. The findings of this study suggest that the first age of using VPA under 4 years is related to an increased risk of thyroid function disorders, especially subclinical hypothyroidism. Therefore, tighter supervision of thyroid function in children who start therapy with VPA at an early age is highly recommended. This knowledge is important to improve therapy management and minimize the risk of adverse side effects in epilepsy patients.
Q&A: The Relationship Between Valproic Acid Use and Thyroid Function Disorders in Patients with Idiopathic Epilepsy

Q: What is the main finding of this study?

A: The main finding of this study is that the first age of using valproic acid (VPA) under 4 years is related to an increased risk of thyroid function disorders, especially subclinical hypothyroidism, in patients with idiopathic epilepsy.

Q: What is subclinical hypothyroidism?

A: Subclinical hypothyroidism is a condition where the thyroid-stimulating hormone (TSH) level is elevated, while the levels of thyroxine (T4) and triiodothyronine (T3) are within normal limits. This condition can be a precursor to overt hypothyroidism and may be associated with various symptoms, including fatigue, weight gain, and hair loss.

Q: What are the risk factors for developing subclinical hypothyroidism in patients with idiopathic epilepsy?

A: The risk factors for developing subclinical hypothyroidism in patients with idiopathic epilepsy include:

First age of using VPA under 4 years
Duration of VPA use (although this was not found to be a significant risk factor in this study)
Other underlying medical conditions, such as autoimmune disorders

Q: How can subclinical hypothyroidism be diagnosed?

A: Subclinical hypothyroidism can be diagnosed through a combination of clinical evaluation and laboratory tests, including:

Thyroid function tests (TFTs) to measure TSH, T4, and T3 levels
Physical examination to assess for signs of hypothyroidism, such as dry skin, hair loss, and weight gain
Medical history to assess for underlying medical conditions that may contribute to hypothyroidism

Q: What are the treatment options for subclinical hypothyroidism?

A: The treatment options for subclinical hypothyroidism include:

Levothyroxine (T4) replacement therapy to normalize TSH levels
Monitoring of thyroid function tests to assess for progression to overt hypothyroidism
Lifestyle modifications, such as a balanced diet and regular exercise, to manage symptoms and prevent complications

Q: Can subclinical hypothyroidism be prevented?

A: While subclinical hypothyroidism cannot be completely prevented, there are steps that can be taken to reduce the risk, including:

Regular monitoring of thyroid function tests in patients with idiopathic epilepsy
Early detection and treatment of subclinical hypothyroidism
Avoiding the use of VPA in patients with a history of thyroid dysfunction or autoimmune disorders

Q: What are the implications of this study for patients with idiopathic epilepsy?

A: The findings of this study highlight the importance of monitoring thyroid function in patients with idiopathic epilepsy who use VPA. Patients with idiopathic epilepsy should be aware of the risks of subclinical hypothyroidism and should discuss their individual risk factors with their healthcare provider.

Q: What are the implications of this study for healthcare providers?

A: The findings of this study emphasize the need for healthcare providers to:

Regularly monitor thyroid function tests in patients with idiopathic epilepsy who use VPA
Be aware of the risk factors for subclinical hypothyroidism and take steps to prevent and manage the condition
Educate patients with idiopathic epilepsy about the risks of subclinical hypothyroidism and the importance of regular monitoring and treatment.

Q: What are the future directions for research on this topic?

A: Future research should aim to:

Confirm the findings of this study in larger and more diverse samples
Investigate the mechanisms underlying the association between VPA use and thyroid function disorders
Develop guidelines for the management of thyroid function disorders in epilepsy patients.