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. 2004 Jan;89(1):37–40. doi: 10.1136/adc.2002.009365

Soy formula complicates management of congenital hypothyroidism

S Conrad 1, H Chiu 1, B Silverman 1
PMCID: PMC1755887  PMID: 14709499

Abstract

Aims: To test the hypothesis that feeding soy formula to infants with congenital hypothyroidism (CH) leads to prolonged increase of thyroid stimulating hormone (TSH).

Methods: The study was a review of 78 patients seen during their first year of life between 1990 and 1998. Data regarding clinical diagnosis, date of treatment initiation, TSH, levothyroxine dose, weight, length, and diet information from each visit were collected from the charts.

Results: There were eight patients in the soy diet group and 70 in the non-soy diet group. There was no significant difference between the two groups in the starting dose of levothyroxine or the change in this dose over one year. There was a significant difference between the two groups in the following areas: time to TSH normalisation, first TSH on treatment, percentage with increased TSH at 4 months of age, percentage with increased TSH throughout the first year of life, and in the overall trend of TSH at each visit.

Conclusions: Infants fed soy formula had prolonged increase of TSH when compared to infants fed non-soy formula. These infants need close monitoring of free thyroxine and TSH measurements, and they may need increased levothyroxine doses to achieve normal thyroid function tests.

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Figure 1 .

Figure 1

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Equivalent of Kaplan-Meier curves for percentage of patients with an increased TSH over time (p = 0.02).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abusrewil S. S., Tyfield L., Savage D. C. Serum thyroxine and thyroid stimulating hormone concentrations after treatment of congenital hypothyroidism. Arch Dis Child. 1988 Nov;63(11):1368–1371. doi: 10.1136/adc.63.11.1368. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Aronson R., Ehrlich R. M., Bailey J. D., Rovet J. F. Growth in children with congenital hypothyroidism detected by neonatal screening. J Pediatr. 1990 Jan;116(1):33–37. doi: 10.1016/s0022-3476(05)81641-5. [DOI] [PubMed] [Google Scholar]
  3. BECK R. N. Soy flour and fecal thyroxine loss in rats. Endocrinology. 1958 May;62(5):587–592. doi: 10.1210/endo-62-5-587. [DOI] [PubMed] [Google Scholar]
  4. Bongers-Schokking J. J., Koot H. M., Wiersma D., Verkerk P. H., de Muinck Keizer-Schrama S. M. Influence of timing and dose of thyroid hormone replacement on development in infants with congenital hypothyroidism. J Pediatr. 2000 Mar;136(3):292–297. doi: 10.1067/mpd.2000.103351. [DOI] [PubMed] [Google Scholar]
  5. Chorazy P. A., Himelhoch S., Hopwood N. J., Greger N. G., Postellon D. C. Persistent hypothyroidism in an infant receiving a soy formula: case report and review of the literature. Pediatrics. 1995 Jul;96(1 Pt 1):148–150. [PubMed] [Google Scholar]
  6. Craig Frances W., Schunk Jeff E. Retropharyngeal abscess in children: clinical presentation, utility of imaging, and current management. Pediatrics. 2003 Jun;111(6 Pt 1):1394–1398. doi: 10.1542/peds.111.6.1394. [DOI] [PubMed] [Google Scholar]
  7. Divi R. L., Chang H. C., Doerge D. R. Anti-thyroid isoflavones from soybean: isolation, characterization, and mechanisms of action. Biochem Pharmacol. 1997 Nov 15;54(10):1087–1096. doi: 10.1016/s0006-2952(97)00301-8. [DOI] [PubMed] [Google Scholar]
  8. Dubuis J. M., Glorieux J., Richer F., Deal C. L., Dussault J. H., Van Vliet G. Outcome of severe congenital hypothyroidism: closing the developmental gap with early high dose levothyroxine treatment. J Clin Endocrinol Metab. 1996 Jan;81(1):222–227. doi: 10.1210/jcem.81.1.8550756. [DOI] [PubMed] [Google Scholar]
  9. Duncan A. M., Merz B. E., Xu X., Nagel T. C., Phipps W. R., Kurzer M. S. Soy isoflavones exert modest hormonal effects in premenopausal women. J Clin Endocrinol Metab. 1999 Jan;84(1):192–197. doi: 10.1210/jcem.84.1.5387. [DOI] [PubMed] [Google Scholar]
  10. Duncan A. M., Underhill K. E., Xu X., Lavalleur J., Phipps W. R., Kurzer M. S. Modest hormonal effects of soy isoflavones in postmenopausal women. J Clin Endocrinol Metab. 1999 Oct;84(10):3479–3484. doi: 10.1210/jcem.84.10.6067. [DOI] [PubMed] [Google Scholar]
  11. Grant D. B., Fuggle P. W., Smith I. Increased plasma thyroid stimulating hormone in treated congenital hypothyroidism: relation to severity of hypothyroidism, plasma thyroid hormone status, and daily dose of thyroxine. Arch Dis Child. 1993 Nov;69(5):555–558. doi: 10.1136/adc.69.5.555. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. HYDOVITZ J. D. Occurrence of goiter in an infant on a soy diet. N Engl J Med. 1960 Feb 18;262:351–353. doi: 10.1056/NEJM196002182620707. [DOI] [PubMed] [Google Scholar]
  13. Heyerdahl S., Ilicki A., Karlberg J., Kase B. F., Larsson A. Linear growth in early treated children with congenital hypothyroidism. Acta Paediatr. 1997 May;86(5):479–483. doi: 10.1111/j.1651-2227.1997.tb08917.x. [DOI] [PubMed] [Google Scholar]
  14. Irvine C. H., Fitzpatrick M. G., Alexander S. L. Phytoestrogens in soy-based infant foods: concentrations, daily intake, and possible biological effects. Proc Soc Exp Biol Med. 1998 Mar;217(3):247–253. doi: 10.3181/00379727-217-44229. [DOI] [PubMed] [Google Scholar]
  15. Jabbar M. A., Larrea J., Shaw R. A. Abnormal thyroid function tests in infants with congenital hypothyroidism: the influence of soy-based formula. J Am Coll Nutr. 1997 Jun;16(3):280–282. doi: 10.1080/07315724.1997.10718686. [DOI] [PubMed] [Google Scholar]
  16. PINCHERA A., MACGILLIVRAY M. H., CRAWFORD J. D., FREEMAN A. G. THYROID REFRACTORINESS IN AN ATHYREOTIC CRETIN FED SOYBEAN FORMULA. N Engl J Med. 1965 Jul 8;273:83–87. doi: 10.1056/NEJM196507082730205. [DOI] [PubMed] [Google Scholar]
  17. Sato T., Suzuki Y., Taketani T., Ishiguro K., Nakajima H. Age-related change in pituitary threshold for TSH release during thyroxine replacement therapy for cretinism. J Clin Endocrinol Metab. 1977 Mar;44(3):553–559. doi: 10.1210/jcem-44-3-553. [DOI] [PubMed] [Google Scholar]
  18. Schultz R. M., Glassman M. S., MacGillivray M. H. Elevated threshold for thyrotropin suppression in congenital hypothyroidism. Am J Dis Child. 1980 Jan;134(1):19–20. doi: 10.1001/archpedi.1980.02130130011004. [DOI] [PubMed] [Google Scholar]
  19. VAN MIDDLESWORTH L. Thyroxine excretion, a possible cause of goiter. Endocrinology. 1957 Nov;61(5):570–573. doi: 10.1210/endo-61-5-570. [DOI] [PubMed] [Google Scholar]
  20. VAN WYK J. J., ARNOLD M. B., WYNN J., PEPPER F. The effects of a soybean product on thyroid function in humans. Pediatrics. 1959 Nov;24:752–760. [PubMed] [Google Scholar]
  21. Waterlow J. C., Buzina R., Keller W., Lane J. M., Nichaman M. Z., Tanner J. M. The presentation and use of height and weight data for comparing the nutritional status of groups of children under the age of 10 years. Bull World Health Organ. 1977;55(4):489–498. [PMC free article] [PubMed] [Google Scholar]
  22. de Onis M., Habicht J. P. Anthropometric reference data for international use: recommendations from a World Health Organization Expert Committee. Am J Clin Nutr. 1996 Oct;64(4):650–658. doi: 10.1093/ajcn/64.4.650. [DOI] [PubMed] [Google Scholar]

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