CONGENITAL HYPOTHYROIDISM: AWARENESS, DIAGNOSIS AND TREATMENT IN PAEDIATRICS
People In Health Care
Associate Professor Michelle Jack, Paediatric Endocrinologist
Clinical Practice & Co-Lead Doctor of Medicine, Bond University, Queensland
Filmed Robina, Queensland | October 2024
Michelle Jack is Associate Professor of Clinical Practice, Faculty of Health Sciences & Medicine at Bond University, QLD, co-Head of Paediatrics and a Paediatric Endocrinologist at Lismore Base Hospital in NSW and Senior Staff Specialist, Paediatric Endocrinology, Northern New South Wales Local Health District.
Associate Professor Jack is a member of the ANZSPED Laboratory and Newborn Screening Sub-committee https://anzsped.org/subcommittees/lab-group/ and Thyroid working group https://anzsped.org/subcommittees/thyroid-working-group/.
Australian Health Journal spoke to Associate Professor Jack about congenital hypothyroidism and newborn screening and her concerns in the varying thresholds for across different states in Australia. Despite the existence of newborn screening programs since the 1970s, there is still controversy surrounding the appropriate screening levels. Congenital hypothyroidism, affecting about one in 3500 infants, can lead to severe intellectual and physical impairment if not diagnosed early. The condition is mainly caused by the thyroid gland’s failure to develop properly, resulting in insufficient thyroid hormone production.
The current challenge lies in setting the right screening thresholds to avoid false positive or missed diagnoses. Assoc Prof Jack highlights the need for standardisation in the approach to borderline thyroid abnormalities in children, as the wide variety of responses from paediatric endocrinologists indicates a lack of consensus. She emphasises the importance of conducting high-quality research to determine the optimal screening thresholds, considering both the impact on infants and their families and the healthcare system’s cost.
Associate Professor Jack is passionate about the health and wellbeing of children and adolescents, with diverse research areas including the impacts of family friendly workplace initiatives, screening and management of thyroid disorders in infants and children. She supports her First Nations colleagues on Indigenous-led research projects funded by the Medical Research Future Fund, aiming to improve the social and emotional wellbeing of First Nations Children. Through her clinical and academic roles, Michelle hopes to make a positive difference to the health and well-being of children and their families.
References on congenital hypothyroidism
ANZSPED website resources on congenital hypothyroidism
– https://anzsped.org/patient-resources/hormones-me-booklet-series/
– https://anzsped.org/patient-resources/anzsped-patient-flyers/)
Fifty years of newborn screening for congenital hypothyroidism: current status in Australasia and the case for harmonisation
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Calls for National Social Prescribing Scheme
The Royal Australian College of General Practitioners (RACGP), Consumers Health Forum of Australia (CHF) and Mental Health Australia are urging the government to implement a national social prescribing scheme to tackle Australia’s mental health and wellbeing crisis.
Mental ill health is a growing problem in Australia and has been made worse by the COVID-19 pandemic. Since 2017, GPs across Australia have rated mental health as the most common presentation they see as part of the RACGP’s annual Health of the Nation survey. Approximately 20% of patients consult their GP for what are primarily social problems.
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Improving access to osteopathic services and integrated care models
The Chief Executive Officer of Osteopathy Australia, Antony Nicholas spoke with Australian Health Journal about:
– Involvement in the Strengthening Medicare Task Force
– The unique skills osteopaths have that can address the chronic disease burden
– Current workforce issues around osteopaths and if enough are coming through via student placements
– How uploading data to My Health Record by osteopaths could assist team-based care of patients
– How the value of osteopaths in Residential Aged Care Facilities (RACFs) could be better understood and better access for residents
– The recommendations around aged care access to allied health services, including osteopathy
– The recommendations around consumer access to osteopaths and GP referrals
– Other osteopathy recommendations in the upcoming Federal BudgetIn the lead up to the Australian Federal Budget in May 2023, Australian Health Journal reached out to peak health industry bodies to hear about their priorities, either noted in pre-budget submissions lodged with Federal Government in January 2023 or in recent forums such as the Strengthening Medicare Taskforce.
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Medicinal cannabis in Australia Update
According to the Australian Journal of General Practice, published by the Royal Australian College of General Practitioners, more than 130,000 medicinal cannabis approvals have been issued in Australia to date, mostly by general practitioners, with approximately 65% of these to treat chronic non-cancer pain. Despite robust supportive data from animal models, current clinical trial evidence for THC and CBD efficacy in chronic pain is incomplete. In their prescribing decisions, doctors must balance patient demand and curiosity with caution regarding potential risks and limited efficacy (Source: https://www1.racgp.org.au/ajgp/2021/october/medicinal-cannabis)
Australian Health Journal met with 3 speakers at the recent @arcsaustralia ARCS22 Conference providing an update on medicinal cannabis. The discussion with the speakers now centres on affordability and access.
