Higher TSH levels linked to hyperactivity behaviors for children with ADHD
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Key takeaways:
- Children with ADHD and higher TSH levels are more likely to have hyperactivity behaviors.
- Higher levels of serum ferritin and lactic acid were also associated with hyperactivity behaviors.
Children with ADHD may be more likely to experience hyperactivity behaviors if they have an elevated serum thyroid-stimulating hormone level, according to data published in Neuropsychiatric Disease and Treatment.
“Serum TSH levels may be related to the hyperactivity behaviors in children with ADHD,” Guanru Chen, of the department of clinical pharmacy at Anhui Provincial Children’s Hospital in China, and colleagues wrote. “To validate this potential relationship, multicentric studies are clearly required, and to examine the causal relationship between thyroid function and symptoms in children with ADHD, longitudinal studies and randomized controlled trials are warranted.”
Researchers conducted a retrospective cohort study of 49 children aged 6 to 14 years diagnosed with ADHD and receiving no ADHD treatment at Anhui Provincial Children’s Hospital from October 2021 to May 2022. Clinical and laboratory data were collected from electronic medical records. The Conners-3 scale was used to analyze behavior issues associated with ADHD. Researchers used the questionnaire’s hyperactivity index subscale to measure hyperactivity behaviors. Scores on the subscale ranged from 0 to 3, with children scoring 1.5 or higher considered to have a high level of hyperactivity behaviors.
TSH levels were positively correlated with the total score on the Conners-3 scale (r = 0.338; P = .033) and the score on the hyperactivity index subscale (r = 0.371; P = .019). Free triiodothyronine and free thyroxine levels were not associated with Conners-3 scale score, according to the researchers.
The cohort was divided by hyperactivity index score into a group with a high level of hyperactivity behavior group and a group with a low level of hyperactivity behaviors. Children with a high hyperactivity behaviors score had higher levels of TSH (2.99 IU/mL vs. 2.32 IU/mL; P = .027), serum ferritin (15.45 mol/L vs. 12.68 mol/L; P = .048) and lactic acid (197.97 mg/L vs. 155.46 mg/L; P = .03) than those without hyperactivity behaviors. Higher levels of TSH (OR = 2.243; 95% CI, 1.052-4.783) and lactic acid (OR = 1.018; 95% CI, 1.003-1.032) were associated with a higher likelihood for a high hyperactivity index score, according to the study.
“The results of binary logistic regression found that lactic acid was independently associated with hyperactivity index,” the researchers wrote. “It is well known that ADHD children with hyperactivity behaviors have an excess of activity, which may lead to accumulation of lactic acid in serum. Since this study is a single-center study and the sample size is relatively small, this relationship should be confirmed by multicentric studies.”
The area under the curve value of TSH for identifying children with ADHD and hyperactivity behaviors was 0.684, with a sensitivity of 65.4% and a specificity of 78.3%, the researchers reported.
They noted that the small sample size and retrospective design were limitations of the study and more research is needed to examine the causal relationship between TSH levels and hyperactivity behaviors among children with ADHD.
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