Thyroid disease and children

Thyroid problems in children can affect both physical and mental development, which in turn can impact their social and learning skills. Therefore, it is vital that parents understand the signs and symptoms of key thyroid conditions. It is also important to remember that treatments are available and early intervention will help to avoid any long term issues or complications.9

Children diagnosed with thyroid problems need the support of their families to ensure they take their medication regularly and understand their condition. It is also recommended that schools/nurseries are informed so that they are aware of the child’s diagnosis and medication requirements.

Why might my child experience thyroid problems?

Children can experience thyroid problems from birth as they can be born without a properly working thyroid gland, a condition called congenital hypothyroidism. This condition can be difficult to spot at birth as babies may not have any symptoms, or may only display mild effects that often go unrecognised. In some severe cases, babies can be born without a thyroid gland which can often result in physical abnormalities, including a large tongue.10

What should I look for?

Typical symptoms of congenital hypothyroidism include:10

  • Prolonged jaundice
  • Excessive sleeping
  • Poor feeding
  • Poor muscle tone
  • Hoarse cry
  • Infrequent bowel movements and constipation
  • Low body temperature

Babies are screened for congenital hypothyroidism with the goal of starting appropriate thyroid hormone replacement treatment as soon as possible. Screening methods vary from country to country, but generally the preferred time for screening is a few days after the child has been born.10 Children with congenital hypothyroidism are treated with levothyroxine in the same way as adults.10. This treatment can ensure that the child continues to develop normally.

Children may also develop problems with the functioning of their thyroid for the same reason as adults, as a result of any of the following: too little iodine in their diet, an autoimmune disease (such as Hashimoto’s thyroiditis or Graves’ disease) or injury to their thyroid gland.

An underactive thyroid in children

The most common cause of acquired hypothyroidism in children and teenagers is a condition called Hashimoto’s thyroiditis, where the body’s immune system attacks the thyroid gland and interferes with the production of thyroid hormone.11

The signs of hypothyroidism in children can vary depending on their age when the problem starts:

  • Babies may be jaundiced for longer than usual (see section on congenital hypothyroidism)9
  • Older children may experience stunted growth in terms of their bones or teeth9
  • Children of school age may experience learning difficulties and puberty may be delayed12

The goal of hypothyroidism treatment in children is to replace the missing thyroid hormone. Levothyroxine, the mainstay of treatment in adults, is also recommended for use in children. However, the dose is tailored to match the specific weight and needs of the child.9

An overactive thyroid in children

The autoimmune disorder Graves’ disease is responsible for almost all the cases of hyperthyroidism in children. However, Graves’ disease tends to be more common in teenagers than toddlers and generally affects more girls than boys.9

Graves’ disease in children can often be difficult to identify because it develops slowly. However, there are common signs and symptoms to be aware of. These include:9

  • Changes in behaviour and school performance
  • Sleeplessness, restlessness
  • Irritability
  • Needing to get up in the night to go to the bathroom
  • An enlarged thyroid gland
  • Trembling hands and/or and staring eyes
  • An increased appetite but combined with weight loss
  • Diarrhoea

The goal of treatment in children with hyperthyroidism is to reduce the amount of thyroid hormone present in the blood stream. In children who experience side effects from anti-thyroid medications, surgery may be the preferred option.9. Treatment of hyperthyroidism in children is as effective as it is in adults. However, radioactive iodine therapy is unlikely to be used as the long term effects in children and teenagers are not known.

If you are at all concerned that you or your child maybe at risk of, or suffering from, thyroid problems, please discuss this with your doctor. To aid your consultation, download our Wellbeing Diary to help you keep a check of the symptoms you are experiencing.

Did you know?

Thyroid disorders are as much as eight times more common in women than in men?1

References