Thyroid Problems in Children

From an interview with
Dr. Deidre Tyson
McLeod Pediatric Endocrinology

Here’s a summary of Dr. Tyson’s comments:
The thyroid gland, which is located at the base of your neck, is responsible for the metabolic rate of all your tissues and cells of your body. I would compare it to a gas pedal for your body. If you have a deficiency of thyroid hormone, your body slows down. You have weight gain and growth slows, a presenting sign of hypothyroidism in a child. The skin becomes dry. The hair gets brittle and falls out. You develop constipation. You can feel depressed. You can’t concentrate, because everything is just at a slower pace.

Now, the opposite of hypothyroidism is hyperthyroidism, in which the thyroid produces too much thyroid hormone. You tend to lose weight. You feel hot all the time. Your heart is racing. You’re perspiring. You feel very jittery. Hyperthyroidism is uncommon in children — very uncommon under the age of five. It becomes more and more common as you get into your teenage years.

But hypothyroidism in children is very prevalent. One in 4,000 babies is born with some sort of problem with their thyroid gland, whether it’s a structural abnormality or an enzymatic abnormality, in which the thyroid hormone is not produced properly. The important part about being born with a thyroid problem is that thyroid hormone is critical to brain development. If the child is not promptly diagnosed, they can develop brain damage.

Treatment options depend on whether you make too little thyroid hormone or excessive amounts of thyroid hormone. If you have hypothyroidism or thyroid failure, you just replace the thyroid hormone that is missing. And that’s just one pill a day. It’s very easy to treat in most circumstances.

Hyperthyroidism is more challenging. You have to use antithyroid medications that do have side effects. If it’s persistent, then you’re looking at surgery to remove the thyroid gland or radioactive iodine to burn out the gland.

I think parents should be aware of any change in their child, such as weight gain or falling grades. These should trigger suspicion and result in a trip to the pediatrician. It’s very easy to screen for thyroid levels.  It’s a simple blood test.

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