Your thyroid gland is a butterfly-shaped gland located at the base of your neck, just above your collarbone. It is one of your endocrine glands, which means its job is to produce hormones. Thyroid hormones control your body’s metabolism, including how fast you burn calories and how fast your heart beats. They also help regulate your body’s calcium levels.
Hypothyroidism is a condition in which the thyroid gland is underactive and produces an insufficient amount of thyroid hormones. It is the most common thyroid disorder affecting children.
Children who are born to mothers who are being treated for a thyroid disorder are at risk for hypothyroidism. Other risk factors may include:
Congenital hypothyroidism is present at birth. This occurs when the thyroid gland doesn’t develop or function while the baby is still in the womb. Because it may affect one baby out of every 3,000, it is something all babies are checked for during routine newborn screening.
Acquired hypothyroidism develops after birth. This condition often shows up in late childhood or in the teens. It is thought to be a result of the body mistaking the thyroid for an invader. The immune system then attacks the gland, as it would anything that is seen as a threat.
The symptoms of hypothyroidism in children are different than those in adults. Symptoms may vary from child to child, and some children may have no symptoms at all. Infants with more severe forms often have a specific appearance that includes a dull look, puffy face and a thick protruding tongue.
The most common cause of hypothyroidism is an autoimmune disorder called Hashimoto’s thyroiditis, in which the body's immune system slowly destroys the thyroid gland. It may also be caused by overtreatment of hyperthyroidism.
The treatment of choice for hypothyroidism is thyroid replacement therapy pills. Some children will need to take the medication for the rest of their lives, while others will outgrow the disorder, often by the age of 3. Regular monitoring of your child's thyroid hormone levels during the course of treatment is necessary in order to ensure appropriate treatment.
Hypothyroidism in the newborn, when left untreated, can lead to intellectual disability and profound developmental delays. Untreated hypothyroidism may also lead to anemia, low body temperature and heart failure.
Surgery may be considered for children with hyperthyroidism who don’t respond to medication, have bad side effects or are allergic to it, or in cases where the gland has gotten too large. It also is used when cancer has been confirmed.
American Board of Pediatrics/Endocrinology