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Pediatric Hypothyroidism

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Summary

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.

Types

  1. Congenital hypothyroidism is present at birth.
  2. Acquired hypothyroidism develops after birth.

Causes

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.

Risk Factors

Children who are born to mothers who are being treated for a thyroid disorder are at risk for hypothyroidism. Other risk factors may include:

  • Family history of thyroid disease
  • Treatment for hyperthyroidism
  • Previous radiation exposure to the chest or neck
  • Surgery to remove the thyroid gland

Symptoms

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.

Hypothyroidism symptoms in newborns may include:

  • Fatigue
  • Poor appetite
  • Constipation
  • Slow bone growth

Hypothyroidism symptoms in children may include:

  • Slow growth
  • Delayed tooth development

Hypothyroidism symptoms in adolescents may include:

  • Slow growth
  • Delayed puberty
  • Hoarse voice
  • Slow speech
  • Droopy eyelids
  • Puffy face
  • Hair loss
  • Dry skin
  • Slow pulse
  • Weight gain

Diagnosis

For acquired hypothyroidism, your child’s doctor will make a diagnosis based on a combination of patient history, physical exam and blood tests that measure thyroid hormone (T4) and thyroid-stimulating hormone (TSH) levels. Congenital hypothyroidism is usually detected during the routine newborn screening.

At Children’s Health℠, all patients will be evaluated by a medical endocrinologist.

Treatment

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.

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