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In children, the two most common types of hypothyroidism are congenital hypothyroidism (CHT) and Hashimoto's thyroiditis. Congenital Hypothyroidism. Hypothyroidism is a condition that results from an under-active thyroid that does not produce enough thyroid hormone. ‘Congenital’ means that this condition is present at birth.
Both men and women can have an underactive thyroid, although it's more common in women. Children can also develop an underactive thyroid and some babies are born with it. All babies born in the UK are screened for congenital hypothyroidism using a blood spot test when the baby is about 5 days old.
- Overview
- What is hypothyroidism?
- Symptoms of hypothyroidism in children
- Types of hypothyroidism in children
- Causes
- How do doctors diagnose hypothyroidism in children?
- Treatment
- When to contact a doctor
- What’s the outlook?
- Summary
In hypothyroidism, the thyroid gland is underactive and does not produce enough thyroid hormone. Thyroid hormone controls how the body uses energy and is essential for children’s growth and development.
The thyroid is a butterfly-shaped gland at the lower front of a person’s neck. According to a 2022 study, it produces the hormones thyroxine (T4) and triiodothyronine (T3). Thyroid hormone is essential throughout life and controls a person’s metabolism, growth, and brain development.
Hypothyroidism in children can be congenital, meaning it is present at birth. Some children develop autoimmune thyroid disease, which can affect them through adolescence.
This article explains the different types of hypothyroidism that affect children and how doctors treat them.
Hypothyroidism is when the thyroid gland does not produce enough thyroid hormone. Thyroid hormone is vital for controlling growth and other bodily functions.
Thyroid hormone affects almost every organ in a person’s body. During childhood, thyroid hormone works with growth hormones to stimulate bone growth and is essential for healthy brain development.
It also affects breathing, heart rate, and digestion. Too little thyroid hormone slows these processes and can make people feel tired, cold, and generally sluggish.
Learn more about hypothyroidism here.
The American Thyroid Association (ATA) explains that the symptoms of hypothyroidism in children can be vague and variable. They can include:
•slower growth rate
•puffy face
•increased sensitivity to cold
•slow heart rate
•dry skin
Congenital hypothyroidism
The ATA explains that there are different types of congenital hypothyroidism. Sometimes, babies are born without a thyroid gland, or it may not develop properly during gestation. If the baby’s mother has hypothyroidism, thyroid-blocking antibodies may pass through the placenta during pregnancy. This form of congenital hypothyroidism is usually temporary, and the baby may only need thyroid hormone treatment for a few months. According to research from 2017, other causes of congenital hypothyroidism are: •prematurity •iodine deficiency •maternal thyrotropin receptor-blocking antibodies •maternal or newborn iodine exposure •hepatic hemangioma, which is a benign tumor in the liver •gene mutations that change the way genes function Congenital hypothyroidism may be more easily detected in screening programs with lower thyroid stimulating hormone (TSH) level thresholds.
Acquired hypothyroidism
Some children develop hypothyroidism after infancy. If the child’s immune system malfunctions, it can lead to an autoimmune disease where the immune system attacks healthy cells. Hashimoto’s thyroiditis is the most common autoimmune disease that causes hypothyroidism. Learn about Hashimoto’s thyroiditis here.
According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDKD), hypothyroidism tends to run in families. It is also more common in females.
Children who have had thyroid surgery, or radioactive iodine to treat a thyroid condition, may develop hypothyroidism, but no one knows exactly what causes autoimmune conditions.
Infections can also inflame the thyroid. Doctors call this thyroiditis, and it is usually temporary.
Learn more about autoimmune diseases here.
Hypothyroidism can interfere with children’s intellectual development, so all newborns in the United States are tested at birth, according to the NIDDKD.
For older children, doctors will perform a physical exam and find out about any family history of hypothyroidism. They may also take blood tests to check the levels of T3 and T4 in the child’s blood.
Doctors also test the levels of TSH in the blood. The pituitary gland secretes TSH to encourage the thyroid to produce T3 and T4. High levels of TSH in the blood indicate that the thyroid is not producing enough thyroid hormone to keep the body functioning properly.
If doctors suspect an autoimmune condition, they may recommend thyroid antibody tests. People produce thyroid antibodies when their immune system attacks their thyroid.
Doctors may also recommend imaging tests, such as an ultrasound, to check the size and shape of the child’s thyroid.
Learn more about the TSH test here.
Doctors usually prescribe hormone replacement medication for children with hypothyroidism. The ATA says taking levothyroxine tablets daily is usually enough to bring thyroid hormone levels back to normal.
Children with hypothyroidism need regular blood tests to check their hormone levels. Doctors will usually test the child’s blood 4–8 weeks after prescribing levothyroxine and then every 3–12 months until they are fully grown. They may ask for more tests if they change the levothyroxine prescription to a higher or lower dose.
The symptoms of hypothyroidism can be vague and may develop slowly. The ATA says that the most important symptoms to look out for in children and adolescents are a slowing in their growth rate and a delay in puberty.
If a child’s dose of levothyroxine is too high, they may develop hyperthyroidism symptoms. These include a rapid heart rate, excessive sweating, diarrhea, and anxiety. If caregivers notice these symptoms, they can talk with a doctor, who can arrange blood tests to check the dosage.
Some children with congenital hypothyroidism may only need short-term treatment. However, those with hypothyroidism due to Hashimoto’s thyroiditis or underdeveloped or missing thyroid glands will need lifelong treatment.
Children with Hashimoto’s thyroiditis, or other autoimmune diseases affecting the thyroid, may be sensitive to iodine, according to the NIDDKD. They may need to avoid foods rich in iodine, such as kelp, and other seaweeds.
Hypothyroidism is the result of an underactive thyroid. It can cause growth and developmental issues for children.
Most people with hypothyroidism need lifelong hormone replacement treatment to maintain healthy levels of thyroid hormones in the blood. Doctors usually prescribe levothyroxine tablets to take every day.
Hypothyroidism in Infants and Children - Etiology, pathophysiology, symptoms, signs, diagnosis & prognosis from the MSD Manuals - Medical Professional Version.
There are several different types of hypothyroidism, including: Congenital hypothyroidism (CH) occurs when the thyroid gland does not develop or function normally prior to birth. It is a very common problem, affecting about 1 in every 2,500 to 3,000 babies.
Also, because the condition can develop slowly over many years, the symptoms may be less noticeable or ignored. Two important symptoms in children are: • Slowing of height - an important early sign of hypothyroidism in children and. • Pubertal development that may be delayed in adolescents. An important finding on physical exam is an ...
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Feb 18, 2024 · Hypothyroidism results from low levels of thyroid hormone with varied etiology and manifestations. Hypothyroidism is primarily categorized as primary and secondary (ie, central) hypothyroidism. In primary hypothyroidism, the thyroid gland cannot produce adequate thyroid hormone.
