Symptoms of Thyroid Disease in Children

While thyroid disease most often develops during adulthood, it can occur in infants, children, and teenagers as well. The symptoms of thyroid disease in children may be hard to recognize because many—changes in appetite, sleep patterns, emotions, and energy levels—are all also experienced as part of normal development during these years.

Thyroid Disease in Children

Thyroid disease during infancy, which is usually identified through newborn screening tests, is not common. Congenital hypothyroidism is the most common thyroid problem identified at birth.

After infancy, your child might not have thyroid tests unless you mention symptoms of thyroid disease to his or her pediatrician, or if your child has a risk of thyroid disease due to a family history.

In kids, hypothyroidism, which occurs when the thyroid gland is underproducing thyroid hormone, is more common than hyperthyroidism, a condition in which the thyroid gland produces too much thyroid hormone. Both can produce consequences that affect your child's growth, health, mood, and ability to concentrate and learn.

Hashimoto's thyroiditis (HT), which typically causes hypothyroidism, is the most common type of thyroid disease in children.

Frequent Symptoms

Reviewing some of the common signs and symptoms of hypothyroidism and hyperthyroidism can help guide you if you are concerned that there could be a possible problem.

Hypothyroidism

Hypothyroidism most commonly occurs when the thyroid gland isn't producing enough thyroid hormone, either because it can't (primary hypothyroidism) or because it isn't being stimulated properly (secondary hypothyroidism).

Kids with hypothyroidism may have the following symptoms:

  • Short stature or slow growth
  • Rough, dry skin
  • Constipation
  • Cold intolerance
  • Fatigue and decreased energy
  • Sleeping more
  • Bruising easily
  • Bone fractures or delayed bone age on X-ray
  • Delayed puberty

If you're worried about thyroid issues because your child is overweight, it may help to know that children who experience weight gain due to thyroid problems are typically shorter than expected for their age.

Hyperthyroidism

In hyperthyroidism, there is an excess of thyroid hormones, either due to overactivity or overstimulation of the thyroid gland.

Symptoms of hyperthyroidism, also called thyrotoxicosis, can include:

  • Emotional lability, crying easily, irritability, or excitability
  • Short attention span
  • Tremors
  • Increased appetite
  • Weight loss
  • Enlarged thyroid gland (goiter)
  • Exophthalmos (protruding eyes)
  • Upper eyelid lag
  • Infrequent blinking
  • Flushed skin
  • Excessive sweating
  • Muscle weakness
  • Tachycardia (rapid heartbeat) and palpitation (a sense that you can feel your heart beating)
  • High blood pressure

Thyroid Disease and Endocrine Dysfunction

The thyroid gland is an endocrine gland. Thyroid disease can occur along with other endocrine conditions, such as diabetes, pituitary tumors, and adrenal tumors. If your child has thyroid disease, his doctor will likely run tests to rule out other endocrine conditions. Similarly, if your child has another endocrine condition, he will also likely be tested for thyroid disease as well.

Sometimes, people who have a thyroid tumor may also have other endocrine tumors, a hereditary condition described as multiple endocrine neoplasia (MEN).

Symptoms and signs of thyroid disease combined with other endocrine conditions include:

  • Hyperglycemia (high blood sugar) or hypoglycemia (low blood sugar)
  • Galactorrhea (white breast discharge)
  • Pseudoprecocious puberty (early puberty)
  • Headaches
  • Vision problems
  • Hypertension (high blood pressure) or hypotension (low blood pressure)

Complications

For children, thyroid disease can produce issues with development, particularly if they are not treated. There may also be an increased risk of certain types of thyroid cancer among children who have noncancerous thyroid disease.

Complications of thyroid disease in children include:

  • Slow growth: Children with thyroid disease may not reach optimal height if the thyroid condition is not treated before adolescence.
  • Delayed puberty: Delayed puberty can manifest with delayed menstruation and slow development of sexual characteristics in boys and girls.
  • Myxedema: Severe hypothyroidism can cause a condition called myxedema, which is characterized by skin swelling.
  • Fertility problems: Boys and girls who have thyroid disease can have problems with infertility in later life. Women who become pregnant can also experience complications during pregnancy and delivery.
  • Heart problems: High blood pressure, arrhythmias (heartbeat irregularities) and heart failure are all associated with chronic thyroid problems.
  • Cancer: Thyroid cancer can develop in children who have HT. Thankfully, the prognosis of thyroid cancer is good for children.

If you are a parent of a child who has thyroid disease, the complications can seem alarming. While thyroid disease can be a lifelong condition, these complications can be prevented with appropriate treatment and consistent management of thyroid hormone levels.

When to See a Doctor

Thyroid issues are often hereditary, so if you have a family history of these conditions, talk to your pediatrician about how often you should schedule thyroid disease screening tests for your child.

If you notice that he or she has symptoms of hyperthyroidism or hypothyroidism, make a doctor's appointment so that the cause can be identified and treated.

Your child's doctor will likely order blood tests that include thyroid hormone levels:

  • Children with hypothyroidism may have a low free thyroxine level (free T4) and an elevated level of thyroid stimulating hormone (TSH).
  • Children with hyperthyroidism will usually have a high T4 and triiodothyronine (T3) and a low TSH.

She may also order imaging studies or diagnostic tests to rule out other conditions as well.

A Word From Verywell

If your child has thyroid disease, treatment is necessary. Parents often feel guilty for not noticing medical conditions in their children sooner. Thyroid disease, in particular, is very hard to recognize in growing children, so try not to blame yourself for "missing" early symptoms. The truth is, those symptoms could have just as easily been related to normal growth patterns of childhood.

Once your child is diagnosed, your role is important. Help your child learn about his or her condition and provide guidance so that your child can recognize symptoms of high or low thyroid function. This can help optimize medication management as thyroid levels change throughout life.

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Article Sources
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  • Penta L, Cofini M, Lanciotti L, Leonardi A, Principi N, Esposito S. Hashimoto's Disease and Thyroid Cancer in Children: Are They Associated? Front Endocrinol (Lausanne). 2018 Oct 9;9:565. doi: 10.3389/fendo.2018.00565. eCollection 2018.