Symptoms of Thyroid Problems in Children

Boy sleeping on bed
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Thyroid problems aren't rare in children, but they're not as common as parents may believe. In kids, hypothyroidism, which occurs when the thyroid is underproducing thyroid hormone, is more common than hyperthyroidism, when the thyroid produces too much thyroid hormone.

Reasons Parents May Think Kids Have Thyroid Problems

If you're worried about thyroid issues because your child is overweight, it's important to keep in mind that children with thyroid problems are typically short.

Kids who are overweight because they eat too much or exercise too little are usually normal height and their weight is rarely due to a thyroid disorder.

Sleeping a lot is another common symptom that brings parents to their pediatrician looking for a thyroid problem. While that symptom usually deserves checking your child's thyroid function, without other symptoms, the tests are likely to be normal. You might look for other causes of excessive sleepiness, such as obstructive sleep apnea, depression, or mononucleosis.

Thyroid Problems in Children

This isn't to say that kids can't get thyroid problems.From congenital hypothyroidism and Hashimoto's thyroiditis to Graves disease, children and teens can indeed develop thyroid problems.

Reviewing some of the common signs and symptoms of hypothyroidism and hyperthyroidism can help you know when to get thyroid function tests ordered for your child and when to look for another cause for your child's symptoms.

Symptoms of 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 primary hypothyroidism will usually have a low free thyroxine level (free T4) and an elevated level of thyroid stimulating hormone (TSH) and associated symptoms of hypothyroidism, such as:

  • Short stature or deceleration of growth
  • Rough, dry skin
  • Constipation
  • Cold intolerance
  • Fatigue and decreased energy
  • Sleeping more
  • Bruising easily
  • Delayed bone age on X-ray
  • Delayed puberty (teens)
  • Galactorrhea (white breast discharge)
  • Pseudoprecocious puberty (early puberty)
  • Headaches
  • Vision problems

Newborns with congenital hypothyroidism are usually identified on their newborn screening test, which routinely tests for hypothyroidism.

Symptoms of Hyperthyroidism

In hyperthyroidism, also called thyrotoxicosis, there is an excess of thyroid hormones. These children will usually have a high T4 and T3, and a low TSH.

Symptoms of hyperthyroidism can include:

  • Emotional lability, with your child being more likely to cry easily, be irritable and excitable, etc.
  • Short attention span
  • Finger tremor
  • Increased appetite
  • Weight loss, failure to thrive
  • Enlarged thyroid gland (goiter)
  • Exophthalmos (protruding eyes)
  • Upper eyelid lag
  • Infrequent blinking
  • Flushed skin
  • Excessive sweating
  • Muscle weakness
  • Tachycardia and palpitation
  • High blood pressure

Whether you think your child's thyroid is underactive or overactive, talk to your pediatrician if you think his thyroid isn't working properly. As thyroid disorders are sometimes hard to diagnose and thyroid function tests can sometimes be hard to interpret, an evaluation by a pediatric endocrinologist can also be helpful.

Sources:

Kliegman, RM, Stanton, B, St. Geme, J, Schor, NF. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016.

Melmed, S, Polonsky, KS, Larsen, PR, Kronenberg, HM. Williams Textbook of Endocrinology. 13th ed. Philadelphia, PA: Elsevier; 2016.

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