All about thyroid disorders in children
Thyroid disorders in children are relatively uncommon but can significantly impact a child’s growth, development, and overall health. The thyroid gland, located at the base of the neck, plays a critical role in regulating metabolism by producing hormones such as thyroxine (T4) and triiodothyronine (T3). These hormones influence many bodily functions, including energy use, growth, and brain development.
When the thyroid gland is underactive (hypothyroidism) or overactive (hyperthyroidism), it can lead to various health issues. Here to talk more about this is revered consultant paediatrician and endocrinologist, Dr Nirit Braha.
Types of thyroid disorders
Hypothyroidism occurs when the thyroid gland doesn’t produce enough hormones. In children, this can be caused by congenital factors (being born without a properly functioning thyroid gland), autoimmune diseases like Hashimoto’s thyroiditis, or iodine deficiency.
Hyperthyroidism, on the other hand, is characterized by an overproduction of thyroid hormones. The most common cause in children is Graves’ disease, an autoimmune condition where the body makes antibodies against receptors found on the thyroid gland. These antibodies stimulate the gland to make excess amounts of thyroxine and triiodothyronine.
Symptoms
The symptoms of thyroid disorders in children vary depending on the type of condition. Children with hypothyroidism may exhibit signs like fatigue, weight gain, slow growth, constipation, cold intolerance, dry skin, and delayed puberty. If left untreated, hypothyroidism can lead to intellectual disabilities and stunted growth.
In contrast, hyperthyroidism can cause rapid heart rate, weight loss, restlessness, sweating, tremors, difficulty concentrating, and an enlarged thyroid gland (goiter). Children with hyperthyroidism may also have trouble sleeping and mood and behavioural changes leading to difficulty concentrating, anxiety and irritability.
Diagnosis and treatment
Early diagnosis of thyroid disorders is crucial for effective treatment. Following a careful clinical assessment, a blood test is undertaken to measure levels of thyroid hormones (T3, T4) and thyroid-stimulating hormone (TSH) and to look for the presence of autoantibodies. In some cases, imaging tests like an ultrasound or a radioactive iodine uptake test may be used to further assess the thyroid.
Treatment depends on the type of disorder. Hypothyroidism is usually treated with daily thyroid hormone replacement therapy, in the form of levothyroxine. This supplements the thyroxine a child would usually be making and normalises their thyroid hormone levels in the bloodstream. Hyperthyroidism is treated in the first instance with medication such as carbimazole or propylthiouracil, sometimes combined with propranolol if there is moderate to severe thyroid hormone excess. In children whose thyroid disease is not controlled with medication, or who have a relapse after coming off their medication, radioiodine therapy or surgery may be offered.