Hypothyroidism | Overview
What is hypothyroidism?
Hypothyroidism is the condition in which the thyroid is underactive and produces an insufficient amount of thyroid hormones. Hypothyroidism is the most common thyroid disorder. Children with this disorder display symptoms differently than adults with the disorder.
What is transient hypothyroidism?
Some newborns may have abnormal thyroid hormone levels at birth, which eventually stabilize and become normal. These children are said to have transient hypothyroidism as a result of exposure to antithyroid medications, maternal antithyroid antibodies or an iodine deficiency in the womb. Thyroid function in these children usually returns to normal and doesn’t require long-term treatment.
What is congenital hypothyroidism?
Congenital hypothyroidism means the disorder is present at birth. About 1,400 per 5,000,000 newborns are diagnosed with congenital hypothyroidism shortly after birth each year.
Congenital hypothyroidism is one of the most common, preventable causes of mental retardation. Children in the U.S. are tested for the disorder during their standard newborn screening. In about 10 percent of cases, congenital hypothyroidism is inherited by an autosomal recessive gene, which means that two copies of the gene are necessary to produce the condition and both males and females are equally affected. Most children born with congenital hypothyroidism appear normal at birth, possibly because the maternal thyroid hormones have sustained the infant's normal thyroid function in the womb.
Care for hypothyroidism
The Thyroid Center at Boston Children's is one of the only centers in the U.S. exclusively devoted to the care of children with thyroid diseases. We are distinguished by our expertise in thyroid ultrasonography, fine needle aspiration and radioiodine therapy. Our Thyroid Nodule Clinic is one of the largest and most experienced pediatric practices of its type in the U.S.
Hypothyroidism | Symptoms & Causes
What are the symptoms of hypothyroidism in children?
The symptoms of hypothyroidism in children are different than in adults. Each child may experience symptoms differently, and often the symptoms are not seen at all. This is why all infants should be screened for low thyroid.
Symptoms in newborns (neonatal hypothyroidism) may include:
- jaundice (yellowing of the skin, eyes, and mucous membranes)
- hoarse cry
- poor appetite
- umbilical hernia (navel protrudes out)
- slow bone growth
Childhood (juvenile hypothyroidism):
- slow growth, sometimes resulting in abnormally short limbs
- delayed tooth development
Adolescents (adolescent hypothyroidism):
- slow growth
- delayed puberty
- hoarse voice
- slow speech
- droopy eyelids
- puffy and swollen face
- hair loss
- dry skin
- slow pulse
- weight gain
What causes hypothyroidism in children?
The most common cause of hypothyroidism is the body's autoimmune reaction producing antibodies against the thyroid gland. A mother's thyroid disorder treatment (such as iodine) or maternal antithyroid antibodies can affect her unborn child's thyroid function.
Hypothyroidism | Diagnosis & Treatment
How is hypothyroidism diagnosed?
Congenital (present at birth) hypothyroidism is usually detected during a child’s routine newborn screening. Blood samples will reveal any abnormal levels of T4 or TSH hormones, which may indicate that your child has thyroid problems. Your physician may also want to scan your child’s thyroid gland to check for abnormalities.
What are the treatment options for hypothyroidism?
Left untreated in newborns, hypothyroidism can lead to mental retardation. Untreated hypothyroidism may also lead to:
- low body temperature
- heart failure
The goal of treatment is to restore the thyroid gland to normal function, producing normal levels of thyroid hormones. Treatment may include thyroid hormones to replace deficient hormones. Some children will require hormone replacement therapy for the rest of their lives, while others appear to outgrow the disorder, often by the age of 3. Regular monitoring of your child's thyroid hormone levels during the course of treatment, including a 30-day discontinuation of treatment to see how the thyroid responds, can help your child's physician diagnose your child's condition more accurately.