Hypothyroidism in Children: Symptoms and Treatments

The thyroid is a butterfly-shaped organ located in the front of the neck and plays a big part in the human body's metabolism, growth, and development. 

Hypothyroidism is an endocrine disorder in which the thyroid gland doesn't produce enough thyroid hormone that the body needs. An underactive thyroid is the most common thyroid disease and can affect anyone at any age. 

In fact, one in 3,000 to 4,000 newborns and one in 2,000 children are diagnosed with hypothyroidism in the United States each year. 

Congenital hypothyroidism

Congenital hypothyroidism occurs when a baby is born without the ability to make adequate amounts of thyroid hormones. Screening for hypothyroidism is mandatory for all newborns in the United States. 

Causes of congenital hypothyroidism 

Hypothyroidism in newborns is usually due to a non-functioning, underdeveloped or missing thyroid gland. Less common causes include:

• Medications taken by the mother during pregnancy

• Iodine deficiency in the mother's diet during pregnancy

• A thyroid blocking antibody passed from mother to baby

Acquired hypothyroidism

Acquired hypothyroidism is hypothyroidism that develops later in childhood and adolescence. Hashimoto thyroiditis is the most common cause of acquired hypothyroidism in children and occurs when the immune system mistakenly attacks cells in the thyroid gland.

Children who are at risk of developing acquired hypothyroidism 

While hypothyroidism can develop in anyone, certain children are at greater risk.

Risk factors for children include:

• Congenital disorders, like Down syndrome

• Autoimmune diseases, like Type 1 diabetes

• radiation for cancer treatment

• Injury to the thyroid gland 

• A family history of autoimmune thyroid disease

• Inadequate iodine intake 

Signs and symptoms of hypothyroidism in children 

Hypothyroidism symptoms in children can differ from those in adults. Symptoms can also vary from child to child. 

Newborns (neonatal hypothyroidism):

These symptoms usually occur within the first few weeks or months after birth. Many times the signs are subtle and easily overlooked by parents and doctors. Hypothyroidism screening right after birth is critical because starting treatment right away can prevent these:

• Jaundice (yellowing of the skin and whites of the eyes)

• Decreased crying or a weak cry 

• Poor appetite

• Umbilical hernia (navel protrudes out)

• Constipation

• More prominent soft spot on the head 

• Slow bone growth

Childhood (juvenile hypothyroidism)

• Slow growth, which can cause shorter limbs 

• Delayed tooth development

• Decreased energy

• Dry skin

• Dry, brittle hair 

• Constipation 

• Lack of school performance 

• Cold intolerance 

Adolescents (adolescent hypothyroidism)

• Slow growth

• Delayed puberty

• Hoarse voice

• Slow reaction time

• Droopy eyelids

• Puffy face

• Hair loss

• Heavy or irregular periods in girls 

• Enlarged thyroid gland 

(Many of the same symptoms can occur in childhood and adolescents)

Treatment for children with hypothyroidism 

If your child is showing any signs of hypothyroidism or you are concerned about their health, seeing your pediatrician is an important first step in their treatment.  

The typical treatment for babies, children, and teens with hypothyroidism is a synthetic thyroid hormone called levothyroxine (Synthroid). Dosage is determined by your doctor based on the age and weight of your child.

Since your child's dosage will change as they grow, it's critical to have them seen and retested frequently to ensure they are getting the right amount of medication.

Untreated hypothyroidism can lead to:

• developmental delays, including sexual maturity 

• stunted growth

• intellectual disabilities

• anemia

• fertility issues in adulthood

• low body temperature

• heart failure

Final thoughts

Hypothyroidism can be a lifelong condition for your child, but it can be managed. Many children with hypothyroidism lead a healthy, normal life as long as they are consistent with their medicine.

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