Thyroid conditions in children
From newborn screening and congenital hypothyroidism to underactive and overactive thyroid in childhood, and the result that is only slightly high.
What does the thyroid do?
The thyroid is a small gland at the front of the neck that sets the speed at which the body works. Thyroid hormone is needed for brain development in the first years of life and for growth in height throughout childhood.
Congenital hypothyroidism and newborn screening
Some babies are born with a thyroid that does not make enough hormone. These babies often look healthy, which is why a blood sample is taken from the heel in the first days of life.
If you are called to repeat the screening test, act the same day. Most of these results are normal on repeat, but for a baby who truly has the condition, early treatment matters greatly for the brain. Treatment is a daily tablet, and most children treated early and regularly grow and learn normally.
Underactive thyroid in childhood and the teenage years
The most common cause is an autoimmune condition (Hashimoto’s). These signs appear slowly:
- Slower growth in height
- Tiredness and feeling cold
- Constipation and dry skin
- Falling school results or late puberty
- A swelling in the neck (goitre)
The diagnosis is made with TSH and T4 blood tests, and the treatment is levothyroxine tablets. The amount changes as a child grows, and regular tests are needed.
Overactive thyroid
This is less common in children, and the usual cause is Graves’ disease. Signs include weight loss with a good appetite, a racing heart, shaky hands, restlessness, poor concentration, feeling hot and sweating, and sometimes prominent eyes. The first treatment is usually medicine, with regular follow-up during treatment. If a child on this medicine develops a fever or sore throat, call the doctor the same day, because the blood count needs checking.
A lump in the neck
Have any swelling at the front of a child’s neck examined. Thyroid nodules are less common in children than in adults, but they need a closer look.
A result that is only slightly high
A slightly high TSH with a normal T4 in an older child often needs no medicine and is settled by a repeat test. Read the article on slightly high TSH.
Frequently asked questions
My child is overweight. Is the thyroid the cause?
Rarely. An underactive thyroid mainly slows growth in height and usually adds little weight. A child who is growing tall well and is overweight is unlikely to have a thyroid problem.
How long must the thyroid tablet be taken?
It depends on the cause. Some children need it for life, and some babies are reassessed after a few years with the doctor's advice. Do not stop the tablet yourself.
Can I give the tablet with milk?
Calcium, iron and some foods reduce the absorption of this tablet. Agree the timing with the doctor and give it the same way each day.
The first step is a calm measurement.
Talk to the support team to arrange a visit. If you have your child's earlier heights and weights, find them and bring them along.