Hypothyroidism (Low Thyroid Level)

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KEY POINTS

• Hypothyroidism means that your child’s thyroid gland does not make enough thyroid hormone.
• Your child’s healthcare provider will prescribe thyroid hormone medicine. Most likely, your child will need to take thyroid hormone medicine every day for the rest of your child’s life.
• Follow the full course of treatment prescribed by your child’s healthcare provider. Your child should not stop taking the prescribed medicine or change the way it’s taken unless advised by the healthcare provider.

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What is hypothyroidism?

Hypothyroidism is when the thyroid gland does not make enough thyroid hormone.

The thyroid gland is in the lower front of your child’s neck. This gland takes iodine from the food your child eats to make thyroid hormones. Thyroid hormones are chemicals that control the way your child’s body turns the food eaten into energy and how fast or slowly your child’s body uses that energy. They also control body functions such as temperature, heart rate, and appetite. They also affect emotions, growth rate, and puberty.

Mild hypothyroidism may cause no symptoms. Without treatment, however, the disease can cause heart problems or problems with memory and thinking.

Hypothyroidism is more common in girls than in boys.

What is the cause?

Low thyroid levels may be caused by:

• Inherited thyroid problems, which means that they are passed from parents to children through their genes. Genes are inside each cell of the body. They contain the information that tells the body how to develop and work.
• Thyroiditis, which is swelling and irritation of the thyroid gland. There are different types of thyroiditis. Hashimoto's thyroiditis is the most common type. It is an autoimmune disease, which means it causes your child’s body to mistakenly attack its own tissue. Thyroiditis may also be caused by a virus or bacteria. Sometimes the cause of thyroiditis is unknown.
• Radiation treatment, which can destroy the thyroid gland and its ability to make thyroid hormone. This may happen if your child takes radioactive iodine for an overactive thyroid gland, or if your child has radiation treatment for cancer of the jaw, neck, or upper body.
• Medicine taken to treat high thyroid levels. If your child takes medicine for a thyroid problem, your child’s thyroid levels should be checked as often as advised by your provider. Tell your child's healthcare provider and pharmacist about all the prescription and nonprescription medicines, natural remedies, vitamins, and supplements your child takes. Some medicines and supplements change how thyroid medicine works.
• Surgery to remove all or part of your child’s thyroid gland for another thyroid problem

What are the symptoms?

Symptoms may slowly get worse for months or even years. Symptoms may include:

• Puffiness or swelling in the face and neck
• Feeling tired all the time
• Depression
• Weakness
• Constipation
• Weight gain
• Feeling cold a lot of the time
• Heavy, long menstrual periods in females
• Dry skin, hair, or nails
• Hoarse voice
• Trouble concentrating or remembering
• Feel confused and irritable, and have worsening problems with thinking

After several months or years of untreated hypothyroidism, you may be slow to talk and move, be less alert, and feel drowsy much of the time. It may also cause heart damage.

Symptoms may slowly get worse over months or even years. Symptoms may include:

• Puffiness or swelling in the face and neck
• Feeling tired all the time
• Constipation
• Slow growth and development
• Mild weight gain
• Feeling cold a lot of the time
• Dry skin, hair, or nails
• Hoarse voice
• Trouble learning or remembering
• Your child may have delayed puberty, but some children can have early breast development in girls younger than 7 and enlarged testicles in boys younger than 9.
• Heavy or long menstrual periods in young women

After several months or years of untreated hypothyroidism, your child may be slow to talk and move, be less alert, and feel drowsy much of the time. Heart damage can also occur.

How is it diagnosed?

Your healthcare provider will ask about your child’s symptoms and medical history and examine your child. Your child will have blood tests. Newborns get tested at birth.

How is it treated?

Your healthcare provider will prescribe thyroid hormone medicine. After starting treatment, your child will have blood tests to be sure your child is getting the right amount of thyroid hormone. It may take several weeks to find the right dosage for your child. Once the correct dosage is found, your child’s thyroid hormone level will need to be checked regularly.

Most likely, your child will need to take thyroid hormone medicine every day for the rest of his or her life.

Children often start to grow taller very quickly once they start treatment. Your child’s growth should be carefully monitored by your healthcare provider. Your child may be referred to a healthcare specialist who treats diseases of thyroid glands to help check growth rate and hormone treatments.

How can I take care of my child?

Follow the full course of treatment prescribed by your child’s healthcare provider. Your child should not stop taking the prescribed medicine or change the way it’s taken unless advised by the healthcare provider.

Your child will need to have blood tests to check thyroid hormone level every few months for the rest of his or her life. The tests can help make sure your child is getting the right amount of medicine.

• Ask your child’s healthcare provider:
  • How and when you will get your child’s test results
  • If there are activities your child should avoid and when your child can return to normal activities
  • How to take care of your child at home
  • What symptoms or problems you should watch for and what to do if your child has them
• Make sure you know when your child should come back for checkups. Keep all appointments for provider visits or tests.