Three thyroid-related conditions that children may more commonly develop include Graves’ disease, Hashimoto’s thyroiditis, and thyroid nodules. Talking with their pediatrician about symptoms and testing can help with diagnosis.
Children, like adults, can also develop thyroid diseases and conditions. Some may be born with a condition, while others may develop one later in their childhood.
Causes may include an underlying health condition, surgery, or treatment for a different health problem.
While most thyroid conditions don’t have a cure, proper treatment and lifestyle modifications can help manage the symptoms.
Though this article lists some of the more common thyroid-related conditions in children, they still occur at relatively low rates. Most of these conditions are more likely to occur in adults but can happen at any age.
This condition is less common in children than in adults, yet according to a 2023 research review, it’s the most frequent cause of hyperthyroidism in adolescents.
The exact cause isn’t well understood, but experts believe it to be a mix of:
- genetics
- environment
- immune system differences
Symptoms
Graves’ disease can occur at any time, but it often becomes more common as a child enters adolescence.
It presents itself with characteristic signs and symptoms of hyperthyroidism, including:
- tachycardia (fast heart rate)
- goiter (enlarged thyroid gland)
- diarrhea
- increased appetite with or without weight loss
Diagnosis
To provide a diagnosis, a doctor might test for high levels of FT4 and free FT3 and low thyroid-stimulating hormone levels (TSH) in the blood and perform a physical exam.
Depending on the results, a child may need to undergo more testing.
Treatment
Treatment for children with Graves’ disease will depend on their age, the severity of the disease, personal preferences, and, if present, goiter size.
Options may include:
- antithyroid drugs
- thyroidectomy
- radioiodine
This condition is the most common cause of hypothyroidism in children. It often occurs in children who live with an autoimmune disorder already, such as type 1 diabetes or celiac disease.
Multiple factors are likely at the root of this condition, including:
- genetics
- environment
- hormones
Symptoms
Like Graves’ disease, Hashimoto’s thyroiditis may develop at any time, but when it occurs in children, it’s more common as they reach adolescence.
Symptoms can mimic those of other conditions. Some of the more telltale signs and symptoms include:
- goiter
- slow height growth
- cold intolerance
- unexplained weight gain
- menstrual cycle irregularities
- bradycardia (slow heart rate)
- pale or yellowish skin tone with facial puffiness (myxedema)
However, children with Hashimoto’s thyroiditis might not show any symptoms at all. Instead, their pediatrician might observe signs during a routine checkup.
Diagnosis
A doctor will most likely perform a physical exam to look for a goiter, ask about symptoms, and run blood tests to check thyroid status.
From the blood tests, they’ll
However, these tests can sometimes indicate normal thyroid function (euthyroidism). Additional testing may be warranted in this case.
Treatment
Whether Hashimoto’s thyroiditis requires treatment is largely dependent on a child’s thyroid levels.
If treatment is required, a doctor might recommend hormone therapy, such as levothyroxine, which may help maintain normal thyroid levels. This therapy will likely be needed for life.
The risk of developing thyroid nodules increases with age. The condition itself occurs at a relatively low rate in children — at just about 1% to 2%.
Thyroid nodules are usually not a cause for concern. But a 2018 study estimates that about 19% may be cancerous, especially if they present with certain characteristics.
Symptoms
A child with a thyroid nodule will have a firm lump in their thyroid gland, which is located in the front of the neck. But some nodules are too small to be felt with a physical exam.
Thyroid nodules uncommonly cause other symptoms. If symptoms do occur, they may include:
- hoarseness
- difficulty swallowing (dysphagia)
- difficulty breathing
Diagnosis
Most thyroid nodules are diagnosed by having a visible or tangible neck mass. In some cases, radiological imaging (for reasons other than examining the thyroid) may discover the mass.
An ultrasound may be used to confirm the presence of a thyroid nodule if one is suspected. A fine needle aspiration biopsy may be performed to rule out cancer.
Treatment
If the nodule doesn’t show signs of growth or is benign (noncancerous), no treatment may be required. The nodule will be monitored with regular checkups and ultrasounds.
However, surgical removal is often the first-line treatment if the nodule:
- is cancerous or potentially cancerous
- grows larger (more than 3 to 4 centimeters across)
- produces too much thyroid hormone
- negatively impacts quality of life
When to seek medical attentionIf a child shows symptoms of any of the conditions mentioned in this article, or other symptoms of hyperthyroidism and hypothyroidism, you should speak with their pediatrician.
In most cases, hormone therapy or other medication may help manage symptoms and balance thyroid levels. Surgery may be required in more serious situations.
Hashimoto’s thyroiditis, Graves’ disease, and thyroid nodules are among the most common thyroid-related conditions in children, though they occur at relatively low rates overall in children. They’re much more common in adults.
While these conditions can present with symptoms, they may sometimes be asymptomatic. Treatment often depends on the severity of the condition in the child
Speak with their pediatrician if you have concerns about a child’s thyroid health. They can perform diagnostic tests, such as blood draws and physical exams.