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Thyroid Disorders in Children

Diagnosis and management of pediatric hypothyroidism, hyperthyroidism, and thyroid nodules

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Çocuk Sağlığı ve Hastalıkları department. Book Appointment →

What is Thyroid Disorders in Children?

Congenital hypothyroidism affects ~1 in 3,000-4,000 newborns and is detected by mandatory newborn screening; untreated, it causes intellectual disability and growth failure.

Acquired hypothyroidism in children is most often due to Hashimoto autoimmune thyroiditis, with female predominance and frequent association with Down or Turner syndrome.

Pediatric hyperthyroidism is uncommon; Graves disease is the leading cause and presents with goiter, ophthalmopathy, weight loss, and tachycardia.

Thyroid nodules in children carry a higher risk of malignancy than in adults (~20-25%), so any pediatric thyroid nodule warrants ultrasound and fine-needle aspiration.

Symptoms

Hypothyroidism: fatigue, cold intolerance, constipation, dry skin, weight gain, growth deceleration, delayed puberty, poor school performance
Congenital hypothyroidism: prolonged jaundice, hypotonia, feeding difficulty, large fontanelles, umbilical hernia
Hyperthyroidism: weight loss despite increased appetite, heat intolerance, tachycardia, tremor, behavioral changes, exophthalmos
Goiter (visible or palpable thyroid enlargement)
Thyroid nodule: painless neck mass, sometimes with hoarseness or cervical lymphadenopathy

Risk Factors

Family history of thyroid disease, especially autoimmune
Down syndrome, Turner syndrome, type 1 diabetes (autoimmune polyglandular syndromes)
History of head/neck radiation (for malignancy)
Iodine deficiency (in endemic regions) or excess
Female sex (especially adolescents) for autoimmune thyroid disease

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Apply for evaluation if newborn screening reveals abnormal TSH or T4 — confirmatory testing within 2-4 weeks
  • Re-evaluate any child with growth deceleration, school performance decline, or behavioral changes
  • Seek prompt review for any palpable neck mass, persistent goiter, or symptoms of hyperthyroidism
  • Schedule annual thyroid screening in children with Down/Turner syndrome, type 1 diabetes, or family history

Treatment Methods

01
Hypothyroidism: levothyroxine titrated to maintain TSH in age-specific range; congenital cases need treatment within 2 weeks of birth
02
Hashimoto thyroiditis: levothyroxine if hypothyroid; periodic monitoring if euthyroid with positive antibodies
03
Graves disease: methimazole as first-line (avoid PTU due to hepatotoxicity); definitive therapy with radioiodine or thyroidectomy if relapse
04
Thyroid nodules: ultrasound, fine-needle aspiration; surgical excision for suspicious or malignant cytology, with thyroid cancer follow-up
05
Multidisciplinary care including pediatric endocrinology, surgery (when indicated), and family counseling on lifelong therapy and adherence

Which Department to Visit?

You can visit our Çocuk Sağlığı ve Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.