Located in the neck, the thyroid gland is responsible for producing a range of hormones that regulate the body's metabolism (chemical reactions in the body that help it function and grow). Hyperthyroidism (overactive thyroid) occurs when the thyroid gland makes too much thyroid hormone.
Hyperthyroidism occurs more commonly in adolescents and more often in girls than boys. However, hyperthyroidism can occur in younger children of both genders.
Symptoms of hyperthyroidism in children may include:
- Enlarged thyroid gland
- Weight loss
- Excessive sweating or feeling warm when others are comfortable
- Fast or irregular heartbeat
- Moodiness or irritability
- Bulging or prominent eyes
- Hand tremors
- Trouble sleeping
- Frequent bowel movements
- Poor school performance
Hyperthyroidism in children may be caused by:
- Graves disease. Graves disease is an autoimmune thyroid condition and is the most common cause of hyperthyroidism in children. With Graves disease, the body's immune system makes antibodies that overstimulate the thyroid gland and cause it to be overactive. With time, the thyroid gland grows larger. Graves disease can also cause the tissues behind the eyes to swell, causing the eyes to be prominent or bulge.
- Hashimoto thyroiditis. Hashimoto thyroiditis is an autoimmune disorder in which the thyroid gland is usually enlarged. This usually causes hypothyroidism (underactive thyroid), but it can sometimes cause the gland to release too much thyroid hormone or develop thyroid nodules. This is a less common cause of hyperthyroidism.
- Subacute thyroiditis. Subacute thyroiditis is caused by a viral infection. The infection may cause the thyroid to become painful and inflamed and release too much thyroid hormone. The thyroid usually returns to normal once the infection clears. Hyperthyroidism caused by subacute thyroiditis is rarely permanent.
Diagnosis of Hyperthyroidism
Your child's doctor at Riley at IU Health can use the following exams and tests to diagnose hyperthyroidism:
- Physical exam. Your child's doctor can feel the thyroid by physically examining the neck. An enlarged thyroid gland may indicate a thyroid problem.
- Blood test. Your child's doctor can perform a blood test to confirm a diagnosis of hyperthyroidism. In hyperthyroidism, blood tests show high levels of the thyroid hormones triiodothyronine (T3) and thyroxine (T4) and decreased levels of thyroid-stimulating hormone (TSH).
Hyperthyroidism is most commonly treated with:
- Anti-thyroid medicine. Anti-thyroid medicine causes the thyroid gland to make and release fewer hormones. About 20-30 percent of children can safely stop the use of anti-thyroid medicine after two years of treatment. This medicine may lead to hypothyroidism if the dose is too high. If this happens, your child’s medication dose may need to be decreased.
- Radioactive iodine. Older children and teenagers can take radioactive iodine. Taken as a capsule or drink, radioactive iodine slowly destroys the thyroid gland over a period of months. If your child experiences side effects from using anti-thyroid medicine, such as hives, itching, rash, joint pain or low white blood cell count, or if the medicine stops working, he or she may also take radioactive iodine. This causes hypothyroidism, so your child will need to take levothyroxine every day for life if he or she undergoes this treatment. Radioactive iodine and thyroid medicine are safe for use in children.
- Thyroid surgery. Rarely, if treatment with medicine is not enough, the thyroid gland may be surgically removed. This treatment carries risks, though. Risks include damage to the parathyroid glands (leads to low calcium and high phosphorous in the blood) and laryngeal nerves (causes a hoarse voice). Removal of the thyroid causes hypothyroidism, so your child will need to take levothyroxine every day for life if he or she undergoes this treatment.
Hyperthyroidism responds well to treatment and is a manageable condition.
Key Points to Remember
Key Points to Remember
- Hyperthyroidism occurs when the thyroid gland produces too much thyroid hormone.
- Graves disease is the most common cause of hyperthyroidism in children.
- Anti-thyroid medicine causes the thyroid gland to make less thyroid hormone and is one of the common treatments for hyperthyroidism.
- Radioactive iodine may be used to treat hyperthyroidism in older children and teenagers.
- If treatment of hyperthyroidism causes permanent hypothyroidism, your child will have to take a thyroid pill every day for life.
Support Services & Resources
Support Services & Resources
Visit the links below to learn more about hyperthyroidism and discover support groups and resources.
Riley at IU Health offers a broad range of supportive services to make life better for families who choose us for their children's care.
This website by the U.S. National Library of Medicine provides in-depth information about hyperthyroidism.
Read this online brochure from the American Thyroid Association to learn more about Graves disease.
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