9/21/22, 2:42 PM Hyperthyroidism in Children and Teens: Symptoms and Causes

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Conditions Thyroid Conditions Hyperthyroidism

Hyperthyroidism in Children and Teens

Though less common than in adults, excess production of thyroid hormone can occur in kids and adolescents,
especially girls. Here’s how to spot and address it.

Sep 15, 2022

Blythe Bernhard
Medical Reviewer: Ricardo Correa, MD, Ed. D, FACE, FACP, FACMQ

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9/21/22, 2:42 PM Hyperthyroidism in Children and Teens: Symptoms and Causes

The thyroid gland produces hormones which travel through the blood to all parts of the body. These hormones regulate the metabolism
of the cells and the body. In children, thyroid hormones help with normal growth and brain development and serve to maintain the
function of every organ. Children with hyperthyroidism have an excessive production of thyroid hormones, a problem that requires
medical attention.
The main cause of hyperthyroidism is Graves’ disease, which is an autoimmune condition that is more common in adults but can affect
people at any age.
While the signs of hyperthyroidism in kids can be subtle or mimic other conditions, if your child is experiencing several of the most
common symptoms, it’s worthwhile to seek out medical attention.

Common Signs and Symptoms of Hyperthyroidism in Kids

An overactive thyroid can speed up the body’s metabolism, heart rate, and other functions in children with hyperthyroidism. Some of
the common symptoms in children include:
• Abnormal growth spurts
• Anxiety
• Attention deficits or struggles to concentrate
• Declining grades in school
• Delayed puberty
• Fatigue
• Feeling overly warm
• Frequent bowel movements or diarrhea
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 • Rapid heartbeat (heart palpitations)
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• Insomnia
• Irritability
• Moodiness
• Nervousness
• Shaky hands (tremors)
• Weakness
• Weight loss, even with increased appetite
• Memory problems
Common Signs and Symptoms of Hyperthyroidism in Teens
While still rare, teenagers are more likely to develop hyperthyroidism than younger children.
The symptoms of hyperthyroidism in teens are similar to those seen in younger kids, along with a few additional signs to look for:
• Development of prominent or bulging eyes
• Goiter, or enlarged thyroid gland at the base of the throat
• Hair loss
• Increased sweating
• Menstrual cycle disorders in girls
• Restlessness
• Shiny and smooth skin
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 Shiny and smooth skin
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Causes and Risk Factors of Hyperthyroidism in Children and Teenagers

Hyperthyroidism in kids and teens is most commonly caused by Graves’ disease. Children with the condition have an antibody in their
immune system that overstimulates the thyroid gland. A combination of genetics, environmental factors, and the immune system are
believed to contribute to the development of hyperthyroidism in children.
Graves’ disease can run in families; a child is at higher risk for it if others in their family have thyroid conditions or other autoimmune
conditions such as Celiac disease, adrenal insufficiency, or type 1 diabetes. In rare cases, a pregnant mother with Graves’ can pass it on
to the developing fetus in a condition called neonatal Graves’ disease. Babies born with neonatal Graves’ disease typically outgrow it
within four months.
Graves’ is rare in children, who make up 1% to 5% of total cases. It appears much more frequently in girls than in boys. The risk of
childhood Graves’ disease increases with age and peaks during adolescence.
In about 3% of cases, hyperthyroidism in children can be caused by a thyroid nodule that overproduces hormones, a tumor on the
pituitary gland, or a reaction to medication used to treat other conditions.
This YouTube video shows the process of a thyroid exam for children and teens. Hyperthyroidism is diagnosed with blood tests of
thyroid hormone levels and a physical exam, where the thyroid gland is palpated. In some cases, the enlarged gland or goiter is visible
through the skin.

Treatment of Hyperthyroidism in Children and Teens

Hyperthyroidism in children and teenagers is highly treatable.
In most cases, the goal of treatment is to reduce or eliminate symptoms by lowering the thyroid’s production of hormones. About one-
fourth of children or teens with Graves’ disease will outgrow the condition on their own, but the majority will require some form of
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treatment.
Treatment options include drug therapy, which can put hyperthyroidism into remission, or more-permanent procedures if the drugs
grow less effective over time.
Drug Therapy

Anti-thyroid drugs block the production of new hormones and are typically prescribed as a first-line treatment. The only medication
approved for use in children and teens is called methimazole (brand name Tapazole). The drug is considered highly effective and safe
for children with hyperthyroidism. Common but temporary side effects can include joint pain or rash. More serious side effects occur in
fewer than 1% of cases and can include hepatitis (inflammation of the liver) or a decrease in white blood cells called neutropenia.
Radioactive Iodine Therapy

In this permanent treatment, radioactive iodine is absorbed by the thyroid cells to destroy them with a goal of stopping production of
thyroid hormones. The treatment consists of a small capsule taken by mouth. Radioactive iodine therapy has proven safe and effective
for more than 50 years. It cures hyperthyroidism in children in an estimated 95% of cases. It is typically not prescribed for children
younger than 10 to avoid exposure to radiation.
Surgery

A thyroidectomy, or surgical removal of the thyroid gland, is the recommended course of treatment for children and teens with thyroid
nodules that are overproducing hormones, known as autonomous or “hot” nodules. Surgery is typically recommended for children
younger than 10 with uncontrolled hyperthyroidism where drugs have failed to maintain a child’s remission. Side effects of thyroid
surgery include damage to the vocal cords or low calcium (hypoparathyroidism).
Children or teens who receive radioactive iodine or surgery to permanently treat hyperthyroidism will likely end up with its reverse,
hypothyroidism (underactive thyroid). Most of them will require lifelong thyroid replacement hormone therapy. But hypothyroidism can
be treated with a once-a-day pill. Kids and teens can be expected to return to their usual activities within weeks of radiation or surgical
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MORE ON THIS TOPIC

• Hyperthyroidism
• Hypothyroidism
• Thyroid Nodules
• Thyroiditis
• Papillary Thyroid Cancer
• Medullary Thyroid Cancer
• Hurthle Cell Thyroid Cancer
• Goiters
• Follicular Thyroid Cancer
• De Quervain's Thyroiditis
• Anaplastic Thyroid Cancer
• Thyroid Cancer
• Hashimoto’s Thyroiditis
• Thyroid Eye Disease
• Graves’ Disease
• Conditions

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Notes: This article was originally published August 24, 2022 and most recently updated September 15, 2022.
https://www.endocrineweb.com/conditions/hyperthyroidism/hyperthyroidism-in-children?ap=nl2001&rhid=62d863df652cb08baa0d4851&mkt_tok=NTQxLUdLWi0yNDMAAAGG-jCRC0AHaVZJketjbSEFtNbihh7yNdEdg… 7/8
 otes: s a t c e as o g a y pub s ed ugust , 0 a d ost ece t y updated Septe be 5, 0 .
9/21/22, 2:42 PM Hyperthyroidism in Children and Teens: Symptoms and Causes

Blythe Bernhard
Journalist
Blythe Bernhard is a staff writer and freelance journalist specializing in education and health care. She has
covered health care for the St. Louis Post-Dispatch and the Orange County Register and written for other
publications including Disability Scoop.

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