Pediatric – Thyroid Disorders

Pediatric Thyroid Disorders

The thyroid gland, which is a butterfly-shaped gland located in the front of the neck below the voice box (larynx), is essential to the process of turning food into energy — metabolism.

The thyroid uses iodine, found in iodized salt and some foods, to produce the thyroid hormone knowns as thyroxine or T4.

The thyroid gland is controlled by a variety of factors, but mainly by the pituitary gland in the brain. The pituitary gland talks to the thyroid by a chemical/hormone called thyroid stimulating hormone or TSH. Just like the name implies, the pituitary gland stimulates the thyroid to work more or less, depending upon the needs of the person.

The pituitary gland regulates the thyroid, through the secretion of TSH, to control heart rate, blood pressure, metabolic function and growth.   When the production of T4 is abnormal, diseased or malfunctioning in a child, the condition is known as a pediatric thyroid disorder.

Types of Pediatric Thyroid Disorders

In general, when the amount T4 in the blood is elevated, it is known as hyperthyroidism.  Alternatively, when T4 levels are low, it is known as hypothyroidism.  

The most common thyroid disorders in children include:

  • Hyperthyroidism (sometimes called Grave’s Disease) – Elevated T4 in the blood, with low TSH
  • Hypothyroidism (sometimes called Hashimoto’s Thyroiditis) –  Low levels of T4 in the blood, with high TSH
  • Thyroid Nodules –  A lump on the thyroid 
  • Thyroid Cancer – Rapid development of abnormal cells in the thyroid 
  • Multiple Endocrine Neoplasia Type 2 (MEN2) – A hereditary cancer syndrome that includes a type of thyroid cancer

Common Symptoms

The symptoms of pediatric thyroid disorders will vary but common symptoms include:


  • Hyperactivity/Nervousness
  • Increased Heart Rate
  • Tremors/Shaky Hands
  • Bulging Eyes
  • Flushed Skin
  • Muscle Weakness
  • Increased Appetite


  • Decrease of Energy
  • Lethargy/Fatigue
  • Slow Heart Rate
  • Cool Skin/Cold Intolerance
  • Slow Growth  & Development
  • Delayed Puberty

Thyroid Growths/Cancer

  • Enlarged Thyroid
  • Lump on the Thyroid
  • Trouble Breathing
  • Trouble Swallowing
  • Hoarseness/Voice Change
  • Firm, Hard Areas in the Neck

Common Causes

Congenital thyroid disorders exist at birth and are a result of being born with a nonfunctional thyroid.  Other causes are hereditary in nature and thus related to family history. Autoimmune conditions, where the immune system of the body erroneously attacks itself, are also a contributor of thyroid disorders.  Pituitary gland disorders may also be identified as the cause of thyroid conditions.

Diagnosis and Treatment

When a child is experiencing hyper- or hypothyroidism symptoms, Dr. Joshua Smith, our pediatric endocrinologist, will identify the specific thyroid disorder and develop a treatment plan.  Treatment plans typically include medication to help regulate a child’s T4 and in some cases may require surgery.

Thyroid nodules are not necessarily cancerous and such nodules don’t always require treatment.  However, when thyroid cancer exists, surgery, radioactive iodine therapy or targeted drug therapy may be used.

Pediatric Endocrinology Specialist

If your child is experiencing any of these symptoms, call Dr. Joshua Smith for an appointment or fill out the form below to request an appointment.  Dr. Smith is the region’s only specialist in pediatric endocrinology and is specifically trained to properly diagnose and treat thyroid disorders.

Appointment Form – Pediatric

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