Does My Teen Have Thyroid Disease?

It could be easy for you to miss that your teen has thyroid disease. Symptoms can be subtle, appear gradually and be mistaken for other conditions. Hormones produced by the thyroid can affect heart rate, energy, metabolism, growth and development – so it’s important to know the signs.

Understanding Thyroid Disease

There are two kinds of thyroid disease that your teen could have. Hypothyroidism is from an underactive thyroid gland, most likely from an autoimmune condition called Hashimoto's thyroiditis. Hyperthyroidism is the result of an overactive thyroid gland from an autoimmune condition called Graves’ disease.

Teens can get both diseases, but hypothyroidism is much more common. Primary thyroid disease is more prevalent in females, especially if there is family history of an autoimmune disorder. (Primary hypothyroidism means that the thyroid gland itself is diseased, while secondary hypothyroidism is caused by problems with the pituitary gland, the brain structure that controls the thyroid gland.)

The most important sign of primary thyroid disease is the development of an enlarged thyroid gland known as a goiter. This is a butterfly-shaped mass near the Adam’s apple. A goiter may be an overall enlargement of the thyroid or it may be the result of irregular cell growth that forms one or more lumps in the thyroid.

Other Symptoms of Thyroid Disease

Symptoms of hypothyroidism can include:

• Fatigue
• Poor growth
• Weight gain
• Irregular menstrual cycles
• Cold intolerance
• Changes to hair and skin
• Constipation

The symptoms of hyperthyroidism are the opposite of hypothyroidism, and they include:

• Hyperactivity
• Jittery behavior
• Rapid heartbeat
• Weight loss
• Bulging eyes

Although these signs may indicate a thyroid problem, they also can be attributed to other factors, so a thorough evaluation and diagnosis by your teen’s doctor is essential.

Causes of Thyroid Disease

If your teen has thyroid disease, the most likely cause is one of the autoimmune diseases mentioned above. Less common causes of hypothyroidism in children include:

• Thyroiditis, a temporary inflammation of the thyroid that may be caused by a viral infection.
• Surgical removal of the thyroid gland to treat thyroid nodules, thyroid cancer or Graves’ disease.
• Radiation treatment that destroys or injures the thyroid, including radioactive iodine to treat Graves’ disease or radiation to the neck area used to treat Hodgkin’s disease, lymphoma or other cancers.
• Medicines like lithium, amiodarone and oxcarbazepine that can prevent the thyroid gland from working.
• Too much or too little iodine, which can prevent the thyroid gland from working normally.
• Damage to the pituitary gland, which tells the thyroid how much hormone to make. When the pituitary is damaged, it may no longer be able to make enough TSH to ensure normal thyroid function.

Diagnosing Thyroid Disease

Hypothyroidism is diagnosed by physical examination and blood tests. Your teen’s doctor also may order an ultrasound or radioactive iodine scans to check the internal structure of the thyroid.

Treating Thyroid Disease

Your teen’s hypothyroidism is treated by replacing the missing thyroid hormone with a pill that is taken once a day. Regular blood tests monitor thyroid levels so the dose can be adjusted as needed.

In contrast, treatment for hyperthyroidism is much more difficult and may involve anti-thyroid medication, thyroid surgery or radioactive iodine ablation. Your teen’s doctor will recommend  the best option after reviewing the risks and benefits of each treatment with you.

Untreated hypothyroidism in a child can result in poor growth, severe short stature and compromised final adult height. In addition, decreased metabolism can cause weight gain and increased body mass index resulting, causing metabolic complications such as insulin resistance, diabetes and dyslipidemia. Untreated hyperthyroidism can lead to unhealthy weight loss, rapid or irregular heartbeat, cardiac complications and osteoporosis.