Janie didn't notice the changes very much at first - but her
teachers did. Since starting sixth grade, Janie had become
restless. She was squirmy and nervous, and it was hard for her to
sit still in class. Paying attention was hard, too. Finally,
Janie's teachers asked the school nurse to call her father.
Janie's dad had noticed some changes as well. She was eating
more than usual. But instead of gaining weight, Janie was getting
thinner. And even though it was December, she was sweating a
lot.
He decided it was time for Janie to have a checkup. It
didn't take Janie's doctor long to discover what was wrong.
Janie had a problem with her thyroid gland. Now the doctor knew
just how to help her. But first Janie had a question: What in the
world is a thyroid?
What Is the Thyroid?
The
thyroid
(say:
thi
-royd) is a gland, which is an organ where special chemicals are
produced. These chemicals are called
hormones
(say:
hor
-moans). The major hormones that the thyroid makes and releases
into the bloodstream are called T4 or
thyroxine
(say: thi-
rocks
-in) and T3 or
triiodothyronine
(say: tri-eye-o-doe-
thi
-row-neen). All the cells in the body need thyroid hormones to work
properly. These hormones control how fast the body uses up energy.
They are also key factors in helping kids grow.
The thyroid is shaped like a little butterfly or bow tie and it
sits under the skin in the front of your neck. To find it, touch
your throat in the
Adam's apple
area with one finger and the top of your breastbone (the flat bone
that runs down the middle of your chest) with another finger. The
thyroid is in that small space in between your fingers. (And it
bobs up and down when you swallow. See if you can feel it!)
The thyroid works like the thermostat in your house. If the
thyroid is too active and produces too much T4 and T3, it's
like having a thermostat that's set too high, so the house gets
overheated. If it's not active enough, it's set too low and
the house is too cold. And if it's making just the right amount
of thyroid hormones, then it keeps the temperature just right.
What Is Thyroid Disease?
There are two main kinds of thyroid disorder or thyroid disease.
Hyperthyroidism
(say: hi-per-
thi
-roy-diz-em) happens when the thyroid is too active and releases
too much thyroid hormone into the blood. Kids with the opposite
problem have
hypothyroidism
(say: hi-po-
thi
-roy-diz-em). In this case, the thyroid isn't active enough, so
not enough thyroid hormone is being made and released into the
kid's bloodstream.
Why Do Kids Get Thyroid Disease?
In most cases, doctors and scientists can't say exactly why
a kid gets thyroid disease. It's not something that you can
catch from someone else like a cold, and usually it isn't
caused by anything you've eaten (or didn't eat) or done to
your body.
A kid with thyroid disease may have inherited the condition
because the tendency to get thyroid disease may run in the family.
That means that a kid's mom or dad, grandparents, or other
close relatives might have thyroid problems, too.
A baby can have hypothyroidism from birth if he or she is born
without a thyroid gland or if the thyroid didn't develop
completely before birth. And sometimes a baby's thyroid is
fully developed at birth, but it just can't make enough thyroid
hormone.
Not having enough
iodine
(say:
eye
-o-dine) in the diet can cause thyroid problems. Iodine is a
mineral that's needed by the body to make thyroid hormone.
It's found naturally in foods like seafood and milk. After
scientists discovered that iodine is so important to the thyroid,
it was added to most kinds of salt we use to help make sure that
people get enough iodine in what they eat. Because of this,
it's very uncommon for a kid in the United States to get a
thyroid problem from lack of iodine.
Some medications also can cause thyroid problems by blocking the
thyroid from making enough hormone.
What Are the Symptoms of Thyroid Disease?
Kids with hyperthyroidism can feel jumpy and have trouble
concentrating. Like Janie, their
hearts
might beat fast and their hands may tremble. They can
sweat
a lot and have trouble sleeping. And even though they might have
more of an appetite, they often lose weight or stop gaining it as
they grow. Sometimes kids with hyperthyroidism will have a
wide-eyed stare all the time, as if they are frightened, and in
some cases their eyes may bulge out somewhat.
Kids with hypothyroidism tend to feel tired and not have much
energy. Their hearts might beat slower and they may feel cold when
the temperature of the room is comfortable for everyone else. Their
hair
may become brittle and break off more easily, and their
skin
may be dry and look pale and yellowish.
Constipation
(infrequent, hard bowel movements) can be a problem.
Kids with hypothyroidism tend to grow more slowly and may not
show the changes of
puberty
until they receive treatment. The doctor may suspect hypothyroidism
if he or she sees that a kid's
growth
is not staying on track on the growth charts. Although kids with
hypothyroidism may tend to gain weight more easily, thyroid disease
is almost never the cause of the problem in kids who are
overweight.
A
goiter
(say:
goy
-ter) is another symptom of thyroid disease. A goiter results when
the thyroid gland gets swollen, or enlarged. A goiter can happen
either when the thyroid is too active or when it's not active
enough.
Sometimes a lump, called a
nodule
(say:
nod
-jool), can develop in the thyroid gland, indicating thyroid
disease.
What Will the Doctor Do?
When Janie went for her checkup, the doctor examined her thyroid
and found that she had a goiter. The doctor also did blood tests to
check how much thyroid hormone her thyroid gland was making - it
was making too much.
In most cases of thyroid problems in kids, the
doctor
doesn't need to do anything other than a physical examination
and blood tests to find out what's wrong. But sometimes,
especially if the kid has a nodule in the thyroid gland, the doctor
may order other tests such as an ultrasound study or a special
scan, called a
thyroid scan
, that's like an X-ray.
If the tests show that a kid has hyperthyroidism, the doctor
will usually start him or her on medication that keeps the thyroid
from making too much thyroid hormone. But if the thyroid problem
doesn't go away after the person has taken the pills for about
2 years, the doctor may decide (along with the patient and the
patient's family) that other treatment should be given to
permanently keep the thyroid from overproducing thyroid hormone.
This might involve taking a medicine by mouth that destroys the
thyroid gland or removing most of the gland with surgery.
Whichever treatment is used, hyperthyroidism can be controlled
and its symptoms will go away. A kid who has this condition will
need to have blood tests done - usually a couple of times a year -
to be sure the treatment is keeping the levels of thyroid hormone
in the blood normal.
Blood tests are also done to diagnose hypothyroidism. All babies
are tested for hypothyroidism right after they're born, even if
they don't have symptoms. It's important to treat a baby
with hypothyroidism in the first few weeks of life. Otherwise, the
baby won't grow and develop normally.
The good news is that hypothyroidism is easy to treat. Kids with
this disease will have to take a pill every day, but their symptoms
will go away. They'll usually need to take this medicine for
the rest of their lives, but it's a simple way to make sure the
body has enough thyroid hormone to grow and develop normally.
Kids who have been growing slowly because of hypothyroidism will
usually catch up to their correct height after they're treated.
They'll go through puberty the way they should, too. Kids who
have hypothyroidism will also need to have blood tests to measure
their thyroid hormones once or twice a year to guide their
treatment.
With a little care, the thyroid and the conditions it may cause
can be easily managed. The end result? You'll feel like
yourself again!
Reviewed by:
Steven Dowshen, MD
Date reviewed: March 2006
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
© 1995-2009 The Nemours Foundation/KidsHealth. All rights reserved.