Thyroid Problems Treatment Options
Doctors called endocrinologists treat conditions linked to hormones, including problems with the thyroid. Thyroid hormones (and other hormones) are closely linked to a child’s growth and development. So children with thyroid problems need to see pediatric endocrinologists. They specialize in kids, and they will tailor treatment to your child’s age and the needs of your child’s growing body.
The team in our Endocrinology and Diabetes Department may be able to treat your child’s thyroid problem with no need for surgery.
For a child with too much thyroid hormone (overactive thyroid, or hyperthyroidism), doctors may prescribe a medicine to take by mouth every day to block thyroid activity. Common medicines for this are called propylthiouracil and methimazole. Or doctors may suggest treatment with radioactive iodine taken by mouth. The thyroid gland tends to take up, or concentrate, any iodine in the body. Then the radioactivity shrinks the thyroid, lowering the amount of hormone.
For a child with too little thyroid hormone (underactive thyroid, or hypothyroidism), doctors may prescribe pills of thyroid replacement hormone. This can keep the hormone level in the right range. Children taking these pills need to see the doctor regularly. The doctor will check their hormone level and adjust their medicine as they age and grow.
Some children with thyroid problems do need surgery.
A child with overactive thyroid may need surgery to remove the thyroid if one of these things happens:
- The medicine doesn’t correct their hormone level.
- The medicine causes unwanted side effects or an allergic reaction.
- The child cannot have radioactive iodine because of their age or size.
- The thyroid has gotten too large.
A child with thyroid nodules that clearly are benign (not cancer) might have surgery to remove the nodules if they are causing problems, such as because of their size.
A child with nodules that might be cancer or are clearly cancer will have surgery. If the area of concern is in one half, or lobe, of the thyroid, surgeons may remove only that half. This surgery is called lobectomy. If there are concerns about both lobes, they will remove the whole thyroid. This is called total thyroidectomy. If there is cancer in the thyroid, doctors will also check whether the cancer has spread to nearby lymph nodes or other structures. These may need to be removed, too.
For children with thyroid cancer, surgery is only one part of their treatment. Our surgeons work together with our childhood cancer doctors (oncologists) and nuclear medicine doctors to create a treatment plan for each child based on his or her needs. Seattle Children’s cancer program is part of Seattle Cancer Care Alliance, along with UW Medicine and Fred Hutchinson Cancer Research Center.
If multiple endocrine neoplasia (MEN II) runs in your family, your doctor may suggest having genetic testing and genetic counseling. This can help tell whether your child has MEN II and can give you information about your options. Children with MEN II nearly always get thyroid cancer. So families may choose to have the child’s thyroid removed early on — usually before age 5 — to prevent cancer from starting.
For one or more overactive parathyroid glands, surgeons may remove the glands causing the problem. There are four parathyroid glands near the thyroid. The body only needs one for normal function.
After surgery to remove the whole thyroid, children need to take thyroid hormone replacement pills so their bodies get this important hormone. If only half the thyroid is removed, the other half will make enough thyroid hormone to meet their needs.
You can read about what to expect when your child visits a clinic at Children’s, has surgery here or needs to stay in the hospital. You can get practical details about topics like what to do and bring the day of surgery and who will be on your child’s care team.