Endocrine and Immune System Conditions

Thyroid Problems

What Are Thyroid Problems?

The thyroid is a small gland in the front of the neck. It is shaped like a butterfly. One half (lobe) of the thyroid lies along one side of the windpipe (trachea), and one half lies along the other side. It's between the Adam's apple and breastbone.

A healthy thyroid makes hormones that control metabolism - the way the body breaks down food and uses or stores the energy. Common thyroid problems are:

  • Too much thyroid hormone (overactive thyroid, or hyperthyroidism)
  • Too little thyroid hormone (underactive thyroid, or hypothyroidism)
  • Thyroid nodules
  • Thyroid cancer

Near the thyroid are four small glands called the parathyroid glands. These control the level of calcium in the body. They can also develop problems, like being overactive (hyperparathyroidism).

Thyroid Problems in Children

Children can get thyroid problems, including overactive thyroid, underactive thyroid, thyroid nodules and thyroid cancer.

Most children with overactive thyroid have Graves disease. In Graves disease, the child's own immune system makes antibodies (proteins that normally fight infection) that are not normal and that increase thyroid activity.

Some children with underactive thyroid have Hashimoto's disease. In Hashimoto's disease, the child's own immune system makes antibodies that are not normal and that decrease thyroid activity.

Thyroid nodules are small lumps that form in the thyroid. They can be fluid-filled sacs (cysts) or solid masses. Most thyroid nodules are not cancer (benign), but some are cancer (malignant).

The most common type of thyroid cancer in children is called papillary carcinoma. Children can also get other types of thyroid cancer - follicular carcinoma of the thyroid and, rarely, medullary carcinoma of the thyroid (MCT). MCT can run in families.

Some children with thyroid cancer have another condition that runs in families, called multiple endocrine neoplasia (MEN II).

Parathyroid problems are rare in children. The most common parathyroid problem is one or more overactive glands (hyperparathyroidism). This causes the child's calcium level to be higher than normal.

Thyroid Problems at Seattle Children's


Many children with thyroid problems see our doctors who specialize in conditions linked to hormones (endocrinologists). So your child may first visit our Endocrinology and Diabetes Department. The team there may be able to diagnose and treat your child's thyroid problem, with no need for surgery. Medicine may be all your child needs to correct too much or too little thyroid hormone.


Some children with thyroid problems do need surgery. Our surgeons are experienced at doing the surgeries these children may need, including removing thyroid nodules and removing part or all of the thyroid gland. We'll work closely with you and your child's healthcare providers to tell whether your child needs surgery, which procedure is best and how to fit it in with the rest of your child's treatment.

Team approach

When you come to Seattle Children's, you have a team of people to care for your child. Along with your child's physicians, you are connected with nurses, dietitians, child life specialists, social workers and others. We work together to meet all of your child's health needs and help your family through this experience.

Focus on children

Since 1907, Seattle Children's has been treating children only. Our team members are trained in their fields and also in meeting the unique needs of children. For example, the endocrinologists, surgeons and anesthesiologists who care for your child are board-certified pediatric specialists. They have spent years training in their general medical specialty and have extra years of training in how to take care of kids. Our child life specialists know how to help children understand their illnesses and treatments in ways that make sense for their age. Our expertise in pediatrics truly makes a difference to our patients and families.