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Hypothyroidism in Children

Hypothyroidism in Children

Hypothyroidism means that the thyroid gland does not make enough thyroid hormone. Thyroid hormone regulates many natural processes of metabolism and growth.

Illustration of the thyroid gland and its location
Thyroid Gland - Click to Enlarge

Congenital hypothyroidism means the condition was present at or before birth. Severe physical and mental developmental delays can occur if congenital hypothyroidism is not identified and treated in a timely matter. Older children may fail to grow properly if any type of hypothyroidism is inadequately treated.

Congenital hypothyroidism occurs in about one in 2,000 to 4,000 live term births. Newborn screenings promote earlier treatment and reduce the risk for developmental delay.

Facts about hypothyroidism

Causes of hypothyroidism in infants, children, or adolescents include:

  • Missing or poorly developed thyroid gland

  • Pituitary gland that doesn’t work effectively

  • Hashimoto's thyroiditis, or Hashimoto's disease, in which the immune system destroys the thyroid

  • Side effect of certain medications

  • Inadequate iodine in the diet, which is rare in developed countries

  • Exposure to ionizing radiation, although this is rare as a cause of hypothyroidism


Many babies born with hypothyroidism have no symptoms at all, or their symptoms do not present for several days to weeks.

Symptoms of congenital hypothyroidism can include:

  • Heavier birth weight

  • Dull look on the face

  • Puffy face

  • Tongue that seems to stick out

  • Constipation

  • Difficulty eating or choking issues

  • Difficulty maintaining temperature

  • Unusual, hoarse cry

  • Difficulty breathing

  • Longer than normal jaundice

  • Lack of activity

Symptoms of hypothyroidism that develop later include:

  • Goiter (a swelling in the lower neck)

  • Slow growth

  • Dry skin, dry hair, and brittle nails

  • Not wanting to be active

  • Difficulty sleeping

  • Constipation

  • Difficulty with temperature extremes

  • Abnormal sexual development

  • Slightly heavier weight than peers


If untreated, hypothyroidism can cause the following problems for children and teens:

  • Developmental delays, both physical and mental

  • Heart problems

  • Incorrect development of the central nervous system

  • Failure to grow and meet developmental milestones

When to seek medical care

Call your health care provider if your child shows any hypothyroidism symptoms. Early diagnosis and treatment are important.


Doctors typically take a medical history and do a physical exam. A simple blood test can let you know whether your child’s thyroid is functioning correctly. Imaging studies, such as a thyroid scan or ultrasound, might also be needed to diagnose the condition.


The goal of treatment is to get thyroid hormone levels up to normal and reduce symptoms of hypothyroidism.

Treatment is usually one of two options:

  • Taking thyroid hormones regularly to increase the levels in the blood

  • Having surgery for an extreme goiter