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Diagnosing and Treating Thyroid Disorders in Teens

By Jill Brodsky, MD FAAP | Pediatric Endocrinology

Is your teen is sleeping a lot? Isn’t that what all teens do? Maybe, but excessive fatigue and lack of energy is just one of many symptoms that may indicate a thyroid disorder – which affects an estimated 2% to 3% of teenagers.

For many, the thyroid is a somewhat mysterious gland. Shaped like a butterfly, it sits at the base of the neck, bobbing up and down when we swallow. But the thyroid is incredibly important to health, since all the body’s cells require thyroid hormone to work correctly.

But why would someone as young as an adolescent develop thyroid disease? It’s not always clear, although thyroid problems can’t be “caught” from someone else. More likely, a teen with a thyroid disorder may have inherited the predisposition from a family member. Rarely, it is brought on by certain medications.

Types of Thyroid Disorders

Thyroid disease is broken down into two main types: hyperthyroidism, when the gland makes too much thyroid hormone; and hypothyroidism, when it makes too little. Each person’s symptoms are based on which type of thyroid disorder they have. They include:

Hyperthyroidism: Excess sweating; feeling jumpy; high blood pressure; fast heartbeat; trouble sleeping; trembling hands; flushed skin; weight loss despite sufficient food intake; irregular periods, and bulging eyes and/or a wide-eyed look.

Hypothyroidism: Fatigue and lack of pep; slow heartbeat; always feeling cold; brittle hair; headaches; vision problems; dry, pale and/or yellow skin; irregular periods, and constipation.

Additionally, hypothyroidism may cause slower growth and the changes of puberty may be delayed if a young teen suffers from this disorder. It’s important to note that thyroid problems are rarely the cause of weight gain in teens that are overweight.

Diagnosis and Treatment Process

Patients should undergo a physical exam looking for presence of a goiter – a swollen or enlarged thyroid gland – or a lump called a nodule in the gland.  Blood tests to measure levels of thyroid hormone are performed. If a teen has a nodule in his/her thyroid gland, a special scan known as a thyroid ultrasound may also be performed.

The good news is that treating thyroid disease is usually quite straightforward. Depending on test results – whether thyroid hormone is too high or too low – medication is typically prescribed to regulate or supplement those levels. Typically, drug treatment for thyroid conditions is lifelong.

But don’t worry: Teens who had been growing slowly because of thyroid disease before diagnosis will likely catch up to their correct height once they’ve been treated. The normal body changes associated with puberty will follow as well. Follow-up care is simple, with regular blood tests to keep track of thyroid levels and medication “tweaks” based on these results.

Symptoms of thyroid disease can be right in front of you, resembling “normal” teenage habits and conditions. But spotting signs of thyroid problems in your teen requires keeping your eyes open. If you notice any signs of thyroid disorders in your teen, consult your primary care doctor for confirmation.