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In hypothyroidism, the most common thyroid illness, the butterfly-shaped thyroid gland produces too little thyroxine. Hyperthyroidism refers to an overactive thyroid that is making too much hormone. Both these autoimmune disorders are five to ten times more prevalent among women than among men.

Hashimoto’s Thyroiditis (chronic lymphocytic thyroiditis), named for the physician who first described it, is the leading cause of hypothyroidism. Graves’ disease, named for its discoverer, is a form of hyperthyroidism—and the type seen most frequently in adolescents and young adults. Some people afflicted with an autoimmune thyroid disease inherited the trait genetically, so there may be a family history.

Symptoms That Suggest Hypothyroidism/Hashimoto’s Disease May Include:

  • Sluggishness, fatigue, drowsiness
  • Depression
  • Anxiety
  • Constipation
  • Dry, brittle hair
  • Dry, itchy skin
  • Muscle cramps
  • Increased menstrual flow in young women
  • A feeling of tightness or fullness in the neck
  • Enlarged thyroid (goiter)
  • Appetite loss
  • Fluid retention, particularly around the eyes
  • Anemia
  • Numbness and tingling of the hands and feet
  • Poor memory
  • Deepened voice or hoarseness
  • Impaired hearing
  • Chest pain
  • Irregular heartbeat
  • Decreased sweating
  • Frequent complaints of feeling cold
  • Weight gain or weight loss

Symptoms That Suggest Hyperthyroidism/Graves’ Disease May Include:

  • Hyperactivity, restlessness, anxiety, irritability
  • Frequent complaints of feeling warm
  • Flushed face
  • Profuse perspiration
  • Thinning, itchy skin
  • Brittle hair
  • Tremoring fingers
  • Rapid, irregular heartbeat
  • Insomnia
  • Unexplained weight loss
  • Fatigue
  • Weakness, especially in the thighs and upper arms
  • Insomnia
  • Diarrhea
  • Decreased menstrual flow and less frequent periods in young women

Additional symptoms associated with Graves’ disease:

  • Enlarged thyroid (goiter)
  • Bulging eyes, sometimes accompanied by double vision

Youngsters with either an overactive or underactive thyroid may go for months without exhibiting symptoms. An enlarged thyroid, or goiter, may not develop until the disease is well advanced. Hashimoto’s disease is the most common cause of thyroid enlargement in children.

How Thyroid Disorders Are Diagnosed

Physical examination and thorough medical history, plus one or more of the following procedures:

  • Thyroid function blood tests to measure the circulating levels of thyroid hormone and thyroid-stimulating hormone (TSH)
  • Nuclear scan of the thyroid, for which the patient first drinks a small amount of radioactive iodine

Thyroid disorders can often be diagnosed on the basis of laboratory tests alone, although a nuclear scan may be ordered. Thyroid hormone and thyroidstimulating hormone act as “thermostats” for each other. Therefore, a youngster suffering from an overactive thyroid will have an overabundance of thyroxine and too little TSH, while in hypothyroidism the proportions will be reversed.


Last Updated
Caring for Your Teenager (Copyright © 2003 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.