What thyroid disorders affect babies and children?

Although hypothyroidism (underactive thyroid) is a common disorder in adults, it is less common in children. One child in every 2-3,000 is born with hypothyroidism in the UK. It is more common in girls.

In children, the two most common types of hypothyroidism are congenital hypothyroidism (CHT) and Hashimoto's thyroiditis.

Content overview

Congenital hypothyroidism

Hashimoto's thyroiditis

Hyperthyroidism

Graves' disease

Further information and resources

Congenital hypothyroidism

Hypothyroidism is a condition that results from an underactive thyroid that does not produce enough thyroid hormone. ‘Congenital’ means that this condition is present at birth.

Very early in an unborn baby's development the thyroid gland moves from the back of the tongue to its normal position in the neck. In some babies this doesn’t happen and the gland doesn’t develop at all. In others, the thyroid gland is higher in the neck than normal and doesn’t work as well. These are the most common types of congenital hypothyroidism.

Less often the thyroid gland appears normal and is in the right place but doesn’t produce enough thyroxine. This type of thyroid disorder can be inherited.

All babies in the UK have a newborn bloodspot (heel prick ) test at five days of age to screen for several conditions. One of these conditions is CHT and this is tested for by measuring a hormone called TSH (Thyroid Stimulating Hormone). If the TSH is high on the heel prick blood test, it suggests that the thyroid hormone is low and the baby will need to have a small blood sample taken from a vein to confirm the diagnosis.

Hashimoto’s thyroiditis

Hypothyroidism is most commonly caused by autoimmune thyroid disease. The most frequently occurring form is Hashimoto’s thyroiditis. It occurs when your child’s autoimmune system attacks their thyroid gland and can cause inflammation and swelling of the thyroid gland. The enlarged thyroid is also called a goitre. Goitres do not always appear or can go unnoticed.

As a result of autoimmune thyroid disease your child becomes hypothyroid, which means that their thyroid gland does not produce enough thyroid hormone. Young people with Hashimoto’s thyroiditis very occasionally develop signs of an overactive thyroid gland (this is sometimes called Hashitoxicosis) because the swollen gland makes too much thyroid hormone. This period of ‘overactivity’ is usually brief and the main problem in the long term is likely to be a thyroid gland that is underactive.

There is often a family history of thyroid disease or other autoimmune disorders in children who have Hashimoto’s thyroiditis.

Autoimmune thyroid disorders, including Hashimoto’s thyroiditis, occur in approximately one in 3,500 children.

Hyperthyroidism

Hyperthyroidism occurs when the thyroid becomes overactive and produces more thyroid hormones than are needed by the body. It is sometimes called thyrotoxicosis. The most common cause of hyperthyroidism is Graves’ disease. Hyperthyroidism is also one of the phases that can occur in a condition called viral thyroiditis, although this is extremely rare in children. The hyperthyroid phase of viral thyroiditis normally settles down without treatment.

Graves’ disease

Graves’ disease is the most frequently occurring form of hyperthyroidism. It is named after the Irish physician who first recognised it in the 19th century. Graves’ disease is caused when the body’s immune system turns against the thyroid gland by producing antibodies. This switches the thyroid gland ‘on’, a bit like flicking on the light switch at home. The thyroid gland becomes overactive and produces too much thyroid hormone.

There may be a family history of thyroid problems or other autoimmune disorders. It is also more common in people who smoke.

Around 200-300 children under 15 years get Graves’ disease in the UK and Ireland each year. Girls are more likely to develop it than boys. 

Further information and resources

Thyroid disorders are rare in children and newborn babies but if your child is diagnosed, it can be isolating and worrying. We have a variety of resources to help you understand more about thyroid disease, and how it can affect young people, and to help you connect with others in a similar position. 

Your Guide to Congenital Hypothyroidism

Parent and carer guide

Information for Teenagers and Young Adults

Children’s Conference 2019

Patient forums

Children’s Research News

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