Hypothyroidism in Children

Hypothyroidism means that the thyroid gland does not produce enough of the thyroid hormone, which plays an important role in the way the body runs.

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

Children with congenital hypothyroidism are born with inadequate thyroid hormone function due to one of several disorders. Severe physical and mental developmental delays can occur if the congenital hypothyroidism is not identified and treated in a timely matter. Older children may fail to grow properly if hypothyroidism is not treated.

Congenital hypothyroidism occurs in approximately 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

These are possible causes of hypothyroidism in children:

  • 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 attacks the thyroid

  • Side effect of certain medications

  • Lack of 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 who are born with hypothyroidism have no symptoms at all, or symptoms that do not present for several weeks to months.

Symptoms of congenital hypothyroidism can include:

  • Heavier birth weight

  • Dull look on the face

  • Puffy face

  • Tongue that seems to stick out

  • Constipation or no or delayed stools after birth

  • 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


Hypothyroidism can cause the following problems for children and teens, if it isn’t treated:

  • Developmental delays, both physical and mental

  • Heart problems

  • Incorrect development of the central nervous system

  • Failure to grow and meet developmental milestones

When to call a doctor

Call your doctor 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