Trouble concentrating, sleep issues: Could your child’s thyroid be the problem?

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Trouble concentrating. Sleep problems. Big appetite.

On their own, none of these issues might seem unusual for a child. They could simply be tired of sitting in a classroom, lobbying for a later bedtime or going through a growth spurt. But, for some children, those symptoms could signal a bigger problem with their thyroid.

The thyroid gland is a butterfly-shaped gland located in the front of the neck that releases thyroid hormone. It acts as kind of like a gas pedal for your body, said Dr. Nina Jain, who specializes in pediatric endocrinology and diabetes at UNC Children’s Hospital.

An underactive thyroid gland, called hypothyroidism, she said, won’t give your body enough gas to run.

“Some kids just can’t focus anymore because they are tired all of the time,” she said. “Some kids will describe feeling like being in a cloud all day long.”

An overactive thyroid gland, called hyperthyroidism, produces the opposite effect, giving the body too much of the hormone.

“These kids are revved up,” Jain said. “They have an increased appetite, but will actually lose weight. … They may feel like their heart is racing when they are just resting. … I’ll go in and see these children and they are fidgeting. Their hands and feet are always fidgeting.”

These thyroid conditions are common. About 1 in 1,250 children has hypothyroidism. About 1 in 10,000 children have hyperthyroidism, Jain said.

More children, today, are being diagnosed with the diseases, in part, because of increased awareness and improved testing in the past 15 to 20 years, Jain said. In the United States, every state requires that newborns are screened for congenital thyroid disease.

But some children and adults develop thyroid disease later in life. Often, it will turn up in late childhood, from about the age of 8 to 10, and, later, from about the ages of 12 to 19, Jain said.

Left untreated, the diseases carry life-long consequences, including weight gain or loss; poor school performance; stunted growth; and the delayed onset of puberty. Severe hyperthyroidism can even result in cardiac heart failure.

Pediatricians often send patients Jain’s way when they see that a child’s growth hasn’t kept up.

“With continued ignoring,” Jain said, “you could definitely have problems.”

The good news is that there is treatment – and it’s effective. A simple blood test is all that’s required to determine if there is a problem. From there, Jain said, there are several treatment options.

“It’s definitely distressing for the child and the family, but it is one of the more treatable disorders that I deal with,” Jain said.

Hypothyroidism is treated with a pill, a synthetic thyroid hormone, that’s taken once a day.

“Children can lead a completely normal, healthy life,” she said.

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Treatment for hyperthyroidism can be a bit more complicated, but still effective. It might include surgical removal of the thyroid or radioactive ablation, which effectively burns out the thyroid gland.

“It sounds really scary,” Jain said, “but it’s been well established.”

Researchers aren’t exactly sure why some children develop these diseases. Family history likely plays a role. And females are diagnosed with it more often than men.

“If you have that family history, it’s worth knowing what the red flags are in your child,” Jain said. “It’s a blood draw. It’s a relatively easy way to screen if there is any concern.”

Below are some common signs of hyperthyroidism and hypothyroidism. If you’re concerned about your child’s health, talk to your pediatrician.

Common Signs of Hyperthyroidism

  • Increased appetite with weight loss
  • Diarrhea
  • The feeling that their heart is racing when they are resting.
  • Difficulty sleeping
  • Difficulty concentrating because their mind is racing.
  • Fidgeting and feeling jumpy

Common Signs of Hypothyroidism

  • Sluggishness
  • Sleepiness despite getting adequate sleep
  • Weight gain despite a decreased appetite
  • Constipation
  • Dry skin and hair
  • Difficulty staying focused
  • Feeling like they’re in a “cloud” all day
  • Decreased growth

Jain treats patients in Chapel Hill at the UNC Hospitals Children’s Specialty Clinic inside N.C. Children’s Hospital. She also has office hours in Raleigh at the N.C. State park Scholars Children’s Speciality Clinic, which is located on the campus of UNC Rex Healthcare.

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