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What are the Symptoms of Hyperthyroidism?
Symptoms directly due to raised hormone levels include :
- Effects on the circulation
High thyroid hormone levels usually lead to a high heart rate, often in the region of around 100-140 beats/minute. This high heart rate even persists at night, when the heart would normally slow down during sleep. In extreme cases, this can lead to heart strain particularly in adults, but this would be unusual in a child.
- Growth, weight and appetiel
Children who develop hyperthyroidism often start growing at a much faster rate than is normal for their age and so become tall in relation to their peer groups. If this happens during the early teenage years it can be confused with the normal teenage growth spurt. Leg growth is accelerated more than upper body & growth. This increased growth rate is often associated with increased appetite although there is often weight loss that may be extreme. These symptoms can be mistaken for anorexia nervosa. Hyperthyroidism is easily diagnosed by a blood test.
- Anxiety and behaviour problems
These can be quite marked in hyperthyroidism. The child may be restless, fidgety and have poor concentration which results in difficulties at school. They have shaky hands giving problems with delicate tasks. These children are frequently moody, emotional and prone to tears. They may be unable to sleep well and may have nightmares.
Any child with eye symptoms, such as unusually large or bulging eyes, should be referred for an early assessment.
How is Hyperthyroidism Diagnosed?
This is normally done by taking a single blood test to check for levels of the two main thyroid hormones, thyroxine (T4) and triiodothyronine (T3). In hyperthyroidism, the levels are raised above the normal levels for age and gender, and conversely, thyroid stimulating hormone (TSH) levels are low. This is because the high levels of T4 and T3 in the blood stop the pituitary releasing TSH.
How is Hyperthyroidism Treated?
The treatment of hyperthyroidism has two main aims; to control the symptoms and to treat the underlying cause. The distressing symptoms such as the fast heart rate and over-excitability, which are caused by the high thyroid hormone levels, can be treated straight away with a therapy known as beta blockers (such as propranolol). This will treat the symptoms but not the underlying cause. Beta blockers needs to be used with caution in children with asthma as they can cause an attack.
Radioiodine Treatment :
In contrast to the surgical approach, radioiodine therapy can appear to be very simple. Your child is treated as an outpatient with iodine being given by mouth. In addition, they will need to stay at home for a few days afterwards. The thyroid gland traps iodine very efficiently and so very little of the iodine will reach other important parts of the body, such as the ovaries. Typically, the radiation exposure to the ovary is less than that of X-rays used in standard diagnostic procedures such as barium meal tests.
Lumps in the Neck
Lumps in the neck are very common in children and are mostly not anything to do with the thyroid gland. Enlarged glands usually cause them, for example during infections. However, a lump at the front of the neck may be in the thyroid. These are much less common in children than in adults. If there is any concern about a lump, it should always be investigated.
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