Hypothyroidism Information for Kids This handout is about Hypothyroidism and will explain:     

Where the thyroid gland is in the body. What thyroid hormones do. How you might feel if you have too much or too little thyroid hormone. Different ways we find out how well your thyroid gland is working. Ways to help a thyroid gland that isn't working well.

We hope this will help you to know why you come to clinic visits, what your doctor looks for, and why you may need to take pills. If you like, you may share this with your parents, friends, and teachers after reading it. If you have any questions, please feel free to ask the doctors or nurses about them during your next clinic visit. Definition of Words There are many medical words used to explain thyroid problems so we will begin by telling you what some of these words mean. 

Gland - A special group of cells in your body that sends out a hormone.

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Hormone - A chemical “messenger” sent out from a gland into the bloodstream where it can carry its message to other cells in the body.

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Euthyroid – “Eu” means “normal”. Euthyroid means your thyroid gland is working normally.

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Hypothyroid – “Hypo” means “too little, not enough or to low”. Hypothyroid means your thyroid gland is not making enough thyroid hormone.

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Hyperthyroid – “Hyper” means “too much or to high”. Hyperthyroid means your thyroid gland is making more thyroid hormone than your body needs.

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Your Thyroid Gland Your thyroid gland is a butterfly shaped group of cells in the front of your neck. The cells in a normal, healthy thyroid gland send out thyroid hormones, called triiodothyronine (T3) and thyroxine (T4). When your thyroid gland gets a message from the brain that your body needs these two hormones, the thyroid gland sends them into the bloodstream. The blood then carries these hormones everywhere in your body. They help tell your body how to use the food you eat, what your temperature will be, and how fast your heart will beat. The thyroid hormones also help decide how much sleep you need, if your hair will be healthy and how often you will have a bowel movement. One of the biggest jobs of thyroid hormones is helping you learn and grow taller. This means that if your thyroid gland doesn't work as it should and send out the correct amount of thyroid hormones you need, your body may not work as well. Hypothyroidism Symptoms When you don’t have enough thyroid hormone in your blood, then you are hypothyroid. If this happens, sometimes you might: -

Not grow as fast as your friends Have a bigger thyroid gland in your neck than before Feel cold when nobody else does Feel especially tired or sleepy during the day Notice that your hair feels thick or rough Be constipated

Treatment When you don’t have enough thyroid hormone in your blood, your doctor may give you a pill to take that’s just like the thyroid hormone your body would normally make. The thyroid hormone pill doctors often give is called Levothyroxine. You will need to take your thyroid pill every day at about the same time. You may find it helpful to talk with your family about what a good time would be that you will not forget. If you are having trouble remembering to take your pills, ask us for some helpful ideas.

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When your doctor first decides you need to take thyroid hormone, we need to be sure you are getting the right amount. It may take a little while to figure out just the right dose that your body needs. When you start taking these pills, your doctor may make many changes in the number of pills or the dose of the pill. As you grow and get older, your body will need different amounts of thyroid hormone. The doctor will have you get blood tests to make sure you are taking the right amount for your body. After you have been taking your thyroid pills for a while, your speed of growing will return to normal. It is still very important for you to keep on taking your thyroid pills, because without them you will become hypothyroid again. One thing you need to do if you are taking pills for this is to be aware of changes in the way you feel. Sometimes, you are the first one to know if you are taking too much or too little medicine. If you are taking Levothyroxine and taking too much you may: -

Have trouble sleeping Lose weight Have diarrhea Not be able to sit still Feel hot when nobody else does Be crabby very often Have fine, silky hair

And if you are not taking enough, you may still be hypothyroid and: -

Be more sleepy during the day Be more constipated Feel cold when nobody else is

If these symptoms remain, be sure to tell your doctor who will decide if you need a change of medicine. Ways of Telling How Well Your Thyroid Gland Is Working Physical Exam These exams give your doctor an idea of how your thyroid gland is working. 

Feeling your thyroid gland: During a physical exam, the doctor may feel your thyroid gland in the front of your neck. Because your thyroid gland is easier to feel when it's moving, your doctor may ask you to swallow several times. If you have trouble swallowing when there is nothing in your mouth, ask for a cup of water.

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Reflexes: The doctor may tap your knee, ankle, or elbow with a rubber hammer to see if it twitches. If you don't have enough thyroid hormone, then part of your reflexes may be slower. If your thyroid levels are higher than normal, your reflexes may be fast.

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Heart Rate: We can also tell how your thyroid is working by timing how many times your heart beats in one minute. If you do not have enough thyroid hormone, your heart rate may be slower. If you have too much hormone, your heart rate may be faster than usual.

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Blood Pressure: Your blood pressure also can tell your doctor or nurse if you have too much, or not enough of the thyroid hormone. A high blood pressure reading may tell us that you may have too much thyroid hormone.

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Skin/Hair: Your doctor may feel your skin and hair to see how well your thyroid gland is working. If you are hypothyroid, your skin and hair may be dry and rough. If you have too much thyroid hormone, your skin and hair may be moist and oily.

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Growth: Your thyroid gland also affects gains in height and weight. If you don't have enough thyroid hormone, you may grow more slowly than as you would with a normal hormone level. If you have too much thyroid hormone, you may not grow as you should either; you may grow too quickly and lose or gain weight. You will be weighed and measured during clinic visits to see if your body is growing as it should.

Blood Test By testing a sample of your blood we can measure how much thyroid hormone you have in your body from your gland or from the pills you are taking. Most often, the blood sample is taken from your arm. It may sting, so it is all right if you cry or say “OUCH” but you need to hold your arm still for us. There is a numbing cream called EMLA or ELAMAX that can be put on your arm before the blood is taken so that the needle doesn’t sting as much. Ask your nurse or doctor if you would like to try it. The blood test will tell us if you have just the right amount of thyroid hormone, or if you need to change the amount of medicine you are taking. As you grow and get older, your body will need different amounts of thyroid hormone. Blood tests help us decide if you need to change, or if you are getting exactly the amount you need.

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Now a Quiz (Fill in the Blanks): 1. The thyroid gland is located ______________________________and shaped like a ______________________________. 2. Thyroid hormones affect the way your body works. Name 3 things that thyroid hormones do in your body. 1. ________________________ 2. ________________________ 3. ________________________ 3. Match examples in column A with answers in column B. Column A

Column B

1. Number of times your heart beats in a minute

A. Gives the doctor a rough idea of how your thyroid gland is working

2. Reflexes

B. Gives the doctor an exact answer as to how well your thyroid gland is working

3. Feeling the thyroid gland 4. Testing a blood sample

4. True or False. Some symptoms of being hypothyroid are A. B. C. D. E.

Feeling cold Lots of energy Thin, silky hair Eat more Constipation

______ ______ ______ ______ ______

5. List 2 symptoms of taking too much thyroid hormone medicine. List 2 symptoms of taking too little thyroid hormone medication. 6. How does thyroid hormone medicine help when a thyroid gland that isn’t working as it should?

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Answers 1. Neck; butterfly 2. How fast your heart should beat How much you grow How to use the food you eat 3. A = Number of times your heart beats in a minute Reflexes Feeling B = Testing a blood sample 4. A. B. C. D. E.

T F F F T

5. A. Warm Lots of energy Lose weight B. Cold Sleepy all the time Gain weight 6. It supplies the thyroid hormone the gland isn't making.

Your health care team may have given you this information as part of your care. If so, please use it and call if you have any questions. If this information was not given to you as part of your care, please check with your doctor. This is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each person’s health needs are different, you should talk with your doctor or others on your health care team when using this information. If you have an emergency, please call 911. Copyright ©10/2015. University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#4604.