Thyroid Clinic

The Division of Endocrinology, Diabetes and Metabolism at Children's Hospital Los Angeles is committed to improving the quality of care and services for youth with thyroid disease.

We are a unique team of specialized doctors, nurses and other allied health professionals dedicated to providing care, treatment and support to pediatric patients who have been diagnosed with various types of thyroid disease. Our thyroid program partners with other centers and multidisciplinary specialists to provide your family with:

  • Comprehensive care and education
  • Training for families and medical professionals
  • Perinatology consultation
  • Genetic consultation and counseling
  • Pediatric otolaryngology (head and neck) consultation
  • Behavioral health and nutritional consultation
  • State-of-the-art imaging

Our multidisciplinary team also provides resources and opportunities for children of all ages and their families to meet, exchange ideas and share experiences. We partner with the following areas:

  • What Is Thyroid Disease?
  • Hypothyroidism
  • Hyperthyroidism
  • Thyroid Cysts, Nodules and Cancer

There are multiple different disorders that can be associated with the thyroid gland:

  • Congenital hypothyroidism
  • Acquired hypothyroidism (Hashimoto disease, iodine deficiency, etc.)
  • Congenital hyperthyroidism
  • Acquired hyperthyroidism (Graves disease)
  • Thyroid cysts and nodules
  • Thyroid cancer (papillary, follicular, medullary and anaplastic)

Congenital hypothyroidism occurs in 1 in 2000 – 4000 births. It is due to a failure of the thyroid gland to develop or inability of the thyroid gland to work. Thyroid hormones are important for growth and development. Congenital hypothyroidism is almost always diagnosed ny newborn screening  and, thus, allowing early thyroidhormone replacement to ensure healthy neurological and other outcomes.

Failure to start thyroid hormone replacement in a timely manner can lead to:

  • Developmental delays
  • Poor growth
  • Constipation
  • Umbilical hernia
  • Large tongue
  • Increase sleep
  • Poor tone
  • Hoarse cry
  • Feeding problems
  • Dry skin
  • Low body temperature
  • Prolonged jaundice

Acquired hypothyroidism can occur in up to 2% of adolescents. This is most often due to an autoimmune condition (Hashimoto thyroiditis) where the body attacks the thyroid gland so that it no longer functions normally.

Signs and symptoms of hypothyroidism may include:

  • Decreased growth velocity leading to short stature
  • Increased weight gain
  • Early or late puberty
  • Poor school performance
  • Lethargy/fatigue
  • Cold intolerance
  • Constipation
  • Dry skin and brittle hair
  • Facial puffiness
  • Muscle aches and pains
  • Enlarged thyroid gland (goiter)

General Approaches to Diagnosis

Delays in diagnosis of hypothyroidism can have a critical effect on the health of your child. To avoid any delay in diagnosis, all 50 states now have implemented a government-mandated newborn screening program for congenital hypothyroidism. Otherwise, your child’s primary doctor may obtain laboratory testing if symptoms arise.

In our multidisciplinary center, we provide access to the following state-of-the-art services to diagnose hypothyroidism in children.

  • Hormonal testing
  • Radiological imaging 

Basic Treatment

Treatment is typically with levothyroxine (generic or brand name) and, depending on the severity of the condition, dosage will vary..

Our Services

  • Clinical examinations
  • Fetal and Neonatal Medicine
  • Hormone treatment
  • Education/training for families and medical professionals

Neonatal Graves disease occurs in 1 in 25,000 births. Typically, the mother has Graves disease which is then passed on to the baby, although most mothers with Graves do not pass the condition onto their baby. This is a temporary condition that almost always spontaneously resolves by 12 weeks. Temporary treatment is recommended.

Some features of congenital hyperthyroidism include:

  • Low birth weight
  • Premature birth
  • Small head
  • Warm, moist skin
  • Irritability, hyperactivity, restlessness and poor sleep
  • Increased heart rate that can lead to heart failure
  • Increased food intake, but poor weight gain
  • Diarrhea
  • Enlarged thyroid gland (goiter)
  • Bulging eyes

Acquired hyperthyroidism (Graves disease) occurs in 1 in 5000 children, typically adolescents. This condition may spontaneously resolve over time.

Signs and symptoms may include:

  • Increased heart rate and blood pressure
  • Diarrhea
  • Jitteriness
  • Anxiety
  • Difficulty with sleep
  • Warm, sweaty skin
  • Enlarged thyroid gland (goiter)
  • Bulging eyes
  • Accelerated growth
  • Irregular menstrual cycles (girls)

General Approaches to Diagnosis

Delays in diagnosis can have a critical effect on the health of your child. Children born to a mother with known hyperthyroidism should be tested at birth. Otherwise, your child’s primary doctor may obtain laboratory testing if symptoms arise.

In our multidisciplinary center, we provide access to the following state-of-the-art services to diagnose hyperthyroidism in children.

  • Hormonal testing
  • Radiological imaging 

Basic Treatment

Depending on the severity of the condition, treatment will vary in terms of medication and dosage.

  • Methimazole (decreases thyroid hormone production)
  • Beta blocker (treatment of symptoms)
  • Glucocorticoids (treatment in emergent situations)

Our Services

  • Clinical examinations
  • Fetal and Neonatal Medicine
  • Hormone treatment
  • Education/training for families and medical professionals
  • Definitive treatment with surgery or radioactive iodine

About 2% of children have thyroid nodules that can be felt. Most of these are benign. However, there is a higher rate of thyroid cancer in children than in adults when a nodule is found. Therefore, thyroid nodules should be evaluated by a specialist to determine if further studies are necessary.

General Approaches to Diagnosis

If your child’s provider is concerned about a thyroid cyst or nodule, an ultrasound should be obtained to look for abnormalities. If anything is detected, a referral to our center is warranted.

In our multidisciplinary center, we provide access to the following state-of-the-art services to diagnose children with thyroid cysts and nodules.

  • Hormonal testing
  • Pathology expertise and molecular genetics
  • Radiological imaging 
  • Fine-needle aspiration
  • Surgical intervention

Basic Treatment

Depending on the severity of the condition, treatment will vary with regard to medications and other interventions. Some treatment options are:

  • Surgical lobectomy or total thyroidectomy
  • Oral Levothyroxine
  • Radioactive iodine treatment

Our Services

  • Clinical examinations
  • Fetal and Neonatal Medicine
  • Genetic testing
  • Hormone treatment
  • Fine-needle aspiration
  • Surgical intervention
  • Education/training for families and medical professionals
  • Otolaryngology
  • Nuclear medicine
  • Interventional radiology