{"id":25289,"date":"2025-09-10T12:10:50","date_gmt":"2025-09-10T11:10:50","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/?page_id=25289"},"modified":"2025-09-23T10:22:16","modified_gmt":"2025-09-23T09:22:16","slug":"hyperthyroidism-children-and-young-people","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/paediatrics\/paediatric-endocrinology-diabetes\/thyroid-disorders-paediatric\/hyperthyroidism-children-and-young-people\/","title":{"rendered":"Hyperthyroidism\u2013Children and Young People"},"content":{"rendered":"\n<p>Thyrotoxicosis is relatively rare in children. Typical symptoms include weight loss, irritability, tachycardia (which may be experienced as palpitations), sweating and heat intolerance.&nbsp; Attention span and school performance can be affected due to the cognitive and psychosocial impact of excess thyroid hormones.&nbsp;More longstanding hyperthyroidism can also lead to growth acceleration and osteopenia, secondary to suboptimal bone mineralisation. Most cases of hyperthyroidism in childhood are due to autoimmune Graves disease. <\/p>\n\n\n\n<p><strong>C.M. &amp; E.B. 23-09-25<\/strong><\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\"><strong>Who to refer:<\/strong><\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>If the child has tachycardia, hypertension, tremor and\/or palpitations present, referral via acute paediatrics on the same day may be indicated, even before blood results are available.&nbsp;<\/li>\n\n\n\n<li>If biochemical hyperthyroidism is confirmed, referral should be made to paediatric endocrinology. Raised T3\/T4 in the presence of suppressed TSH is highly suggestive of hyperthyroidism.<\/li>\n\n\n\n<li>Clinical assessment should include: BP, HR, presence and size of goitre, presence of eye signs.<\/li>\n\n\n\n<li>If bloods are being repeated prior to referral, for example to confirm abnormal results, please request thyroid receptor antibodies (TRABs).<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Who not to refer:<\/strong><strong><\/strong><\/h4>\n\n\n\n<p>Children who have symptoms suggestive of hyperthyroidism, but normal biochemistry, will not generally be accepted as referrals to paediatric endocrinology and should have other potential causes explored.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>How to refer:<\/strong><strong><\/strong><\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Children and young people with evidence of thyrotoxicosis should be&nbsp;<strong>referred urgently<\/strong>&nbsp;(same day) to paediatric endocrinology. <\/li>\n<\/ul>\n\n\n\n<p class=\"has-standard-black-color has-text-color has-link-color wp-elements-0edf9e6eca67a37a09238114ea8e180f\">This can be done via the team registrar on bleep 9187 (Mon-Fri 9-5pm), and outwith normal working hours, please refer via the senior medical paediatric registrar on bleep 9424.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>For children and young people with mild biochemical derangement, or well children with confusing thyroid function tests results, please refer via SCI Gateway to RHCYP &#8211; Endocrinology. The responsible consultant will either respond with advice or appoint the child to an out-patient clinic.<\/li>\n<\/ul>\n\n\n\n<p><\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><a href=\"https:\/\/ep.bmj.com\/content\/early\/2024\/12\/10\/archdischild-2024-327932\" target=\"_blank\" rel=\"noreferrer noopener\">Thyroid function test interpretation for general paediatricians | ADC Education &amp; Practice Edition<\/a><\/p>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Thyrotoxicosis is relatively rare in children. Typical symptoms include weight loss, irritability, tachycardia (which may be experienced as palpitations), sweating and heat intolerance.&nbsp; Attention span and school performance can be affected due to the cognitive and psychosocial impact of excess thyroid hormones.&nbsp;More longstanding hyperthyroidism can also lead to growth acceleration and osteopenia, secondary to suboptimal<\/p>\n","protected":false},"author":6,"featured_media":0,"parent":25283,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[1318],"class_list":["post-25289","page","type-page","status-publish","hentry","category-https-apps-nhslothian-scot-refhelp-hyperthyroidism-children-and-young-people"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"heatherlevy","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/heatherlevy\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/paediatric\/https-apps-nhslothian-scot-refhelp-paediatric-endocrinology-diabetes\/https-apps-nhslothian-scot-refhelp-thyroid-disorders-paediatric\/https-apps-nhslothian-scot-refhelp-hyperthyroidism-children-and-young-people\/\" rel=\"tag\">Hyperthyroidism \u2013 Children and Young People<\/a>","rttpg_excerpt":"Thyrotoxicosis is relatively rare in children. Typical symptoms include weight loss, irritability, tachycardia (which may be experienced as palpitations), sweating and heat intolerance.&nbsp; Attention span and school performance can be affected due to the cognitive and psychosocial impact of excess thyroid hormones.&nbsp;More longstanding hyperthyroidism can also lead to growth acceleration and osteopenia, secondary to suboptimal","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/25289","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=25289"}],"version-history":[{"count":2,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/25289\/revisions"}],"predecessor-version":[{"id":25399,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/25289\/revisions\/25399"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/25283"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=25289"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=25289"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}