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Hypothyroidism in Teenagers

An inside on how to explore treatment with hypothyroidism in teenagers.
Hypothyroidism in Teenagers
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Does your teenager seem tired all the time, sleeps away the weekend, complains about feeling cold all the time, and isn’t working up to their potential at school? It could be normal adolescence, but there’s another possibility. Your teen could be hypothyroid! 

Hypothyroidism is a common thyroid disorder that affects millions of people worldwide. While it is commonly associated with adults, it is important to note that teenagers can also develop this condition. Hypothyroidism occurs when the thyroid gland fails to produce enough thyroid hormones, leading to a range of symptoms that can impact a teenager’s overall health and well-being. This article will explore the unique signs and symptoms of hypothyroidism in teenagers and discuss the current approaches to managing this condition.

Prevalence of hypothyroidism in teenagers

The thyroid gland, located in the lower front of the neck, plays a crucial role in the body’s metabolism, growth, and development. When it doesn’t produce enough thyroid hormones, it can lead to hypothyroidism, an underactive thyroid. 

The prevalence of hypothyroidism in teenagers varies slightly depending on the source. According to one source, Hashimoto’s autoimmune thyroiditis, the most common cause of hypothyroidism in teenagers, affects approximately 1-2% of teenagers, mainly girls. Another study found that the overall prevalence of hypothyroidism in young people less than 22 years of age is 0.135%, and in the group aged 11-18 years, it is 0.113%. Yet another source states that the prevalence of thyroid dysfunction between 11 and 18 years is 1%. These figures suggest that hypothyroidism is relatively uncommon in teenagers but not rare.

Causes of hypothyroidism in teenagers

One of the primary causes of hypothyroidism in teenagers is an autoimmune disorder called Hashimoto’s thyroiditis. This occurs when the immune system mistakenly attacks the thyroid gland, leading to inflammation and damage. It is a common cause of hypothyroidism in adolescents and can be diagnosed through blood tests that measure thyroid hormone levels and thyroid peroxidase (TPO) antibodies.

Another cause of hypothyroidism in teenagers is iodine deficiency. The thyroid gland requires iodine to produce thyroid hormones; without sufficient iodine intake, the gland cannot function properly. Iodine deficiency is more likely to occur in regions where the diet lacks iodine-rich foods such as seafood and iodized salt.

Certain medications, such as lithium (used to treat bipolar disorder) and amiodarone (a heart medication), can also cause hypothyroidism in your teenager. These medications may interfere with the production of thyroid hormones or disrupt the normal function of the thyroid gland. Parents and healthcare providers need to monitor teenagers taking these medications for any signs and symptoms of thyroid dysfunction.

Radiation therapy to the neck and certain surgeries involving the thyroid gland can damage the thyroid tissue and lead to hypothyroidism. This is a less common cause in teenagers but should be considered if they have a history of such procedures.

Finally, genetic factors can play a role in hypothyroidism. If your teenager comes from a family with a history of thyroid disorders, they may be at a higher risk of developing hypothyroidism. Regular thyroid function tests can help detect any abnormalities early on and ensure appropriate treatment.

Recognizing the symptoms of hypothyroidism in teenagers

Teenagers with hypothyroidism may exhibit various symptoms that can easily be mistaken for normal changes associated with adolescence. Parents and caregivers must be aware of these symptoms to ensure their teenagers are diagnosed and treated promptly.

Some of the hypothyroidism signs and symptoms experienced by teenagers include:

Slow growth 

Hypothyroidism can slow down a teenager’s growth, leading to short limbs, shorter stature than peers of the same age, and delayed tooth development. 

Delayed puberty

Delayed puberty can be an early sign of hypothyroidism in teenagers. The signs of delayed puberty can vary between boys and girls. Here are the common signs.

For girls:

  • Lack of any breast development by age 12
  • More than 5 years between initial breast growth and first menstrual period
  • Failure to menstruate by age 15
  • No breast development by age 14
  • Not starting to menstruate within 5 years of when breasts begin to grow or by age 16

For boys:

  • Lack of testicular enlargement by age 14
  • Lack of pubic hair by age 15
  • More than 5 years to complete adult genital development
  • The penis and testicles not starting to grow larger by age 14
  • Genital growth that takes longer than 5 years
  • Short stature compared with their peers, who are now growing faster


One of the most common symptoms of hypothyroidism in teenagers is fatigue and sluggishness. Teens may feel extremely tired even after adequate rest, or sleep excessively, defined as sleeping more than 9-9½ hours per night. 

Poor school performance

Hypothyroidism can lead to lethargy, brain fog, poor memory, and difficulty concentrating, which can negatively impact a teenager’s academic performance.

Weight gain

Teenagers with hypothyroidism may experience weight gain despite no change in diet or exercise or may find it difficult to lose weight. 

Mood changes

Hypothyroidism can lead to depression and anxiety, which can be particularly challenging for teenagers to manage.

Changes in appearance

Teenagers with hypothyroidism may experience other changes in appearance, including dry and brittle hair, hair loss, dry skin, brittle nails, and a puffy and swollen face. 

Other physical symptoms

Other physical symptoms can include:

It’s important to note that these symptoms can be subtle and may be mistaken for normal teenage behavior or other health problems. Therefore, a high index of suspicion is necessary for early diagnosis and treatment. 

Diagnosing hypothyroidism in teenagers

If you suspect that your teenager may have hypothyroidism, it is essential to consult a healthcare professional. They will conduct a thorough medical history review and physical examination and order blood tests to measure thyroid hormone levels. The essential tests measure the levels of thyroid-stimulating hormone (TSH), as well as free thyroxine (free T4) and free triiodothyronine (free T3) levels. Because autoimmune Hashimoto’s thyroiditis is the most common cause of hypothyroidism in teenagers, it’s also important to measure thyroid peroxidase (TPO) antibodies. Elevated TSH, along with low or low-normal free T4 and free T3 levels, can indicate hypothyroidism. Elevated TPO antibodies can help doctors make a diagnosis of Hashimoto’s. 

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Treating hypothyroidism in teenagers

Once diagnosed, hypothyroidism in teenagers can usually be effectively managed with medication. The most common treatment is daily thyroid hormone replacement therapy. This medication aims to restore the thyroid hormone levels in the body and alleviate the symptoms associated with hypothyroidism. Regular blood tests are also necessary to monitor the effectiveness of the treatment and adjust the medication dosage as needed.

In addition to medication, teenagers with hypothyroidism will feel their best if they also adopt a healthy lifestyle. Regular exercise, a balanced diet, and sufficient sleep can help manage symptoms and improve overall well-being. It is also essential for teenagers to attend regular follow-up appointments with their healthcare provider to monitor their thyroid hormone levels and make any necessary adjustments to their treatment plan.

Challenges for teenagers with hypothyroidism

Being diagnosed with a chronic condition like hypothyroidism can be challenging for teenagers. Parents, caregivers, and healthcare professionals need to provide support and education to help teenagers cope with their condition effectively.

It is crucial to encourage open communication and create a safe space for teenagers to express their concerns and emotions. Joining support groups or online communities specifically for teenagers with hypothyroidism can also provide them with a sense of belonging and the opportunity to share experiences with others who understand.

Hypothyroid teens who experience delayed puberty may experience feelings of embarrassment or isolation among peers. Additionally, since hypothyroidism can lead to poor growth and short stature, this can further contribute to feelings of self-consciousness. 

Difficulties with concentration, tiredness, forgetfulness, short-term memory lapses, and a lack of interest and mental alertness can affect a teenager’s academic performance and social interactions, leading to further emotional distress and adverse effects on self-esteem. These challenges can also be mistaken for attention issues. This can lead to misunderstandings and frustrations in both academic and social settings. 

Changes in appearance due to symptoms like weight gain or hair loss can negatively impact a teenager’s self-image and confidence. 

It’s important to note that these challenges can be mitigated with proper diagnosis and treatment. However, these potential effects of hypothyroidism underscore the importance of early detection and management of hypothyroidism in teenagers.

A note from Paloma

Hypothyroidism in teenagers can have far-reaching effects on their physical and emotional well-being and quality of life. Hypothyroidism can potentially impact their growth, pubertal development, school performance, and mental health. Recognizing the signs and seeking appropriate care is crucial. 

Supporting teenagers with the emotional challenges of hypothyroidism requires patience, understanding, and proactive involvement. Parents can play a crucial role in helping their teenagers cope with the impact of the condition. This can involve creating a supportive and open environment for discussing their feelings and concerns and actively participating in their medical care and treatment. Additionally, being aware of the potential psychiatric symptoms associated with hypothyroidism, such as moodiness, irritability, and trouble concentrating, can help parents recognize and address these issues effectively. Seeking professional guidance from endocrinologists and mental health professionals and ensuring that teenagers adhere to their treatment plans can significantly contribute to managing the challenges associated with hypothyroidism.  

Becoming a Paloma member offers comprehensive hypothyroidism support for you and your teens, providing easy virtual access to expert practitioners, nutritionists, health coaches, personalized treatment plans, and ongoing support. Paloma’s convenient at-home blood testing kit tests TSH, free T4, free T3, and TPO antibodies, and the painless fingerstick tests are perfect for teens who hate needles! By joining Paloma, you can ensure that your teenager will receive the specialized care and attention they need to manage hypothyroidism effectively, minimize its impact on their lives, and thrive during these formative years while living a healthy, normal life. 


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Mary Shomon

Patient Advocate

Mary Shomon is an internationally-recognized writer, award-winning patient advocate, health coach, and activist, and the New York Times bestselling author of 15 books on health and wellness, including the Thyroid Diet Revolution and Living Well With Hypothyroidism. On social media, Mary empowers and informs a community of more than a quarter million patients who have thyroid and hormonal health challenges.

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