The Thyroid Gland and Thyroid

The thyroid gland is a butterfly-shaped gland that sits in the neck at the front ofthe wind-pipe or ‘trachea’. Sometimes it can be seen at the front of the neck but in many healthy people it can’t. The thyroid gland is, in many respects, like a factory. Factories make things and in the case of the thyroid gland the thing that it makes is a natural chemical called thyroid hormone. Thyroid hormone is important because after being made by the thyroid gland it then goes on to help many parts of the body to work properly:

  • It helps people to think properly
  • It helps the abdomen/tummy to work properly
  • It helps the bones to develop properly

The thyroid can sometimes stop working properly and when this happens it usually makes either too much hormone (over-activity) or too little hormone (under-activity). Some young people reading this article will have had an over-active or an under-active thyroid gland and may be on medicine because of this. You can see the two main groups of thyroid problems in young people – over-activity and under-activity– in the table below and in the picture.

We thought it would be useful to talk about these problems in more detail and will start by talking about ‘under-active’ thyroid glands first because this is a more common problem.

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An underactive thyroid gland

An underactive thyroid gland in babies – ‘congenital hypothyroidism’

Sometimes people are born without a thyroid gland or with a gland that is too small. They don’t have enough thyroid hormone because their thyroid gland ‘factory’ is not properly built. These babies are usually picked up by a blood spot test in early life and are treated with thyroid hormone replacement (otherwise known as thyroxine) which is the same as the natural thyroid hormone. The thyroid hormone replacement can be given as liquid or tablets. Babies and some older children find the tablets can be difficult to swallow but fortunately they can be crushed and mixed with fluid such as milk. Thyroid hormone replacement works very well so an under-active thyroid doesn’t stop them doing what they want.

An under-active thyroid gland due to antibodies (sometimes called Hashimoto’s Disease

In this condition antibodies (which usually fight bugs such as bacteria or viruses) attack the thyroid gland by mistake and damage it. Sometimes it is obvious that something is wrong because the gland gets big but sometimes it happens without the person knowing anything about it until they become under-active. In this case they may have problems such as tiredness, altered appearance and being quite short. Thankfully this problem is quite easy to treat as well by putting back the thyroid hormone – either as thyroid hormone tablets or liquid.

An overactive thyroid gland

An overactive thyroid gland (children and teenagers) – also called ‘Graves’ disease’

Antibodies sometimes make the thyroid gland underactive as we talked about before. However, some antibodies can actually make the thyroid go over- active because they switch the gland on and tell it to make extra thyroid hormone continuously instead of just when it is needed. This can make people feel poorly and stop them from concentrating and sleeping properly. An over-active gland can be more difficult to treat than an under-active one. Some people will be given an anti-thyroid’ medicine to take by itself (usually a medicine called carbimazole) which reduces the amount of thyroid hormone made by the thyroid gland. The amount can then be adjusted until the thyroid hormone levels are normal. Other people are given a bigger dose which stops the gland from working completely. The body’s need for thyroid hormone can then be met by thyroxine to replace the missing hormone.