Hyperthyroidism (medically known as Graves' disease) is an endocrine disorder caused by the thyroid gland producing excess hormones. The incidence of hyperthyroidism in children is relatively low, accounting for only about 5% of all patients, among which 7-14 years old is the most common age, and girls are more than boys, with a ratio of about 5:1.

Symptoms

• Anxiety, palpitation (tachycardia), tremor.
• Fear of heat and excessive perspiration.
• Increased appetite (but no weight gain or loss), increased frequency of defecation or diarrhea.
• Emotional instability, hyperactivity.
• Inability to concentrate, poor memory, and poor academic performance.
• Enlargement of the thyroid gland resulting in thickening of the neck.
• Puberty is characterized by slow sexual development, menstrual disorder, amenorrhea and oligomenorrhea.

＊Acute thyroid storm: extremely serious hyperthyroidism, causing fever, tachycardia, heart failure, coma and shock.

Treatment

There are three ways to choose: oral medication, radioiodine therapy or surgical resection. There may be complications of hypothyroidism after radioiodine therapy and operation, which has a great influence on children's growth and development. Therefore, for children's hyperthyroidism, oral medication is the first choice.

Symptoms usually improve with 2-3 weeks of medication, and thyroid function can be brought back to normal after 1-3 months, followed by continued low-dose medication. The total course of drug treatment is generally 2-3 years, and some may take 5 to 6 years or longer.

• Thionamides

These drugs inhibit the conversion of inorganic iodine to organic iodine, thereby reducing the synthesis of thyroxine, including propylthiouracil (PTU) or methimazole. Methimazole is a relatively new drug, which has a relatively low incidence of side effects occasionally accompanied by prurigo, and can be taken only once a day after stable disease control.

• b₂-adrenergic blocking agents

Propranolol is commonly used, usually in severe cases, to slow down tachycardia, and when the thionamides work, their dosage can be reduced and then discontinued. Patients with asthma are not advised to use it.

Daily care

• When the heart rate is too fast and symptoms are obvious in the acute period, avoid intense exercise and iodine rich food, and do not drink tea nor coffee (caffeine will stimulate sympathetic nerves). After stable control, normal (moderate) exercise can be done.
• During the stable period, do not eat more high-iodine food, such as kelp, laver, seaweed, shrimp shells, and processed food with salt.
• Diet should be based on the principles of high calories, high proteins, high vitamins, appropriate fat and sodium salt intake to correct the high consumption caused by the disease. Eat less spicy and irritant food. The food should be soft, easy to digest and rich in nutrition.
• Take proper rest, avoid overwork, mental stress and emotional agitation.