Hypothyroidism (underactive thyroid) occurs when the thyroid gland makes too little thyroxine, the thyroid hormone. Too little thyroid hormone can cause fatigue, weight gain, constipation, decreased growth and other issues. In children, hypothyroidism can be present at birth (a condition called congenital hypothyroidism) or it can develop later in childhood.


  • Fatigue
  • Weight gain
  • Constipation
  • Thinning or dry hair
  • Dry skin
  • Slow pulse
  • Cold intolerance
  • Hoarse voice
  • Slow speech
  • Puffy and swollen face
  • Increased menstrual flow and cramping in females
  • Swelling in the neck (goiter)


Hypothyroidism diagnoses will begin with a physical exam and review of your child’s full medical history. In addition, our physicians may use a variety of diagnostic tests including:

  • Blood tests to measure the thyroid hormone and thyroid-stimulating hormone (TSH) levels, as well as thyroid auto-antibodies.


At Texas Children’s Hospital, treatment plans are tailored to your child’s individual needs. Hypothyroidism treatment may include:

  • Thyroid medication: Most children will be treated with hormone replacement medication.

For more information, visit thyroid.org