Childhood Graves' Disease: Diagnosis and Treatment

How Do We Diagnose Graves’ Disease?

If we think your child has Graves’ disease based on his or her symptoms, we will have your child get a blood test to check the levels of thyroid hormones in your child’s blood.

Sometimes, we will also have your child get a thyroid uptake study (also called a radioactive iodine study or technetium uptake study). A thyroid uptake study measures how well your child’s thyroid is working. We will talk with you about which tests your child should have.

How Do We Treat Graves’ Disease?

There are 3 main treatments for Graves’ disease. We will talk with you about which treatment is best for your child.

Medications

We usually treat Graves’ disease with medication first. There are 2 types of medications, which are beta blockers and antithyroid medications. Each one works differently, so we will talk with you about which one is best for your child and how long your child should take the medication.

The first type of medication is called a beta blocker. Beta blockers are used to treat faster heart rate or increased blood pressure. They typically do not affect how much thyroid hormone the thyroid releases.

The second type of medication is called methimazole. Methimazole is used to control how much thyroid hormone the thyroid releases. Children can usually take methimazole with little trouble, but it can have rare, but possibly serious side effects. Minor (less serious) side effects include a metallic taste in the mouth, allergic reactions with rashes and itching and joint pain. Major (rare, but serious) side effects include liver problems, rash and a lower numbers of white blood cells in the body. This can lower your child’s ability to fight off infections.

Radioactive Iodine Therapy

For this treatment, your child will take a pill that contains iodine-131 (also called I-131), which destroys the thyroid without destroying other parts of your child’s body. He or she will come back to the doctor’s office the next day so we can make sure the I-131 worked properly.

If your child has radioactive iodine therapy, he or she will need to take thyroid hormone replacement medication for the rest of his or her life. We will talk with you about this. Some medical studies show that radioactive iodine therapy might make eye diseases associated with Graves’ disease worse. This is usually a less common problem in children.

Surgery to Remove the Thyroid Gland

We usually refer children to have thyroid surgery only if medication and radioactive iodine therapy did not work. It’s important to understand any risks or complications of the surgery. We will talk with you about any risks or complications. We will also discuss referring you to an experienced thyroid surgeon for your child’s thyroid surgery.

Rev. 9/2016. Mass General for Children and Massachusetts General Hospital do not endorse any of the brands listed on this webpage. This webpage is intended to provide health information so that you can be better informed. It is not a substitute for medical advice and should not be used to treatment of any medical conditions.