Medication for Graves' Disease in Children
Doctors at Hassenfeld Children’s Hospital at NYU Langone prescribe medications to treat children with Graves’ disease, an autoimmune disorder. That means the immune system attacks the thyroid and makes it produce too much thyroid hormone. Our doctors often recommend medication to decrease the production of these hormones and to diminish their effects on the body.
Doctors may prescribe an antithyroid medication called methimazole to slow the production of thyroid hormones. Methimazole is often effective in children who have mild symptoms of Graves’ disease. Your child takes this medication daily, by mouth.
Your child may begin to notice improvements in symptoms, such as reduced eye irritation, weight gain, and less sensitivity to temperature, after taking antithyroid medication for several weeks. Antithyroid therapy may be continued for several months, until the immune system reaction that triggered the condition subsides. Our doctors gradually taper the dose of antithyroid medication as your child’s thyroid hormone levels begin to normalize.
Antithyroid medications may cause side effects, such as: a rash; joint pain; jaundice, which causes a yellowing of the skin; dark-colored urine; abdominal pain; and a reduction in white blood cells, which fight infection. To reduce the risk of a serious infection, our doctors closely monitor children who are being treated with antithyroid medication every few weeks with blood tests to measure white blood cell levels. During these visits, doctors may also measure your child’s weight to make sure it’s within a typical range for his or her age and height.
Doctors may prescribe beta blockers to treat the effects of excess thyroid hormones, such as irregular heartbeat, tremor, anxiety, and heat intolerance. These medications, taken by mouth, do not address the underlying cause of Graves' disease. Rather, they help to reduce severe symptoms until other treatments, such as antithyroid medication, become effective.
Beta blockers are generally safe for children and adolescents who do not have asthma or certain heart conditions.
Radioactive Iodine Ablation
Radioactive iodine ablation is a one-time treatment that may be used to stop the thyroid from making too much thyroid hormone. This treatment may be recommended if your child has difficulty taking medication or if the condition isn’t adequately controlled with medication.
Your child takes a capsule or liquid by mouth that contains iodine—an element that is absorbed by the thyroid—combined with a radioactive substance that destroys some of the cells that produce thyroid hormones. Our doctors estimate the correct dosage based on the size and activity of your child’s thyroid, which is measured during diagnosis with a thyroid ultrasound or a radioactive iodine uptake test.
This treatment is safe for children and adolescents. Most of the radioactive iodine is absorbed by your child’s thyroid and does not affect other tissues or organs. But because the treatment involves radiation, our doctors may recommend that your child avoid sleeping with other family members or sharing utensils and personal items with others for about a week, until all of the medication has been eliminated through your child’s urine.
The most common side effect of radioactive iodine ablation is hypothyroidism, a condition in which the thyroid becomes sluggish and cannot make enough thyroid hormone needed for proper growth and metabolism. This side effect can be managed with thyroid hormone replacement therapy, a medication that is taken for life to boost thyroid hormone levels. As your child grows, our doctors monitor the dosage of thyroid hormone therapy and adjust it, as needed.