Pediatric Endocrine System: Symptoms, Causes, and Basic Care

A child who eats a lot but loses weight is one sign of thyrotoxicosis (hyperthyroidism).

What is the endocrine system?

The endocrine system is the body’s network that produces and releases hormones. Hormones send signals to organs to function—for example,
supporting growth, regulating metabolism, controlling brain function and internal organs.
This system consists of several glands working together to keep the body in balance. Understanding the endocrine system
is the first step toward staying healthy from childhood through adulthood.

Key components of the endocrine system:

The endocrine system includes several important glands:
– Pituitary gland: Controls other glands such as the thyroid, adrenal glands, and gonads.
– Thyroid gland: Regulates metabolism and growth.
– Adrenal glands: Produce cortisol and adrenaline to handle stress and maintain fluid–electrolyte balance.
– Parathyroid glands: Regulate calcium and phosphorus levels.
– Pancreas (endocrine portion): Produces insulin and glucagon to control blood sugar.
– Gonads: Regulate sexual development and reproduction.
Each gland works together in complex ways to maintain body homeostasis.

Functions of the endocrine system

The endocrine system plays many key roles:
– Regulating growth: Pituitary and thyroid hormones support height and bone mass development in children.
– Controlling metabolism: Thyroid hormones drive energy expenditure and body temperature.
– Regulating blood sugar: Insulin and glucagon from the pancreas keep glucose in balance.
– Governing sexual development: Sex hormones from the gonads enable normal puberty.
– Responding to stress: Cortisol and adrenaline from the adrenal glands help the body cope with stress.
When the endocrine system functions normally, children grow and develop appropriately.

Endocrine disorders

Endocrine disorders in children can present in many forms, such as:
– Thyrotoxicosis (hyperthyroidism): Eating a lot with weight loss, palpitations, and sleep problems.
– Hypothyroidism: Short stature, slowed cognition, developmental delay.
– Type 1 diabetes: The pancreas produces insufficient insulin, leading to high blood sugar.
– Type 2 diabetes: Insulin resistance, often in children with excess weight.
– Disorders of sex hormones: Precocious puberty or delayed sexual development.

Causes may include genetics, autoimmune disease, nutrient deficiencies, or stress.

Symptoms

Goiter, easy fatigue, palpitations, increased appetite with weight loss, in some cases diarrhea and frequent stools, irritability, heat intolerance, sweating, bulging eyes.
Menstrual irregularities are common in adolescence and occur more often in girls than boys.

Causes

The most common cause is Graves’ disease.

Treatment

First-line treatment is oral medication. If medication is ineffective or causes adverse reactions, other options may be considered, such as
radioactive iodine therapy or surgery.

Without treatment—or with delayed treatment—symptoms may become severe, leading to heart failure or arrhythmia
and possible admission to the ICU.

Hypothyroidism

This condition may be present from birth (congenital), which can cause cretinism, or it may occur later in life—thus it can be found at any age.

• In newborns: jaundice, edema, poor feeding, constipation, delayed passage of meconium, delayed fontanelle closure, delayed umbilical stump separation,
  and global developmental delay affecting cognition, height, and muscle strength.

• In older children: short stature, constipation, goiter, poor academic performance. Treatment with thyroid hormone replacement
  can improve symptoms and height velocity.

Precocious puberty

Girls

Signs before age 8 include breast development, acne, body odor, axillary hair,
pubic hair, and being taller than peers; some may have the first menstrual period before 9½ years of age.

Causes

In many girls no specific cause is identified. Some may be exposed to environmental or dietary hormones,
and some cases are due to certain tumors.

Boys

Signs before age 9 include enlargement of the penis and testes, acne, axillary hair,
pubic hair, and voice deepening.

Causes

A common cause in boys is a pituitary tumor.

Impacts or adverse effects of precocious puberty

• Physical: Early closure of growth plates can result in reduced adult height (short stature).
• Psychological: Particularly in girls who may not be ready to manage menstruation and related changes.

Treatment

Treatment may involve intramuscular injections once monthly or once every three months
to slow bone maturation and prevent early epiphyseal closure,
suppress menstruation, and preserve final height potential.

Type 1 diabetes

Type 1 diabetes is common in children and adolescents and is more prevalent than type 2 diabetes in this age group.

Type 1 diabetes occurs when the immune system attacks the insulin-producing cells of the pancreas. Typical symptoms include frequent urination, excessive thirst,
and weight loss. If treatment is delayed and the condition progresses, children may become fatigued, drowsy, breathe deeply and rapidly,
and develop abdominal pain. Without treatment, shock may occur and can be life-threatening.

Treatment

Treatment requires insulin injections to maintain blood glucose within target range.
Children and families need education on healthy food choices, carbohydrate counting, insulin administration,
self-monitoring of blood glucose, and recognizing signs of both high and low blood sugar.

Type 2 diabetes

Children with type 2 diabetes are often overweight, may have darkened skin on the neck, and experience frequent urination and thirst.
It is commonly diagnosed around puberty.
Some may have perinatal risk factors such as birth weight under 2,500 g or over 4,000 g,
maternal gestational diabetes, or a family history of diabetes.

Type 2 diabetes results from insulin resistance. Management includes oral medication along with diet and exercise. In advanced cases or with delayed care,
injectable therapy may be required.

Short stature: what criteria and possible causes?

Short stature in children is defined as height below the 3rd percentile for age and sex.

Multiple possible causes

• Short stature without underlying disease: familial short stature or a “late bloomer.”
• Short stature due to disease: malnutrition, chronic illnesses, hypothyroidism, growth hormone deficiency,
  rickets, genetic disorders, and others.

***If you notice a child has short stature, consult a doctor to determine the cause through blood tests and a bone-age X-ray,
and begin prompt treatment based on the underlying cause.

Frequently Asked Questions (FAQ)

What happens if the endocrine system malfunctions?

Children may show varied signs such as short stature, weight loss, weight gain, eating more yet becoming thinner, or puberty out of sync with age.
Regular health checkups help detect and treat problems early.

How can we care for a healthy endocrine system?

Have annual checkups including hormone assessments. Eat a balanced diet with iodine, calcium, and vitamins.
Exercise regularly. Monitor a child’s growth and development, and consult a doctor promptly if abnormalities are noted.

Which endocrine glands are important?

Key glands include the thyroid, parathyroid, adrenal glands, pituitary, pancreas, and ovaries/testes,
each with essential roles in a child’s health and development.

Consult a pediatric endocrinology specialist at the Pediatric Diabetes & Endocrine Center of Synphaet Hospital
near you

Synphaet Children’s Hospital

Synphaet Hospital Ramintra

Synphaet Hospital Lam Luk Ka

Synphaet Hospital Srinakarin

Synphaet Hospital Seriruk