Thyroid Program

What is the Thyroid Program?

Seattle Children’s Thyroid Program provides comprehensive, team-based care for children and adolescents up to age 21 with thyroid conditions. Such conditions include thyroid nodules, too much thyroid hormone (hyperthyroidism), too little thyroid hormone (hypothyroidism) and thyroid cancer.

The thyroid is an organ in the neck that affects your child’s growth and development because it makes hormones that control metabolism and affect growing cells. If your child has a thyroid condition, it is important to work with pediatric specialists who understand the best ways to diagnose and treat these conditions in young people who are still growing and developing.

Seattle Children’s Thyroid Program brings pediatric specialists together to tailor care to your child, whether your child needs medicine, a biopsy, surgery or other treatment.

How will the Thyroid Program meet my needs?

Seattle Children’s Thyroid Program is the only multidisciplinary program in the Pacific Northwest to specialize in children and teens with thyroid conditions.

The program brings together experts from endocrinology, otolaryngology, general surgery, oncology and other fields to evaluate and address your child’s healthcare needs.

Seattle Children’s is proud to be recognized among the top places in the nation to care for children.

The experts you need are here

We work as a team, bringing a wealth of combined experience to your child’s care. We talk with each other and with you to coordinate your child’s diagnosis and treatment and connect you with the right specialists.

If your child needs surgery, our otolaryngologists who are head and neck surgeons and our general surgeons have the special training and experience to perform surgery for infants, children and teens. We do many thyroid surgeries each year and are considered a high-volume surgical center.

For children with thyroid cancer, Seattle Children’s oncologists and radiologists offer the most advanced treatment options.
Our approach to biopsies is easier on your child
- If your child has a thyroid nodule or thyroid mass, your child might need a biopsy (cell or tissue sample) to check for cancer. We get your child in quickly. For most children, we can do a physical exam and a fine-needle aspiration biopsy in the same clinic visit. Using a fine-needle procedure to draw up a sample is not as invasive as cutting into the skin and avoids the need for general anesthesia. Watch the video about the procedure.
- We numb the area using a needle-free device called a J-tip that pushes medicine (buffered lidocaine) into your child’s skin with a strong puff of air. Then we use a very thin needle (thinner than for a blood draw) to take a sample of cells. We use ultrasound to guide the needle to the right place.
- You and your child are in control – if your child feels too nervous about being awake during the biopsy, we schedule a biopsy under general anesthesia (so your child is unconscious) instead.
We are active in research to advance pediatric care
- Research on fine-needle aspiration biopsies for thyroid conditions shows our results for children and adolescents are as accurate as the results of doctors doing these biopsies for adults.
- Surgery to remove the thyroid can disturb blood flow to the parathyroid glands, leading to low levels of calcium in the blood (hypocalcemia). This needs treatment and can extend a child’s hospital stay after surgery. A study at Seattle Children’s showed our patients are ready to leave the hospital sooner, compared to children in other studies, because of our methods to carefully manage low calcium.
- Dr. Marguerite T. Parisi has been involved in many studies on the use of radioactive iodine (radioiodine, or I-131) therapy for overactive thyroid. She is part of the American Thyroid Association Pediatric Guidelines Committee. The committee develops guidelines to help doctors decide on the best care for children with specific thyroid conditions.

Conditions We Treat

Hyperthyroidism (too much thyroid hormone, or overactive thyroid), including Graves disease
Hypothyroidism (too little thyroid hormone, or underactive thyroid), including Hashimoto’s disease
Thyroid nodules, including an enlarged thyroid with more than 1 nodule (multinodular goiter)
Thyroid cancer, including well-differentiated thyroid cancer (papillary and follicular) and medullary thyroid cancer
Conditions that may raise a child’s risk for thyroid cancer, including these:
- Family history of thyroid cancer (familial thyroid cancer)
- Multiple endocrine neoplasia (MEN) syndromes
- Prior radiation therapy for other cancers
- PTEN syndrome (Cowden syndrome)
Our Cancer Predisposition Clinic screens and cares for children born with a gene change that raises their cancer risk.

How can I get an appointment?

If you would like a referral to the Thyroid Program, talk to your primary care provider.

If you have a referral:

Please call Otolaryngology at 206-987-2105 to schedule an appointment if your child:
- Needs a thyroid nodule checked
- Has a referral for a fine-needle aspiration biopsy of the thyroid
- Was diagnosed with thyroid cancer
Please call Endocrinology at 206-987-2640 to schedule an appointment if your child has any other thyroid concern.

Learn more:

If you already have an appointment with Otolaryngology, learn more about how to prepare.
If you already have an appointment with Endocrinology, learn more about how to prepare.
Learn more about Otolaryngology resources and Endocrinology resources such as useful links, videos and recommended reading for you and your family.

Telemedicine at Seattle Children’s

Your child’s first appointment in our clinic will be in person and take about 90 minutes. Later visits may be offered via telehealth (virtual). Learn more.