Congenital hypothyroidism-a detailed review

[@lankalapallimanikantakumar8633]

Great information sir👍

[@SridharKs]

Thank you

[@jabezb.johnson8221]

Hello Sir, good to see your videos. Sir our daughter is just 2 months old and her blood report seems TSH 12.04 and the free T4 level is 0.74. Sir, please guide us.

[@SridharKs]

Is T4 low? Is this the first result or was there a test earlier, why was it done now?

[@jabezb.johnson8221]

@@SridharKs this is the first result dated on 3rd Feb. Actually she was sticking her tongue outside, that's why the doctor suggested for thyroid test.

[@SridharKs]

@@jabezb.johnson8221 what is the lab range for free T4, and what is your doctor’s advice

[@jabezb.johnson8221]

@@SridharKs lab range showing 1.7 to 9.1 for age category 2 weeks to 24 weeks. Started thyroxine 50 mg tablets and the endocrinologist asked to repeat the test. Actually what do we do? can cure completely with treatment?!

[@SridharKs]

@@jabezb.johnson8221 yes, that is the right advice. We need to monitor and possibly reduce the dose. Likely to need treatment for at least 2-3 years and then review.

[@AnushaBM27]

Hello Doctor, My daughter was born on 31stJuly 2024 . Her TSH was >100 IU/ml and The test test was repeated on 8th August 2024 we got the results today and the T3 is 0.69 and T4 is 4.76 and TSH is > 100 again . Please suggest what should be done . And if my baby grows normally after medication.

[@SridharKs]

@@AnushaBM27 I hope treatment has been started immediately without delay. With treatment, results are good

[@AnushaBM27]

@@SridharKs Sir She has been given 25mcg of thyronorm from 11th of August . Hope the dosage is appropriate. and when should we re evaluate her ? Does the dosage change ?

[@localvolgs5606]

Sir my daughter who is of one month old diagnosed with hyperthyroidism, after the scan report says that right lobe is not visible. Is there any chance that later she can develop that lobe ? And can’t the left lobe alone cannot secret the required thyroid hormone??

[@SridharKs]

It depends so need to continue recommended treatment and monitoring

[@meth2003]

Sir, my son who is 7 weeks old when the initial tests at 5 days were done the T4 was 12 (normal range is 11.4 to 29.2) and TSH was 8 (normal range is 0.86 to 5.7) So the initial results were classified as borderline results. The repeated results at 7 days was T4 at 12.4 and TSH was 8.5 After 3 weeks his T4 was 12.9 and TSH was 14.7 After 5 weeks his T4 was 13 and TSH was 8.05 The latest results at 7 weeks T4 is 13.2 and TSH at 10.80 The doctor has suggested we should start giving the baby thyroxine of 2.5ml Do you think we should have continued monitoring instead of starting the medication? How long should the monitoring take before taking medication in a situation where the results are borderline and frustrating? Thank you Sir

[@SridharKs]

It’s fairly stable and not increasing, do free T4 with TSH next time, I think we can monitor without treatment till next repeat in 2 weeks if baby otherwise well

[@meth2003]

Thank you so much Sir

[@meth2003]

Good day, Sir. We have done another blood test for TSH and it came back as 6.4 and the normal range is between 0.86 to 5.7.and the T4 is 13 and the normal range is 11.4 to 29.2. We still haven't started the medication yet. Sir do you think it may be coming back to a normal range or it is going to be going up and down?? Also do you think we should start the medication? Additionally, a scan was done yesterday and the doctors said that the baby's thyroid grand is small but it in the right place and said that there are other kids with small thyroid whose TSH levels are ok. What is your advice on this Sir? Thank you Sir

[@SridharKs]

@@meth2003 no treatment needed, repeat once more after a month and if normal we could stop checking

[@SridharKs]

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[@fatmahbasar5429]

I really appreciate this, may I know what are your references??

[@SridharKs]

If you need reference for a specific point, let me know

[@suvenduprasad9791]

Sir . My son is 19 days age today.. his thyroid test done today and TSH 21. Shall we start medication @@SridharKs

[@SridharKs]

@@suvenduprasad9791 what is the free T4 level and lab range? Is this the first test? What is your doctor advice

[@suvenduprasad9791]

@@SridharKs thyroid report was normal checked on 6th and 9th day of my baby.. but yesterday it was 21. Free T3 was not checked.. only TSH checked.. 04 Oct report baby age 9 days - Total Triiodothyronine (T3) was 76 and T4 was 10.2 and TSH was 2.3. But, 13 Oct report TSH is 21. Baby is being treated for pneumonia, icubac and vanqo injection are now given

[@SridharKs]

@@suvenduprasad9791 sometimes TSH could go up if betadine was used to clean, so best to repeat free T4 and TSH after a week to decide

[@manasisandeep2924]

Hi Doctor Which all factors are considered while deciding when to stop the medication for CH in babies? Will it be required for life long ?Please advise.

[@SridharKs]

Please review this as well. Majority need treatment for life, for the borderline cases we could try off at 3 years but tough to predict sridharparenting.wordpress.com/2024/02/13/how-do-we-approach-borderline-tsh-results-on-newborn-screening-and-subsequent-tests-for-hypothyroidism-thyroid-hypothyroidism/

[@manasisandeep2924]

Hi doctor How can I contact you, need your advice regarding medication for my 5month old baby who is diagnosed with CH

[@SridharKs]

@@manasisandeep2924 I provide email support to channel members-you can join here and update. kzbin.info/door/zq5FmvyFuAO72VMTzfCl-Qjoin

[@nishimakapoorjha6649]

Doctor we started treatment when my son was 6weeks. (TSH 7.6, t3 normal FT4 normal)After one month of taking medicine 12.5mg( TSH rose to 10.5 ,FT4 normal, t3 got slightly high for the first time). History Newborn screening tsh -14 15 days-9.6 30 days-12.5 40 dsys-7.6 ( we started treatment from here) T3 and T4 was normal throughout. Our doc advised us to increase the dose to 12.5 and 25mg alternatively. We have next test schedule when baby turns 3 months now. My concern is TSH is still.not controlled as our doc is increasing the dose slowly. Is it correct way to do. I hope we are not wasting time for the damage to happen. Please note we did ultrasound also which showed that thyroid is rightly placed. Everything looked normal in ultrasound.

[@SridharKs]

It seems subclinical and we could add thyroglobulin at the next test, baby will be ok, don’t worry

[@nishimakapoorjha6649]

@@SridharKs Thank you doc for your quick response. My concern is that we should increase dose this slowly. Is it correct way.I thought we should focus on getting TSH on normal range. As you said in your videos to start with higher dose and then we can decrease the dose. He is about to be three months and Tsh is still not in normal range. FYI Baby's weight is 5kg

[@SridharKs]

@@nishimakapoorjha6649 this is borderline, so treatment is not definitive, slow increase is fine to avoid overdose

[@USMANMUSAADAMU]

Hello Doctor, My Son is 17months old and was diagnosed with hypothyrodism 2 weeks ago. He is development is greatly affected by this because at 17 months, he cannot stand or walk without support. He hasn't uttered any words yet and he has poor growth and poor weight. He weighs 7.7kg as of today. He has been placed on levothyroxine for 2 weeks now. Is there a chance this has caused damage to his brain? I'm really worried about him.

[@SridharKs]

How severe is the hypothyroidism? Is there any other explanation for the delayed development?

[@USMANMUSAADAMU]

@@SridharKs I have no any other explanation regarding his poor development. At the I'm made to believe hypothyroidism is the cause.

[@SridharKs]

@@USMANMUSAADAMU ok, please continue the treatment and support development

[@MrSoindependente]

Hello Doctor, we would like your assistance with our case. Our son had the newborn screening test which detected an abnormality in TSH. We repeated the test on the 10th day, with the following results: FT4 - 1.96 ng/dl (reference range 1.04 - 2.34), FT3 4.97 pg/ml (reference range 2.73 - 8.46), TSH 16.10 uIU/ml (reference range 1.70 - 9.10). Today, on the 14th day, we had a medical consultation where it was decided to start medication (levothyroxine) 12.5 mcg and repeat the test in 4 weeks. What is your opinion? I am concerned about giving the medication unnecessarily and, after starting, not being able to get a “clean” test result to see if the body is producing thyroid hormones on its own, or if we will always have to give the medication. In the case of the thyroid being healthy, would there be any permanent impact on natural hormone production if the medication is given unnecessarily? Thank you very much from Brazil.

[@MrSoindependente]

Additionally, my wife had hypothyroidism only during pregnancy and gradually increased her levothyroxine dose to 100 mcg, with negative anti-TPO tests. She had a normal delivery at 39 weeks, and the baby’s physical exam was normal, with jaundice lasting only until the 5th day, without any need for treatment. Physical responses and weight gain are normal. Thank again

[@SridharKs]

@@MrSoindependente thank you for a very detailed summary. I agree with you, immediate treatment is not necessary and could confuse the long term plan. Repeat after a week to 10 days and we could decide then. No risk as T4 is normal. Read this sridharparenting.wordpress.com/2024/02/13/how-do-we-approach-borderline-tsh-results-on-newborn-screening-and-subsequent-tests-for-hypothyroidism-thyroid-hypothyroidism/

[@SridharKs]

@@MrSoindependente and this playlist has a few other videos discussing this Playlist covering Thyroid function and hypothyroidism kzbin.info/aero/PLKe2uxLSi6cG4Br9mFnFxm9T_EetL7kNk

[@fatimakhurshid8033]

Hey what was the TSH level at the first day of his birth?

[@dhanrajvhatkar6015]

Sir my daughter is 6 days old and her belirubin was 17.6 after phototherapy it has reduced to 12 but diagnosed and her TSH level is above 150.. sir pls tell if there is any treatment nd chances for permanent recovery from it. me and my wife are very much worried and my wife has went in depression. Sir plz i wil be waiting for ur reply

[@SridharKs]

@@dhanrajvhatkar6015 as explained in the last part of this video, it’s fully treatable and it’s good you picked it early. Don’t worry and be strict with treatment

[@dhanrajvhatkar6015]

@@SridharKs ok thank you sir

[@bellanasandya2544]

Hi..sir My baby girl born on 21st November 2024, after 3days billurubin 19 and Tsh 12. Later phototherapy was done billurubin was count reduced. After 2months Tsh 100 above then doctor started treatment 50mcg thyroxin, after 3weeks tsh levels are little high then doctor suggested 37.5mcg, After 6weeks same repeat 30mcg, after 6weeks same then doctor adgust dose 20msg, after 6weeks same tsh 0.01high then 10msg. Now doctor said no medicine for 6weeks is this correct? Is there any impact on baby brain development?

[@SridharKs]

Did you mean TSH was 100 at 2 weeks (you mentioned 2 months above), when you started treatment? Recheck free T4 and TSH after 10 days of stopping treatment to check

[@bellanasandya2544]

@@SridharKs yes..after 2months they suggest blood test that time only started treatment with 50msg

[@bellanasandya2544]

@@SridharKs no blood test was done till 2months after birth and no treatment was done, we worry about that, what happened that 2month period.

[@bellanasandya2544]

@@SridharKs sir.. 4weeks after stopping treatment results are Tsh 2.86 and free t4 9.4

[@SridharKs]

@@bellanasandya2544 I am not sure if there was a transient cause of hypothyroidism as it’s ok now without treatment. Continue monitoring both thyroid function (again after 2-3 weeks and then 1-2 monthly) and development. There is a risk but if baby normal so far, stay positive. Did you consult endocrinologist

[@prashishjain7062]

Hello doctor, my daughter had 14TSH on the 3rd day. We got the resutls on 8-10 days. We repeated the test. It showed 32 and T4 was 1.3 Normal. And then we started on 25MG tablet. After one month we repeated the test, now the TSH is 0.4 and T4 is 2.1. What should we do now ?

[@SridharKs]

We could keep the same dose and repeat after 2 weeks again and if TSH drops lower, reduce the dose. What is the lab range of T4 (better to do free T4)

[@SridharKs]

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[@prashishjain7062]

Yes Dr. WE did the free T4 both times. First test which was done on 14th day showed 1.3 (normal range 0.8 - 2) and yesterday we did Tsh was 0.4 (Normal range was 0.6 - 10) and Free t4 showed 2.1 (0.8-2 is normal range) @@SridharKs

[@SridharKs]

@@prashishjain7062 since it’s already above the range, you could give alternate days 25 and 12.5 microgram dose (odd even days), and repeat after 2-3 weeks (TSH and free T4)

[@prashishjain7062]

Above the range is good sign or bad ? will we need to continue this for 3 years ? @@SridharKs

[@abdulwali2194]

Sir my daughter has congenital hypothyroidism she is on thyroxine replacement since 1 month of age and I am giving her half tablet of throxine 50mcg daily she is one year old now her serumTSH was

[@SridharKs]

Since TSH is suppressed, what was the free T4? Alternative day dose is an option if needing to reduce dose. Did you show doctor about neck swelling, more likely a lymph node related to viral infection (will improve)

[@abdulwali2194]

Only tsh test was suggested by doctor there was no report about T4 and t3 .and I shall get her to doctor in next week

[@abdulwali2194]

I shall send you her new blood test report?

[@SridharKs]

@@abdulwali2194 please mention here including lab range

[@abdulwali2194]

@@SridharKs ok thank you

[@dranbudentist]

My wife have congenital hypothyroidism..i have a boy baby 1and half age..is that may affect my child too??...please reply..and also i m going to divorce now because i can't live as a normal life..i don't know why..i feel like she is not a normal person..but she take medicines from 8 yr old..can u suggest me am i right or wrong..please🙏🙏🙏

[@SridharKs]

@@dranbudentist sorry to hear that, can’t comment on the divorce part but in general, try your best to discuss, possibly attend counseling for both and resolve if possible. Hope the baby had thyroid tested, if not you could do free T4 and TSH

[@SridharKs]

@@dranbudentist Should we perform thyroid function for the baby if mother is hypothyroid? Dr Sridhar K kzbin.info/www/bejne/fJmTi6mEl8losLc

[@suchandraghosh3006]

Sir my baby is 2 months old. T3 1.03(1.6 -3.8) t4 9.11 (9.4 -19.3)and tsh 4.75 Should i start medication

[@SridharKs]

Is there any constipation or other concerns

[@SridharKs]

Read this sridharparenting.wordpress.com/2024/02/13/how-do-we-approach-borderline-tsh-results-on-newborn-screening-and-subsequent-tests-for-hypothyroidism-thyroid-hypothyroidism/

[@sara78130]

Hi my daughter have that problem. Afrer 10 days born. Test bk 😢. We so much worri

[@SridharKs]

Read this, and if treated early, everything goes well. Our body has a network of glands called endocrine glands, which secrete small amounts … sridharparenting.wordpress.com/2024/02/13/how-do-we-approach-borderline-tsh-results-on-newborn-screening-and-subsequent-tests-for-hypothyroidism-thyroid-hypothyroidism/

[@sara78130]

@@SridharKs thanks doctor

[@SridharKs]

@@sara78130 best wishes

[@parii78921]

​@@SridharKs plzz sir ans me

[@parii78921]

​@@SridharKsSir meri ka daughter 18 days old pr test krya TSH level 50 tha after 10 days repeat the test TSH level 27 without medicine plz tell me what do next medicine start kre others wise test

[@bhaskarapapu6874]

Namasthe sir today we admitted again for billrubin raise again 26.95 Today tested Thyroid Then result is TSH- 1.58 mcIU/mL FT4 - 4.58 ng/dl T4- 24.10 mcg/dl Doctor told us to stop breast feeding for 2 days hopefully jaundice will be controlled .. I will mail the today and old TSH report please check and suggest me sir.

[@SridharKs]

Ok, hopefully it will improve with phototherapy. Express to empty both breasts every 3-4 hours and store the milk in freezer so output doesn’t drop

[@bhaskarapapu6874]

Ok sir thank you..

[@bhaskarapapu6874]

Namsthe sir.. After 3 weeks still billirubin 26.95 But baby under photo therapy treatment.. Plz tell me sir this bilirubin's possible to brain damage under photo therapy treatment is ongoing

[@Pearlypearl277]

Sir my baby tsh is >100 was tested after abirth it was repeated after 3 days t3 and t4 was normal But the tsh showd 100 againThe doctor suggested to give 12.5 mg thyroxine daily and he suggested to take a retest after 2 weeks it was taken and the tsh is showing 100 again t3 is low t4 is normal Doctor increased the dose to 25 mg sir can u pls suggest us y the tsh is not dropping ,if we have to continue with this treatment or take a diff advice

[@SridharKs]

You need to continue the treatment and the dose might need increasing again if not reducing. Very important as this is a crucial period for baby. Test only free T4 and TSH next time, T3 or total T4 don’t offer much information. And it depends on where it is on the lab range, sim for above the mid range for free T4

[@RAHULKUMAR-mx6wp]

Sir my baby tsh after two days of birth was (DOB 07.02.2023)11.8 after two week it was 39.6 and bilirubin was 14.8 after doctor consultation in next day report tsh was 36.11 t3 and t4 was in normal range. Doctor Started thyroxin sodium. Parent have no hypothyroid history. So pls guide us what to do next. Should we go further consultation another doctor or to go higher centre for treatment.

[@SridharKs]

Just continue the treatment but monitor the free T4 and TSH after 2 weeks as it is likely only a low dose will be needed. Could be subclinical

[@RAHULKUMAR-mx6wp]

@@SridharKs sir dose ELTROXIN 50 mcg de rhe hai neck ultrasound report was normal. Doctor asked revisit after one month regularly for one year and second year after every two year. Dose till 3 years. Thanks sir for your response

[@SridharKs]

@@RAHULKUMAR-mx6wp I would suggest repeating after 2 weeks of starting as dose will likely reduce (half dose might be enough in this case)

[@RAHULKUMAR-mx6wp]

@@SridharKs sir, i went chandigrah PGI hospital on 14*03*2023 where tsh test was done report was t3 no reagent/T4 was 13.7 tsh was 0.01. Thyroxin sodium 50 mcg is giving to baby since 20.02.23. Pls sir give your views

[@SridharKs]

@@RAHULKUMAR-mx6wp what did the doctor say, we need to reduce the dose to possibly half and repeat again after 2-4 weeks

[@sayyadafatema4452]

Hello doctor, When my baby was born 02/12/24, TSH was 18. After 4 months, the test taken today, TSH is 6.24. T3 is 155.04 T4 is 7.70. Can we do without medications? Kindly reply

[@SridharKs]

Was it repeated for the first time after birth now? What is the range for T4? If in normal range, it won’t need treatment

[@sayyadafatema4452]

Thank you so much for replying doctor. Yes doctor. Repeated first time after birth. T4 is 7.70. Normal range is 4.87-11.72. She is 4 month old now. And achieving all the milestones. Nothing to worry, right doctor. Kindly reply.

[@SridharKs]

@@sayyadafatema4452 yes, don’t worry

[@sayyadafatema4452]

Thank you so much, Doctor. Thank you for sharing the happy news that she doesn't need treatment.

[@SridharKs]

@@sayyadafatema4452 best wishes