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Is my daughter still having hypothyroidism?

Q: My one-month old daughter is having hypothyroidism since birth. She had high bilirubin count (19.9 mg/dL) at the time of the birth, due to which she had infant jaundice. The doctor suspected thyroid problem for high bilirubin and hence we did a TSH test. Six days after birth, her T4 - 1.97 ng/dL, T3 - 4.99 pg/mL, TSH - 13.76 uIU/mL. After 17 days we started giving her Thyroxine 0.025 mg daily. Then we tested her thyroid levels again after 2 weeks in which, T4 was 1.61 ng/dL, T3 - 4.58 pg/mL, TSH - 2.62 uIU/mL. So, we gave her Thyroxine on alternate days for 4 days. Now last week her thyroid levels were - T4 - 0.94 ng/dL, T3 - 4.85 pg/mL, TSH - 9.76 uIU/mL. Is my child still having hypothyroidism symptoms? Do I need to continue Thyroxine? Are there any side effects of these tablets? What is the normal TSH value for infants?

A:Your child does have compensated hypothyroidism, although it may not be permanent. The treatment needs to be continued till 3 years since thyroid functions must be normal for normal brain development till the age of 3 years. The child can be re evaluated at 3 years of age.

Your child's latest report shows a high TSH again on alternate day of 25 mcg Thyroxine. This means that the dose needs to be increased. You should contact your paediatrician / paediatric endocrinologist. High TSH is not good for the baby. Lab work up should be done regularly for dose adjustment. If the thyroid functions remain normal there are no side effects.

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