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Is my newborn’s thyroid levels fine?

Dr Archana Arya
Consultant Pediatric Endocrinologist,
Centre for Child Health,
Sir Ganga Ram Hospital, New delhi

Q: My wife is a type 2 diabetic and has hypothyroidism. Right through out the pregnancy she was on 150 mcg of Thyronorm and her values for TSH and Free T3 were well within range. The baby's results for TSH and Free T4 are as follows: (test was done when baby was six days old) Free T4 - 2.69* ng/dL (ref range - 0.71-1.85), TSH - 5.14 IU/mL #181 (ref range - 2-20 weeks:1.7-9.1, adults:0.4-4.67, children:0.7-6.4, newborn:1.0-39.0). (* Indicates test value is outside reference range defined). We are worried about the more than normal Free T4 levels. What do we do?

A:T4-2.69 and TSH of 5.14 are normal for a 6-day-old baby. A re-screen (thyroid functions) at 2-4 weeks of age should be done. There is a figure of 181 mentioned with your TSH report. Is it an error, since a TSH of 181 is very high and abnormal.