If your newborn baby is suffering from decreased activity, increased sleep, constipation, prolonged jaundice then the infant may be suffering from Congenital Hypothyroidism. Approximately 1:2000 to 1:4000 new borns are affected by Congenial Hypothyroidism (CH). As many infants have some thyroid hormone production of their own and as some amount of maternal thyroid hormone passes through trans-placenta, the clinical manifestations are not observed during birth.
The common symptoms found upon examination are macroglossia, hypotonia, myxedematous facies, a distended abdomen with umbilical hernia, and large fontanels. The diagnosis of congenital hypothyroidism shall be confirmed by finding an elevated serum TSH and low T4 and Free T4 levels. Underlying etiology of the diseases may also be detected with the help diagnostic tests such as serum thyroglobulin determination, thyroid sonography, and thyroid radionuclide uptake and scan.
The best treatment option is Levothyroxine with a starting dose of 10 to 15 mcg/kg/day. The treatment is primarily given to bring serum TSH levels to normal and to enhance the serum T4 levels to above 10 ug/dL. Serum TSH and free T4 should be measured and monitered regularly to ensure optimal neurocognitive outcome. During first 6 months of life, serum TSH and Free T4 levels should be measured every month. Thereafter, Serum TSH levels and T4 levels are measured for 3-4 months. Always early treatment gives excellent results showing similar IQ levels with that of other kids. But if the treatment is started after 30 days of age or if the lower doses of l-thyroxine than recommended is given or if the child is suffering from severe hypothyroidism, then a lower neurocognitive outcome may occur.