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Diagnosed With Hypothyroidism. Is This Curable? What Are The Treatments Available?

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Posted on Mon, 11 Feb 2013
Question: Hello Sir,
My son is 26 days old its diagnosed that he has hypothyroidism.
The values are :
T3 : 2.13
T4 : 0.16
TSH: 95

Could you please let me know how what is the present condition and is there any abnormalities which can happen to my baby because of this.
Also what is the treatment for this ?
Is it completely curable ?

Thanks& Regards,
XXXXXXX
doctor
Answered by Dr. Sheeba Stephen (3 hours later)
Hello and welcome to Healthcare Magic. Thanks for your query.

I understand your concern about your baby's health condition. The thyroid function tests indicate that the T4 level is low and the TSH level is abnormally high, indicating a neonatal hypothyroidism. If this condition has been present from birth, then it is termed as 'congenital hypothyroidism'.

Infants with hypothyroidism can have various symptoms such as poor feeding, excessive sleepiness, sluggishness, constipation, decreased muscle tone, etc. If left untreated, it can lead on to further systemic complications and even intellectual deficits.

So, early diagnosis and prompt treatment is very important. If appropriate treatment is initiated immediately, then most of the effects of hypothyroidism are easy to reverse. Since your baby's TSH is very high (a value of above 40 is considered significantly high), it may indicate a severe hypothyroidism. In such a case, treatment has to be started immediately. Thyroxine hormone is usually given to treat this condition. Your baby also needs to have a thorough physical examination to check for any possible complications. After starting treatment, periodic blood tests should be done to monitor the improvement.

Don't worry, I'm sure that the doctors treating your baby would be giving him the necessary treatment. I would advise you to consult your neonatologist / pediatrician regarding the treatment details and further management plans.

Wish you all the best.

Regards,
Dr. Sheeba Stephen
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sheeba Stephen (20 hours later)
Hello Dr.Sheeba,

Thanks for your kind reply.

Now my baby is discharged from the hospital after 2 days of phototherapy and he is
taking the medicine Eltroxin.
Also he is taking the medicines:
Calcimax - 1.5 ml
A2Z drops - 4 drops

Lab reports:
Bilrubin total :5.9
bilirubin conjuvated :0.2

Thyroid test(before starting the medicine):
FP3 - 2.14pg/ml
FP4 - .16 ng/dl
TSH > 95 lu/ml

HC: 35 cm(mentioned in the discharge summary)

This is the treatment he is taking, So do you think its fine or do we need to go for some other treatment or checkups. kindly suggest ?

Also i have few more queries, kindly answer me :

You have mentioned that the TSH value is very high and my baby has severe hypothyroidism, does it mean that we were late to diagnose this and he has risk of having some abnormalities and growth problem ?

Could you please tell me what is the biological reference value of T3,T4 and TSH for infants of his age ?

He is suffering from hypothyroidism due to some problem with his Thyroid gland, right ? so eltroxin will cure this problem or only provide the thyroxine hormone needed for the baby ?

Do we need to continue this medicine in his life time ?

What could be the reason for this hypothyroidism. The baby will have this problem only if his parents are suffering from this problem ?

Also kindly suggest, is there any other things that we need to take care of ?

Thanks& Regards,
XXXXXXX
doctor
Answered by Dr. Sheeba Stephen (13 hours later)
Hello again,

The liver function tests indicate that he has jaundice. This could be because your baby was born with a low birth weight and probably premature, and such babies can have neonatal jaundice. This is the reason he was given phototherapy.

His previous thyroid function tests are also indicative of hypothyroidism. These are the general reference values for infants of his age (2 to 6 weeks). There can be minor variations in the reference range from lab to lab.

TSH: 1.7 to 9.1 Mic.U/ml
Total T4: 6.5 to 16.3 Mic.g /dl
FT4 0.9 to 2.2 mg/ml

The current medication prescribed - Eltroxin is a thyroxine hormone supplement and is the correct treatment for hypothyroidism. This will ensure that the baby gets the required thyroid hormone, essential for the inportant growth and developmental functions of the body. It will not cure the hypothyroidism. There can be a variety of causes for hypothyroidism in the newborn. The cause for the hypothyroidism has to be investigated and treated accordingly. It is not possible to arrive at a probable cause without a detailed history, examination, and detailed evaluation.

It is good that the thyroid disorder has been picked up now and appropriate treatment has been started. This will minimize the risk for future growth and developmental problems. But it is very difficult for anyone to say right now whether the diagnosis was done too late or to predict the degree of risk for developing future problems.

I understand that you are very worried and anxious about this, as every father would be, but there are certain medical problems which we can only diagnose early and treat appropriately; but it is not possible to predict how quickly will this get cured or what will be the after effects, especially at this early stage. We have to observe and keep monitoring the baby regularly, both for the thyroid levels as well as for any other complications.

I would advise you not to worry too much because the diagnosis has been made early and correctly and the right treatment has been given. So, trust in God and trust in your doctors and everything will work for good.

Wish you all the best.

Regards,
Dr. Sheeba Stephen

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Sheeba Stephen (1 hour later)
Thank you very much for the detailed explanation .
doctor
Answered by Dr. Sheeba Stephen (1 hour later)
I'm happy to have been able to clarify your doubts. Please close the query and leave a review if you are happy with the answer.

Wish you a happy parenting experience...

Regards,
Dr. Sheeba Stephen
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Sheeba Stephen

Emergency Medicine Specialist

Practicing since :2006

Answered : 300 Questions

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Diagnosed With Hypothyroidism. Is This Curable? What Are The Treatments Available?

Hello and welcome to Healthcare Magic. Thanks for your query.

I understand your concern about your baby's health condition. The thyroid function tests indicate that the T4 level is low and the TSH level is abnormally high, indicating a neonatal hypothyroidism. If this condition has been present from birth, then it is termed as 'congenital hypothyroidism'.

Infants with hypothyroidism can have various symptoms such as poor feeding, excessive sleepiness, sluggishness, constipation, decreased muscle tone, etc. If left untreated, it can lead on to further systemic complications and even intellectual deficits.

So, early diagnosis and prompt treatment is very important. If appropriate treatment is initiated immediately, then most of the effects of hypothyroidism are easy to reverse. Since your baby's TSH is very high (a value of above 40 is considered significantly high), it may indicate a severe hypothyroidism. In such a case, treatment has to be started immediately. Thyroxine hormone is usually given to treat this condition. Your baby also needs to have a thorough physical examination to check for any possible complications. After starting treatment, periodic blood tests should be done to monitor the improvement.

Don't worry, I'm sure that the doctors treating your baby would be giving him the necessary treatment. I would advise you to consult your neonatologist / pediatrician regarding the treatment details and further management plans.

Wish you all the best.

Regards,
Dr. Sheeba Stephen