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    What do these TSH and T4 values indicate?

Posted on Mon, 31 Jul 2017 in Child Health
Question: Our daughter is 2 weeks old and her TSH is at 8.84, whereas her T4 is at 1.84. We haven't been contacted yet by the pediatrician to know if these limits are within the norm. Our daughter doesn't cry much at all and seems week at times and lethargic.
Are these levels normal? Do levels of TSH and T4 change from state to state? We live in WA state.
Mom has thyroid (Hashimoto) and was taking 100mg of medicine (daily) during pregnancy.
Answered by Dr. Mirjeta Guni 40 minutes later
Brief Answer:
About neonatal hypothyroidism;

Detailed Answer:
Hello and thank you for asking!
I can understand your concern regarding to your daughter's health.
It is very important to specify exactly when is TSH level checked;
A physiologic surge of TSH occurs within the first 30 minutes of life and appears to be related to the stress of delivery and exposure to the cold temperature of the extrauterine environment. Serum TSH levels peak at levels as much as 70 mIU/L within the first 24 hours of life and then rapidly drop to less than 10 mIU/L within the first 3 days of life. Beyond the neonatal period, healthy serum levels of TSH are less than 6 mIU/L.
About T4, I would like to know is it Total T4 or Free T4?
Will be a pleasure to help you further.
Kind regards,
Above answer was peer-reviewed by : Dr. Kampana
Follow up: Dr. Mirjeta Guni 10 hours later

Thank you for the prompt reply. We are not sure of it is Total or Free T4. What is the significance if it is Free T4 vs Total T4?
My daughter's TSH at birth was 10.3.
We just want to know that at two weeks of age TSH at 8.84 is not harmful as we understand the implications of high TSH can be devastating!
Answered by Dr. Mirjeta Guni 26 minutes later
Brief Answer:
No need to worry;

Detailed Answer:
Welcome back,

If it is FT4 it is within the normal ranges, if it is total T4 the level you reported is low (even though different labs may have different normal ranges for T4).

The level you reported is not harmful, no need to worry, devastating would be if it were over 40 mUI/ml and in these cases prompt treatment is recommended.

In normal infants TSH may remain up to 9 mUI/ml for up to 12 weeks. So it is considered normal.

Wish you good health,
Kind regards,

Above answer was peer-reviewed by : Dr. Arnab Banerjee
Answered by
Dr. Mirjeta Guni


Practicing since :2006

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