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What does this thyroid report indicate?

Answered by
Dr.
Dr. Sumanth Amperayani

Pediatrician, Pulmonology

Practicing since :2003

Answered : 8100 Questions

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Posted on Thu, 8 Sep 2016 in Child Health
Question: (please refer attachment if question is not properly appearing) The TSH level for my baby was seen slightly above the normal value at 15 days after birth .Suspecting transient hypothyroidism we followed up the tests for TSH , T4 and free T4 for quite a number of times as suggested by the Neonatologist. Results are as follows

Age of baby at which test was conducted       TSHValue T4Value Free T4 Value

1 day (on the day of birth)                11.08 uIU/ml      97.38 nmol/l Not tested
15 days      19.26 uIU/ml      192.86 nmol/l      Not tested
17 days      13.33 uIU/ml      186.59 nmol/l      Not tested
19 days      7.6 uIU/ml      150.94 nmol/l      16.82 pmol/l
24 days      8.05 uIU/ml      121.73 nmol/l      Not tested
36 days      6.69 uIU/ml      90.06 nmol/l      13.24 pmol/l
52 days 9.15 uIU/ml      116.8 nmol/l      Not tested T3=3.1nmol/l on 52 days

Kindly advice whether we have to start the medication for the baby. If not, Considering these values - with what frequency we should monitor the TSH & T4 levels to ensure that the baby is well ?
Also, in the test conducted on 52nd day , we checked T3 for the first time and the value is 3.1 nmol/l

Note : We did Ultra sound of thyroid gland and the same appears normal. She had IUGR attributed to issues in placental blood flow, and weighed 1.94 kg at the time of birth.Presently, she is doing absolutely well and weighs 3 kg 100 grams 45th day. No signs of sickness, constipation or color change to urine/stool. We did another USG suspecting an infection, same appeared normal.




doctor
Answered by Dr. Sumanth Amperayani 43 minutes later
Brief Answer:
Need normal range values please

Detailed Answer:
Hi.... I understand your concern. Actually I was planning to write everything age wise in a tabular form and get back to you. But on opening the PDF which you have uploaded I was quite happy because this was exactly what I wanted. Thank-you for that.

First of all please be rest assured that your baby is normal and doing fine.

Regarding the TSH value we need to put the baby on medication only if it is more than 20. But there is a small point of concern and this is regarding the normal range of TSH and T4 and free T4.

I am telling this because each lab has its own methodology for testing this and their own reagents and so the normal ranges also differ from lab to lab. This is the reason why I am asking you to present me the normal ranges of the values which have been tested.

I will be awaiting your reply.

Regards - Dr. Sumanth
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumanth Amperayani 29 minutes later
Hi Doctor ,

In the lab report , they have not mentioned the term 'Normal range'. Instead the terminology 'reference range' is used . I am attaching such a report which corresponds to 19 days as mentioned in table above.

My neonatologist is telling that , its is not a matter of concern unless TSH level is higher than 10 uIU/ml. What I am looking for is an assurance/correction from an expert.Also, need to know whether I should periodically check the TSH & T4 of the baby and if so till what age and with what time frequency ?.

Note : The test is done by a lab in one of the very famous hospital in XXXXXXX and If the same proves inadequate to draw conclusions for an expert, then I would be worried about the facility there.

Regards
doctor
Answered by Dr. Sumanth Amperayani 32 minutes later
Brief Answer:
Please be rest assured - your baby is normal

Detailed Answer:
Hi... please be rest assured that your baby is -normal. I have gone through the reference ranges and I am satisfied with the report. You need not go to any other lab for for the testing as this seems to be perfectly fine. Coming to your queries one by one -

1. Here after you can check free T4 and TSH for the baby monthly once, until 3 months of age that is another one sample before 3rd month.

2. If that value is normal you can check it at 6 months of age and another at 1 year of age. Apart from this you need not keep repeating the test monthly once or 15 days once.

3. Now I will suggest you the symptoms which should make you think of repeating the test apart from the schedule I have mentioned - constipation, lethargy, baby being in active and preferring to sleep, tongue protruding from the mouth, umbilical hernia, rough skin and cold intolerance. If these are not there and the baby is actively growing and feeding well and otherwise active and playful you need not worry.

I wish your kid a bright future. If you need any future medical consultation and suggestions, I will be glad to help. You can approach me at the following link.

Once the page opens there will be an option below my image as – ASK ME A QUESTION – click on it.

In this way even in health care magic you can follow up always with a single doctor who knows the history of your kid completely. Please find the link below -

www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696

Regards - Dr. Sumanth
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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