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-   -   12 days old and TSH 7 - Congenital Hypothyroid? (http://www.healthboards.com/boards/thyroid-disorders/929180-12-days-old-tsh-7-congenital-hypothyroid.html)

alwaysthere 11-26-2012 06:39 PM

12 days old and TSH 7 - Congenital Hypothyroid?
 
Hi,
my daughter had a TSH reading of 20 in her newborn screening and everything else was negative. About a week later we did another test for TSH and H4 and the results were 7 for TSH and 1.000(something) for T4. The results were given to my SO over the phone so I do not have them in front of me. The doctor also said that the T4 is more or less normal range since was a few decimal points difference but they have 4 as an upper range for for TSH, and our reading was 7. Needless to say, I'm extremely concerned so I have a few questions:

Would this be high, normal high, moderately high or what? I've read here and in other boards of 100+ TSH readings.

Is it normal to drop from 20 to 7 in just a week?

What are the normal TSH ranges in USA or other developed countries...or labs /clinics?

I am starting treatment after meeting an endo this week, but Is it possible for this to disappear in 2-3-X-XX years of time?

I've read about the symptoms (stunted growth, possible retardation, heart and other issues) and as I said I am starting treatment, but the doctor said that this is to prevent future problem for when he becomes an adult. Was that to make us feel better, is the reading borderline and maybe that's why, or is the reading really bad? Before screening and in many countries she said that kids would find out when symptoms had already been manifested and damage done. As of right now my child looks perfectly OK, eats a lot, shows weight gain at 200 gr /week, wants to be held, goes to the bathroom a lot (sometimes just after we wash her for that :) and stays up quite a bit during the night.

What can I ask the endo?

What tests can he /she do to other than blood?

I'd be grateful for any insight. She's my little :angel:

midwest1 11-26-2012 10:35 PM

Re: 12 days old and TSH 7 - Congenital Hypothyroid?
 
Welcome to the board, and congratulations on the birth of that little :angel: .

There aren't a lot of good guidelines for congenital thyroid disease available on the net to laypeople. But I have found one pretty good one that has info I can pass along.

Labs use age-specific references for normal ranges that are used to interpret thyroid status, and those ranges often vary among labs. Ideally, the lab will provide a reference of normal TSH and FT4 ranges for precise postnatal ages based on the specific test methods it uses. There is no one "normal" standard that all labs in the US use. You must view your baby's results in the context of the lab range used.

Normally, TSH and FT4 levels peak shortly after birth and then gradually diminish until onset of puberty, so the high TSH at birth and falling within a few days is a typical pattern. It's just that most newborns don't have TSH as high as yours did.

It isn't actually high TSH that's the problem. It's low FT4. Your baby's TSH of 7 would only be slightly high for a newborn, and it's hard to tell the status of her FT4 without the lab range used for testing... But my guess is that it's moderately lower than most newborns. If it would be severely low, she'd be having symptoms of that... poor feeding, listlessness or fussiness, general "failure to thrive". It sounds as if she is probably only slightly hypothyroid, but to be safe, that T4 should be raised by giving her supplemental hormone.

My source says that babies can be transiently hypothyroid if their mothers are hypothyroid. If mom is not, then the hypoT is more likely to be permanent. In either case, it's best to start treatment and continue it steadily for at least 2-3 years, after which the need for it can be re-evaluated.

I feel sure that sweetie will be just fine with good medical care and your love. :)

alwaysthere 11-27-2012 04:55 AM

Re: 12 days old and TSH 7 - Congenital Hypothyroid?
 
Thank you Midwest,
We will go this week to the endo so I'm trying to read and ask as much as possible to know what to ask and what to look for. I read about how ranges were changed...was as high as 39 and 20 in some guidelines.
Now endos want to lower them again for safety and maybe to get more work :) joke.

If I had to guess, the FT4 was barely within their lab /hospital's range within a few decimals but obviously you want to be somewhere in the middle. I also read about sub-clinical hypot and problems it can cause later in life. Maybe that's what the pediatrician meant. All we know was the accepted threshold for one (TSH most likely) was 4 but she tested a 7 and then 1 was the accepted number for (T4 something, I remember from scanning the prescription) and the baby had a 1.000x or so. Either way the T4 was barely normal.

We'll start the meds, better safe than sorry and was relived to learn that meds can make even extreme cases almost go away.

alwaysthere 01-12-2013 05:09 AM

Re: 12 days old and TSH 7 - Congenital Hypothyroid?
 
Update: Tsh and Ft4 were within the range 1 month later.

FT4 1.20ng /dl and TSH 4.50 uIU/ml
lab range
FT4 0.8-1.80
TSH 0.4 - 4.8

Looks like Ft4 is better to but TSH still a bit high, depending on what range you believe. However, I am gonna monitor it test again in a month or two.

Thoughts anyone?

mkgbrook 01-12-2013 01:18 PM

Re: 12 days old and TSH 7 - Congenital Hypothyroid?
 
Sounds like you have a good handle on things. My daughter is newly three her TSH is just over 3 now. My son took six years to fall below 2 on the TSH range. My MDs recommend keeping detailed symptom logs and growth charts. They say weight gain and lack of constant growth are the first flags too look for. It seems like your little one is rebounding. I am so glad you are her champion and are dedicated to getting the care she deserves.

Good luck and keep us posted on what you find it can help new thyroid suffering moms everywhere!

alwaysthere 01-15-2013 11:02 PM

Re: 12 days old and TSH 7 - Congenital Hypothyroid?
 
Thanks, I am hoping. I am getting different ranges (Mayo clinic for example has 5 as upper range) and for kids is even wider given their specifics.

I was glad about the Ft4, especially since it went up without any meds.

Did you mean that hypothyroid kids, generally [B]gain weight[/B] too much or [B]fail to gain weight[/B] and "to thrive"? We all need to keep an eye on symptoms so thanks again.

The fact that the kids keeps me up all night I was told is a good sign--expect for my brain cells :)

[QUOTE=mkgbrook;5116248]Sounds like you have a good handle on things. My daughter is newly three her TSH is just over 3 now. My son took six years to fall below 2 on the TSH range. My MDs recommend keeping detailed symptom logs and growth charts. They say weight gain and lack of constant growth are the first flags too look for. It seems like your little one is rebounding. I am so glad you are her champion and are dedicated to getting the care she deserves.

Good luck and keep us posted on what you find it can help new thyroid suffering moms everywhere![/QUOTE]


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