Prevent Growth Disorders with Early Detection of Congenital Hypothyroidism

In order to prevent the existence of various risks of serious health problems in newborns, Dante Saksono Harbuwono as Deputy Minister of Health again reminded about the dangers of thyroid hormone disorders or Congenital Hypothyroidism (HK) in newborns.

Congenital hypothyroidism is highly recommended to be detected as early as possible, namely when the newborn is born. Early detection of congenital hypothyroidism through screening in newborns is the best strategy at present. In addition to preventing growth disorders, early detection of congenital hypothyroidism with screening examinations can also prevent children from developing intellectual disabilities later in life.

Congenital hypothyroidism is a malfunction of the thyroid gland that is experienced from birth (congenital), so that the baby has low thyroid hormone levels (hypothyroidism). This condition is found in 1 in 2000-3000 babies born in Indonesia. There are several factors that can cause congenital hypothyroidism.
Screening for congenital hypothyroidism in newborns is done by checking TSH. TSH examination in term infants is carried out at the age of 2-4 days or when they are about to be discharged from the hospital. Screening for congenital hypothyroidism in newborns is positive if the TSH level is 20 mU/L. Infants with positive screening results should be confirmed by re-examination of serum TSH and FT4. The diagnosis of congenital hypothyroidism is made when the TSH level is high and the FT4 is low. In infants who were not screened, the diagnosis was confirmed by clinical symptoms and examination of serum TSH and FT4.

Initial therapy for the first 2 weeks showed significant results in intellectual outcomes. The severity of congenital hypothyroidism is determined by T4 levels (the higher the better).

Monitoring that needs to be done:

1. Laboratory

• Determine whether or not the dose of the drug given is sufficient (FT4 or total t4 & periodic TSH)

• Blood is drawn no later than 4 hours after thyroxine administration

• Performed 2 weeks after initial levothyroxine therapy

• Follow-up follow-up 1-3 months until 12 months of age, 2-4 months of 1-3 years of age, 3 years of age until growth stops regularly every 3-12 months

• If there is a change in the dose of levothyroxine TSH and FT4 repeated 4-6 weeks

2. Inspection targets

• TSH level < 5 mU/L within 2 weeks of starting therapy

• FT4 levels in the range of values ​​according to age

3. Congenital hypothyroid reevaluation

• Done 3 years old

• Evaluation in the form of advanced thyroid function & radiology refer an endocrine consultant

4. Schedule and monitoring of outpatient visits

5. Education

• Causes of congenital hypothyroidism

• The importance of early screening, early diagnosis and therapy

• The importance of taking medication regularly according to a schedule

• Do not stop medication without doctor's instructions

If Friends of Hermina find the symptoms of the baby as stated, don't wait later, please immediately consult a Pediatrician at Hermina Podomoro Hospital.