Management of congenital hypothyroidism | Right Decisions

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SPEG (Scottish Paediatric Endocrine Group)
Management of congenital hypothyroidism

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Please get in touch with ann.wales3@nhs.scot with any questions.

Purpose of guideline

To guide the management of infants referred with an elevated thyroid stimulating hormone (TSH) concentration on Guthrie blood spot screening.
To give guidance on the initial investigations for infants diagnosed with congenital hypothyroidism.
To give guidance for ongoing management and monitoring of infants and children with congenital hypothyroidism

Who should use this guideline

general paediatricians
neonatologists
paediatricians with an interest in paediatric endocrinology
paediatric endocrinologists.

Patients to whom this guideline applies

Infants in Scotland with an elevated TSH on Guthrie blood spot screening.

Last reviewed: 01/02/2022
Next review date: 01/02/2025
Author: Clinical Guidelines Subgroup
Version: V2
Author email(s): nss.speg@nhs.scot
Approved by: SPEG Guidelines Group, SPEG Steering group
Document ID: NSD610-016.06

Summary

Clinical aims

Screening laboratory notification protocol

Laboratory notification list

Clinician procedure following notification of congenital hypothyroidism

Clinical evaluation

Clinician treatment decision tree in management of congenital hypothyroidism

Dosage schedule for infant with elevated TSH

Preparations of levothyroxine

Initial counselling and management

Thyroid imaging

Mutation analysis in suspected cases of dyshormonogenesis

Subsequent monitoring and follow-up

What to do at each visit

Re-evaluation of thyroid axis

References