Re-evaluation of thyroid axis | Right Decisions

Right Decisions
SPEG (Scottish Paediatric Endocrine Group)
Back
Management of congenital hypothyroidism
Re-evaluation of thyroid axis

Please update your RDS mobile app to version 4.7.1

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. When you install the update, you will see that each toolkit has a small QR code icon the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits.

To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

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

This may be required if no cause has been identified for the hypothyroidism in the neonatal period and should be considered after the age of 3 years.

Re-evaluation should be considered in patients with a normally sited thyroid gland and / or those who have had no increase in thyroxine requirement since infancy.

This can consist of either:

An initial reduction in thyroxine dose followed by monitoring of thyroid function and further reductions in thyroxine dose and monitoring of thyroid function if results remain normal, until thyroxine is discontinued
Discontinuation of thyroxine with thyroid function assessment in 4-6 weeks
If the TSH is elevated, hypothyroidism is confirmed, and treatment should be recommenced as soon as possible.

Re-evaluation is not indicated if there has been a rise in the TSH in the first year, if there is a genetic cause or if there is an abnormal gland on imaging.