What to do at each visit | Right Decisions

Right Decisions
SPEG (Scottish Paediatric Endocrine Group)
Back
Management of congenital hypothyroidism
What to do at each visit

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.

Calculate the optimal dose and adjust dosage pre-emptively, using Thyroid Function Tests to confirm adherence.
Assess growth:
- Weight measurement.
- Supine length measurement until 2 years, then height measurement.
- Head circumference measurement until 3 years.
Development assessment:
1. Consider pre-school formal audiology (for subtle hearing impairment due to congenital hypothyroidism.¹
  if aged <4-5 years, developmental progress
  
  aged over 4-5 years, school progress
2. Consider neurodevelopmental assessment.
Education:
- From secondary school onwards ensure the patient has reasonable knowledge of CH.
Adult transfer:
- Boys to GP.
- Girls to GP, give pre-pregnancy counselling.

Transfer to primary care for 6-12 monthly monitoring of TFT’s.

Aim for: fT4 in the upper quartile of reference range and TSH <5.0 mU/I (but avoid undetectable TSH).