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Thyroid Problems/thyroid issues infant


on my son's newborn screen his TSH was slightly elevated. It was 28 and cut off for normal was 25 at 24 hours of age. His free t4 at that time was 18.4 with above 5 considered normal.
Tests were repeated at 2 weeks of age. TSH=8.6 (normal range 0.34-4.82), Total T4: 11.5 (normal range 4.7-13.3)
Now he is 5 weeks old, his labs came back today and his TSH has dropped to 4.2 (0.34-4.82) while his free t4 is 0.89 (normal range 0.59-1.61).
I am really scared that his t4 has dropped to the lower side of normal and I am really scared of God forbid developmental problems. Please help and guide and what we need to do at this point.
His pediatrician feels that as long as all labs are within normal limits there is no need for concern. However, all the things that I have been reading on internet mention that in kids T4 should be on the higher side for optimum development.
Please help.

Warm welcome to you!
After reading your post carefully, I feel the pediatrician is right. All lab values are within normal range. And at present your baby doesnt seem to require any thyroxine therapy. Because here we doctors not only consider lab values, but also depend on the physical examination of newborn. Normally if the hormone levels are not adequate for the newborn there will be signs and symptoms like decreased muscle tone, tongue sticking out, dull look, puffy face, poor feeding etc. Your pediatrician would have definitely considered all these physical examinations and then would have decided not to go for thyroxine therapy. But its better to keep your newborn under your pediatrician's monitoring (regular checkups). Dont be scared. If there is requirement of therapy your pediatricin can start it immediately and the condition is very easy to manage. In practicing medicine lab values are not important, what is important is how patient feels or how healthy and comfortable he feels. Here experience matters than lab values. Was your wife hypothyroid during preganancy?

So stop worrying now. Everything is absolutely fine. If possible please send a snap of your newborn :)

Take care. Have a good day!

---------- FOLLOW-UP ----------

QUESTION: Thank you very much this certainly makes me feel better.

No my wife was not hypothyroid in fact she was checked at 12 weeks pregnancy because of weight loss and lack of appetite in first trimester and her TSH was 2.8 and t4 in optimum range. She was checked again last week (4 weeks post partum) and TSH was 1.2.

Do you feel that t4 in the lower side of normal will not impact his growth (God willing)? I absolutely do not want to give him unnecessary medication but at the same time dont want this condition to God forbid create any problems for him too.

Thank you very much,

Hi Sam,
Nice to see you again!
My opinion is you shouldnt be worried about the TSH T4 being in the lower side of the range. As long as pediatrician is monitoring regularly, he will be checking whether your newborn is achieving all the developmental milestones which a normal baby should achieve. So your baby is safe in his hands. At any point of time if he feels there is bit of lag in development he may immediately start thyroxine therapy. So I think there is no reason for you to be worried.

Take care :) Bye.

Thyroid Problems

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Dr.Shrinidhi Kulkarni


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KIMS, Bangalore

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