4 week old has low t4 and normal TSH

[rspencer]

My daughter has a t4 level of 6ug/dL and a normal TSH level... I'm so confused about whether or not she should be treated.

[rspencer]

Now TSH level is 7.35

[foreversummer]

Hi respencer.

I'm sorry to hear you have this worry with your daughter. I must say I have no knowledge of babies levels, but I'm sure someone will be along to help you soon.

I wish you and your baby well.

Foreversummer

[helvella Administrator]

rspencer,

One thing you really need to know - ranges for children are different. Make sure that everyone involved is aware of this. (I wouldn't be at all surprised if some doctor, nurse or other involved person simply thinks about adult ranges.)

For example, the paediatric ranges from one lab are available here:

pathology.bsuh.nhs.uk/Patho...

You MUST use the ranges from the lab doing the tests for your daughter - my link is only for illustration. Labs vary.

I am afraid that I feel very ignorant and, whilst I will answer if I can, I am not sure what I can contribute.

[silverfox7]

Are these readings from the heel prick they do on new bit a as routine in the UK? The fact that you have two readings does suggest that they are wanting to monitor this but I have no experience with how they proceed. Hopefully someone who had had experience with this will make contact. In the meantime I should ask what they are doing and why. If there is a problem you need to know how they will solve it for your own peace of mind.

[PollyAnna90]

My son was found to have the same problem at 12 weeks. He had a few repeats which showed his t4 continuing to drop. He started levothyroxine at 4 months and his t4 has stabilised. Now at 7 months, his TSH has dropped for the first time.

We have had a lot of tests, I am sure your doctors will speak to an endocrinologist if her t4 doesn't improve. Only thing to remember is that a lot of my sons tests have taken a long time because they're so specialised. Some we still haven't got results from November.

I wish you and your little one all the best.

[diogenes Remembering]

Is the T4 test total T4 or Free T4? If total T4, then your daughter is at the bottom end of the spectrum. However, this could be misleading. Free T4 is the only reliable measurement. TSH can be a bit higher in babies and settles down later. If she is hypothyroid she should have some symptoms e.g. listlessness.

[diogenes Remembering]

Here is a table of expected TSH ranges bed on age of baby/child

Table 1

Percentiles for TSH (mU/L) of children and adolescents in different age groups

Age n percentiles

2.5 10 25 50 75 90 97.5

0 – 1 months22 0.701.001.78 3.505.039.34 18.10

1–12 months42 1.121.531.88 2.854.436.81 8.21

1–5 years218 0.801.301.78 2.703.704.80 6.26

6–10 years315 0.80 1.201.70 2.303.103.80 5.40

11–14 years355 0.701.101.60 2.102.803.60 4.61

15–18 years233 0.500.941.30 1.702.353.30 4.33

You can see that for the 1-12 month group the upper limit of normal TSH is significantly higher than for older children and only approaches adult ranges at 11-14 years.