The goals of neonatal hypothyroidism treatment are (1) serum FT4: in the upper range of 50% of the reference value; (2) serum TT4: 10-16 μg/dl from l to 2 years of age, >2 years of age in the upper range of 50% of the reference value; (3) serum TSH: <5.0 mIU/L, with an optimal range of 0.5-2.0 mIU/L. Therapeutic drugs and doses Levo The starting dose of thyroxine is (10-15) mcg x kg body weight/day, taken once daily. Recommended dose of levothyroxine sodium for various etiologies in neonates: Thyroid development deficiency :15 micrograms x kg body weight/day. Ectopic thyroid : 12 micrograms x kg body weight/day. Impaired thyroid hormone synthesis: 10 mcg x kg body weight/day. Regular monitoring of serum TSH and TT4: every 2 to 4 weeks for the first 6 months of treatment, every 1 to 2 months from 6 months to l year, every 3 to 4 months from 6 months to 3 years, and every 6 months from 3 years to the end of the growth period. Do not mix levothyroxine sodium with other foods; soy protein, iron concentrate and calcium can interfere with the absorption of the drug. It is best to fast for 30 to 60 minutes before taking the medication. If hypothyroidism is diagnosed, treatment with levothyroxine should be started as soon as possible to bring the child's serum thyroxine back to normal levels within 1 to 2 weeks, and serum TSH back to normal levels within 2 to 4 weeks.
Early detection, diagnosis and treatment are essential. Assessing whether hypothyroidism is permanent If the initial thyroid scan suggests ectopic or absent thyroid, the diagnosis is permanent hypothyroidism. If the initial TSH is <50mu/l and tsh is not elevated after the neonatal period, treatment may be discontinued experimentally at age 3 years. If tsh is elevated after discontinuation of treatment, permanent hypothyroidism is considered.