Congenital hypothyroidism is a condition where a newborn has decreased or absent thyroid function and thyroid hormone production.
The thyroid is a gland in the lower neck that makes iodine-containing hormones that regulate growth, brain development, and metabolism. Hypothyroidism occurs when the gland is absent, abnormally developed, destroyed, or reduced in size, or the production of thyroid hormones is decreased or absent.
© 2008 Nucleus Medical Art, Inc.
The longer this disorder is unrecognized and untreated, the more damage is done to the brain and the greater the risk of mental retardation and abnormal growth. Fortunately, with early recognition and treatment, damage can be avoided.
In most cases, the cause of congenital hypothyroidism is unknown. A small percentage of cases are inherited and caused by mutations in the genes producing the enzymes (proteins) required to make thyroid hormones. Here are other causes:
Most doctors now depend on the screening test in newborns to diagnose this condition since the symptoms or signs take time to develop. The symptoms of Congenital hypothyroidism may include the following:
At birth, most infants are screened for congenital hypothyroidism. A pediatric endocrinologist is appropriate if a specialist is needed. Tests may include the following:
If untreated, congenital hypothyroidism can lead to severe mental retardation and growth retardation. However, if caught early at birth (preferably during the first two weeks of life) when the brain and nervous system are not yet fully developed, thyroid hormone replacement could prevent damage.
Congenital hypothyroidism is generally treated with hormone replacement therapy. The hormone thyroxine is given in one of the following forms:
Typically, the tablets should be given at least thirty minutes before a meal or feeding. Treatment is individualized in that the amount that is absorbed and handled by the body differs among individuals. Once medication starts, the blood levels of TSH and T4 are frequently monitored to keep the values within normal range. If values are kept within a normal range, there are no side effects or complications.
Last reviewed January 2008 by David Juan, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.