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Infant Secondary hypothyroidism
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Infant Secondary hypothyroidism

My baby boy is 8.5 months old now(Born on Jun22,2013). When he was 3 months old, he was diagnosed with CHD(Coronary Heart Disease) - ALCAPA syndrome(Anomalous origin of the left coronary artery from the pulmonary artery). Because of which he underwent an open heart surgery at his 3rd month itself(Sept 23, 2013) for a coronary replacement. By God's grace and is no longer on any kind of cardiac medication. To be specific, all his medications stopped by end of Oct, 2013. post his operation he was started on Thyronorm 50mcg daily as his thyroid levels were lower than normal.

Please find below the details of the tests done so far:-

1. Test done on Oct 19, 2013
            TSH - 1.36 microIU/ml  (Reference Range - 0.55 - 7.1 microIU/ml)
            FT3 - 3.76 pg/ml             (Reference Range - 2.30 - 4.2 pg/ml)
            FT4 - 0.89 ng/dL             (Reference Range - 0.89 - 1.76 ng/dL

2.         Test done on Dec 26, 2013
            TSH - 0.057microIU/ml  (Reference Range - 0.55 - 7.1 microIU/ml)
            FT3 - 5.21 pg/ml             (Reference Range - 2.30 - 4.2 pg/ml)
            FT4 - 1.99 ng/dL             (Reference Range - 0.89 - 1.76 ng/dL
Post the above tests, his medicine dosage was reduced to Thyronorm 50mcg 3 days per week and Thyronorm 25mcg 4 days per week.

3.         Test done on Mar 4, 2014
            TSH - 0.015microIU/ml  (Reference Range - 0.55 - 7.1 microIU/ml)
            FT3 - 4.44 pg/ml             (Reference Range - 2.30 - 4.2 pg/ml)
            FT4 - 1.39 ng/dL             (Reference Range - 0.89 - 1.76 ng/dL
His dosage of medication remains unchanged.
Please suggest if his treatment is appropriate. We still do not know, if his thyroid problem is congenital or post operative effect. So my question remains, will he have to continue taking thyroid medicines throughout his life(If at all, we can comment  on it now).

His weight as on Feb 6, 2014 is 9.43 kg. Also, is he overweight and needs a diet regulation.



97953_tn?1193367871
I do not see children so cannot comment on expectations for this case.  Would defer to pediatric endocrinologist.
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97953_tn?1193367871
Mark Lupo, M.D.Blank
Thyroid & Endocrine Center of Florida
Sarasota, FL
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