Congenital Hypothyroidism (Neonate)

Clinical Findings

Neonate with abnormal Newborn Screening Test

Referral Timeframe

URGENT: Call MD on-call to discuss and start treatment.
On-Call Phone #
Day: (512) 628-1830
After Hours: (512) 323-5465

Pre-Referral Workup

Confirmatory TSH, Total T4 or Free T4

Referral Requirements

All clinical notes and laboratory results including growth chart.

Congenital Hypothyroidism (Child)

Clinical Findings

Known or treated child with abnormal thyroid function test.

Referral Timeframe

First available appointment, but call the MD on-call to begin therapy until patient can be seen.

Pre-Referral Workup

Current TSH, Total or Free T4

Referral Requirements

All clinical notes and laboratory results including growth chart

Acquired Hypothyroidism or Autoimmune Thyroiditis/Hypothyroidism

Clinical Findings

  • Elevated TSH
  • Low Total T4 or Free T4

Referral Timeframe

First available appointment, but call the MD on-call to begin therapy until patient can be seen

Pre-Referral Workup

  • Current TSH, Total T4 or Free T4, Anti-Thyroglobulin Antibody and Anti-TPO Antibody
  • If TSH is abnormal but < 10 uU/ml and the Total T4 or Free T4 are normal, obtain thyroid antibodies and repeat the TSH, Total T4 or Free T4 in 1-2 months. If TSH rising and antibodies are positive, refer
  • If TSH is abnormal but Thyroid ultrasound is unnecessary unless the gland is asymmetric or nodules are palpable

Referral Requirements

All clinical notes and laboratory records including growth chart

Central Hypothyroidism

Clinical Findings

  • Low to Low normal TSH with low Total T4 or Free T4
  • History of traumatic brain injury, midline facial defects, brain irradiation, hypoxic brain injury

Referral Timeframe

  • URGENT: Call MD on-call to discuss and start treatment.
    On-Call Phone #
    Day: (512) 628-1830
    After Hours: (512) 323-5465
  • After discussion with MD on-call, may be asked to obtain MRI of the brain and pituitary with and without contrast

Pre-Referral Workup

  • Confirmatory TSH, Total T4 or Free T4
  • Consider repeat of labs prior to referral to assure validity

Referral Requirements

All clinical notes and laboratory records including growth chart