Three. Ugh.

It hurts my heart when I think of what “could have” been for my son’s health if we were to have just lived in a state other than Michigan at the time he was born. The cut off value in Michigan is 33 mcU/mL and his TSH value was 30 mcU/mL. That’s just three stupid values below the cutoff. Three. 
State of Newborn Screen – Cutoff Values
Alabama & Utah – 25 mcU/mL
Colorado, Delaware, Maryland, Texas, Wyoming, Massachusetts – 20 mcU/mL
Michigan – 33 mcU/mL

As you can see there are AT LEAST 8 other states with CH newborn screening cutoff levels below the cutoff value for Michigan which basically tells me that Micah would have had treatment if we lived in one of these states!! Three. Ugh.

I recently read a study on routine second NBS testing called the “Routine Second Testing Newborn Screening Project” by Harry Hannon, PhD & Jelili Ojodu, MPH, states, “scientific literature indicates that cases of CH are missed on the initial screen that are detected by a routine second screen.”

I think there should be a routine/required second screening for newborns with a family history of CH, hypothyroidism, or other endocrine disorder. Furthermore, it has been shown missed CH is mostly attributable to higher incidence among Hispanics in 1-screen compared to 2-screen states. Ummm hello? Micah is Mexican-American. 1/4 of his extended familia live in Mexico and have a history of thyroid disease.

Congenital hypothyroidism: Diagnostic algorithm. Diagnostic algorithm: the diagnosis of congenital hypothyroidism begins with either abnormal newborn screening test results or a clinical suspicion of hypothyroidism, leading to serum thyroid function tests (typically TSH and free T4) to confirm the diagnosis. If a diagnosis of primary or secondary (central) congenital hypothyroidism is confirmed, other diagnostic studies can be undertaken to determine the underlying etiology. Rastogi and LaFranchi Orphanet Journal of Rare Diseases 2010 5:17   doi:10.1186/1750-1172-5-17
Ok, that’s my thyroid – medical – newborn screening rant for the evening. 
Carry on, geniuses! 

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