It is recommended that:
All newborns screened for hypothyroidism as per National Newborn Screening Programme (included in ‘heel-prick’ test).
Screening for thyroid disease at 1 year and at any time if there is a clinical suspicion. This screening should include TSH, Free T4, and thyroid antibodies (TPO).
Annual screening of all patients with DS for hypothyroidism with TSH estimation by finger prick could be performed when available. Where TSH is elevated, full evaluation of thyroid function including Free T4 and thyroid antibodies (TPO) should be undertaken.
Any abnormality of thyroid function including isolated TSH elevation should be discussed with an Endocrinologist.
The possibility of hyperthyroidism should be borne in mind and clinical vigilance is important. Symptoms may be subtle such as hyperactive behaviour, sleep disturbance without significant physical signs.