Subclinical hypothyroidism in children with Down syndrome: To treat or not to treat???

Congenital hypothyroidism is 30 times more frequent in newborns with Down syndrome (DS) than in the population of healthy children [1]. Mild isolated plasma thyrotropin (TSH) elevation with normal thyroxine (T4) levels is the most commonly seen pattern of thyroid dysfunction in these children [2,3]. Other terminology used for this pattern of abnormality includes isolated hyperthyrotropinemia, compensated hypothyroidism, and subclinical hypothyroidism [4,5].