Attitudes Towards the Management of Congenital Hypothyroidism in Türkiye: National Survey Study

Thyroid Research Group; Turkish Pediatric Endocrinology and Diabetes Society, Thyroid Research Group, Türkiye

Publisher: Galenos Yayınevi Country of Publication: Turkey NLM ID: 101519456 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1308-5735 (Electronic) NLM ISO Abbreviation: J Clin Res Pediatr Endocrinol Subsets: MEDLINE

Publication: Istanbul : Galenos Yayınevi
Original Publication: Istanbul : Turkish Pediatric Endocrinology and Diabetes Society

Congenital Hypothyroidism*/therapy ; Congenital Hypothyroidism*/drug therapy ; Congenital Hypothyroidism*/epidemiology ; Congenital Hypothyroidism*/blood ; Congenital Hypothyroidism*/diagnosis ; Attitude of Health Personnel* ; Practice Patterns, Physicians'*/statistics & numerical data ; Endocrinologists*/psychology; Humans ; Turkey/epidemiology ; Female ; Male ; Adult ; Thyroxine/therapeutic use ; Thyroxine/blood ; Surveys and Questionnaires ; Infant, Newborn ; Middle Aged ; Thyrotropin/blood

Objective: This study was conducted to assess the perspectives of pediatric endocrinologists in Türkiye about the management of congenital hypothyroidism (CH) and to analyze the potential impact of work environment and professional experience on different attitudes.
Methods: The members of the Turkish Society for Pediatric Endocrinology and Diabetes were invited to participate in an online survey. An evaluation was made after obtaining survey responses from 95 (19%) of 502 members.
Results: Participants’ mean age was 42.0±9.6 years, 46.3% of them were working in a university hospital, and 48.6% had >7 years of work experience. When the participants were asked about their approach to a 1-3-week-old neonate whose serum thyroid stimulating hormone (TSH) concentration was 6-20 mU/L with a serum-free thyroxine (FT4) concentration within the age-specific reference interval, 97.7% of the participants preferred to monitor without medication. Only 24% of physicians consider starting treatment immediately if the serum TSH concentration is 20-40 mU/L with a normal FT4 level. While 5.3% of participants preferred dual imaging (ultrasound and scintigraphy), 90.5% requested only thyroid ultrasound for etiological investigation. When considering the discontinuation of levothyroxine (LT4) in patients with a normal thyroid gland and a low LT4 dose, 28.4% of the participants stated that treatment should be stopped at the earliest at the age of 3 years, 16.8% at 2 years, 5.3% at 1 year, 16.8% at 6 months, and 32.6% at any time if the TSH levels remain low despite the low dosage. Physicians with over 7 years of experience may discontinue medication if TSH is low, even with a lower dose, more frequently than those with less experience (p=0.011). There were no significant differences in the approach of the physicians between employees at university hospitals and other health institutions.
Conclusion: Although the attitudes of pediatric endocrinologists working in Türkiye towards the management of CH are generally consistent with the recommendations of international guidelines, their approaches to the treatment for isolated neonatal TSH elevation, thyroid imaging preferences and time to discontinue treatment differ significantly. These different attitudes, which are similar between all subgroups by experience and work setting, reflect the differences in local conditions in Türkiye and underline the need for a national consensus on the management of CH.
(©Copyright 2025 by Turkish Society for Pediatric Endocrinology and Diabetes / The Journal of Clinical Research in Pediatric Endocrinology published by Galenos Publishing House.)

None declared.

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Keywords: Congenital hypothyroidism; Turkish Society for Pediatric Endocrinology and Diabetes; attitude in management; questionnaire; pediatric endocrinology

Q51BO43MG4 (Thyroxine)
9002-71-5 (Thyrotropin)

Date Created: 20250131 Date Completed: 20251211 Latest Revision: 20251214

20251214

PMC12699088

10.4274/jcrpe.galenos.2025.2024-9-18

39885770