{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T15:37:14Z","timestamp":1792337834229,"version":"4.4.0"},"reference-count":71,"publisher":"Oxford University Press (OUP)","issue":"5","content-domain":{"domain":["eje.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:p>When newborn screening (NBS) for congenital hypothyroidism (CH) using thyroid-stimulating hormone (TSH) as a primary screening test was introduced, typical TSH screening cutoffs were 20\u201350\u2009U\/L of whole blood. Over the years, lowering of TSH cutoffs has contributed to an increased prevalence of detected CH. However, a consensus on the benefit deriving from lowering TSH cutoffs at screening is lacking. The present paper outlines arguments both for and against the lowering of TSH cutoffs at NBS. It includes a review of recently published evidence from Australia, Belgium and Italy. A section focused on economic implications of lowering TSH cutoffs is also provided. One issue that bears further examination is the extent to which mild iodine deficiency at the population level might affect the association of neonatal TSH values with cognitive and developmental outcomes. A debate on TSH cutoffs provides the opportunity to reflect on how to make NBS for CH more effective and to guarantee optimum neurocognitive development and a good quality of life to babies with mild as well as with severe CH. All authors of this debate article agree on the need to establish optimal TSH cutoffs for screening programs in various settings and to ensure the benefits of screening and access to care for newborns worldwide.<\/jats:p>","DOI":"10.1530\/eje-17-0107","type":"journal-article","created":{"date-parts":[[2017,7,11]],"date-time":"2017-07-11T00:10:22Z","timestamp":1499731822000},"page":"D1-D12","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-1","source":"Crossref","is-referenced-by-count":85,"title":["Are lower TSH cutoffs in neonatal screening for congenital hypothyroidism warranted?"],"prefix":"10.1093","volume":"177","author":[{"given":"Samantha","family":"Lain","sequence":"first","affiliation":[{"name":"1Menzies Centre for Health Policy, University of Sydney, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Trumpff","sequence":"additional","affiliation":[{"name":"2Division of Behavioral Medicine, Department of Psychiatry, Columbia University Medical Center, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott D","family":"Grosse","sequence":"additional","affiliation":[{"name":"3National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Olivieri","sequence":"additional","affiliation":[{"name":"4Department of Cardiovascular, Dysmetabolic and Ageing-associated Diseases, Istituto Superiore di Sanit\u00e0 (Italian National Institute of Health), Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy","family":"Van Vliet","sequence":"additional","affiliation":[{"name":"5Endocrinology Service and Research Center of the Sainte-Justine Hospital and Department of Pediatrics, University of Montreal, Montreal, Quebec, 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