Newborns not treated within 6 weeks of life are at a significantly higher risk of developmental retardation. Afterwards, TSH is measured once every 3 months until the patient is 3 years of age, and every 6 months thereafter. After the completion of puberty, patient can undergo a six month trial off thyroid replacement medication to see if they can remain euthyroid without treatment. If hypothyroidism occurs, the patient should resume 4x4 rc jeep and continue therapy for life Rarely, surgery may be required to treat extremely large goitres. In infants, it is primarily due to congenital thyroid dysgenesis, while in children, it is primarily due to chronic autoimmune thyroiditis.

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