[Interpretation of the 2025 "Guidelines for the diagnosis and treatment of congenital hypothyroidism"].

Congenital hypothyroidism (CH) is one of the most common inherited metabolic disorders in children, and delayed diagnosis and treatment can adversely affect intellectual development and growth. In April 2025, the Chinese Society of Endocrinology and the Chinese Society of Pediatrics jointly released the "Guidelines for the diagnosis and treatment of congenital hypothyroidism". Based on the latest evidence-based medical data and clinical experience, these guidelines systematically established a comprehensive management framework covering screening, diagnosis, treatment, and follow-up, aiming to standardize CH screening, diagnosis, treatment, and long-term management. This article provides an interpretation of the main content of the guidelines. The guidelines emphasize that early diagnosis and treatment can improve the prognosis of CH and set a newborn screening cut-off value of≥8-10 mU/L as the standard for recall and examination. In terms of treatment, the guidelines stress the principle of "early and adequate" intervention, recommending levothyroxine (LT4) as the first-line treatment with a starting dose of at least 10 μg/kg. Timely follow-up and avoidance of overtreatment are also highlighted. For transient CH, it is recommended to discontinue LT4 treatment after the age of 3 and conduct further evaluations of thyroid function and imaging examinations. The guidelines also note that genetic testing to identify the molecular etiology of CH has significant guiding value for the treatment of specific types of CH. The guidelines achieve standardization of the diagnostic and therapeutic process, address the gap in lifelong management of CH in China from the neonatal period to adulthood, and provide healthcare professionals with an accurate, effective, and comprehensive normative document.