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Newborn screening (NBS) for congenital hypothyroidism (CH) became feasible after the development of radioimmunoassays (RIA) for the measurement of thyroxine (T4)  and thyroid stimulating hormone (TSH) from dried blood spots (DBS)  in the mid 1970s.Three possible screening strategies for CH were, therefore, possible: Measurement of serum TSH and T4 from cord blood, and measurement of T4 or TSH from a DBS taken at 3–5 days of life . While NBS for CH based on cord blood, could not be centralized, it never got very common. In contrast, TSH or T4 determination from DBS, could be easily integrated into already existing NBS programs for PKU and other metabolic diseases. The pros and cons of these two different approaches have been described, for example by Larsson et al. [4,5]. For further review see . In Europe, except Malta and the Netherlands, where TSH and T4 is measured simultaneously, all other countries have TSH as the primary and decision-making analyte . The situation in the US is different. In total, 43% of the US NBS laboratories use