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REVIEW ARTICLE
Year : 2011  |  Volume : 15  |  Issue : 6  |  Page : 99-106

Central hypothyroidism


1 Department of Endocrinology, Jaslok Hospital and Research Centre, 15-Deshmukh Marg, Mumbai - 400 026, India
2 Department of General Medicine/Endocrinology, Khoo Teck Puat Hospital, Singapore

Correspondence Address:
Vishal Gupta
Department of Endocrinology, Jaslok Hospital and Research Centre, 15-Deshmukh Marg, Mumbai - 400 026
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2230-8210.83337

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Central hypothyroidism is defined as hypothyroidism due to insufficient stimulation by thyroid stimulating hormone (TSH) of an otherwise normal thyroid gland. It has an estimated prevalence of approximately 1 in 80,000 to 1 in 120,000. It can be secondary hypothyroidism (pituitary) or tertiary hypothyroidism (hypothalamus) in origin. In children, it is usually caused by craniopharyngiomas or previous cranial irradiation for brain tumors or hematological malignancies. In adults, it is usually due to pituitary macroadenomas, pituitary surgeries or post-irradiation. Fatigue and peripheral edema are the most specific clinical features. Diagnosis is established by the presence of normal to low-normal TSH on the background of low-normal thyroid hormones, confirmed by the thyrotropin releasing hormone stimulation test. Therapy includes use of levothyroxine titrated to improvement in symptomology and keeping free T4 in the upper limit of normal reference range.


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