Central hypothyroidism - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Symptoms of central hypothyroidism are similar to those of primary hypothyroidism (including fatigability, cold intolerance, weight gain, and depression), and may or may not be accompanied by symptoms of hypopituitarism, such as those of hypogonadism (i.e., decreased libido, infertility) and secondary adrenal insufficiency (i.e., weakness, nausea, vomiting).
Signs of central hypothyroidism on physical examination would also be similar to those of primary hypothyroidism and may include dry skin, hair loss, bradycardia, and delayed deep tendon reflexes.
Specific signs suggestive of a sellar or parasellar mass include papilledema and bitemporal hemianopia.
Diagnostic evaluation of central hypothyroidism includes serum thyroid-stimulating hormone (TSH) and free thyroxine (T4) concentrations. In central hypothyroidism, free T4 is low and TSH may be low, normal, or minimally elevated. Magnetic resonance imaging may reveal a sellar or parasellar mass or infiltrative disorder.
Treatment of central hypothyroidism is by thyroid hormone replacement (levothyroxine).

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Definition

Epidemiology

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Citations

Key Articles

Persani L, Brabant G, Dattani M, et al. 2018 European Thyroid Association (ETA) guidelines on the diagnosis and management of central hypothyroidism. Eur Thyroid J. 2018 Oct;7(5):225-37.[Abstract][Full Text]
Garber JR, Cobin RH, Gharib H, et al. Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Endocr Pract. 2012 Nov-Dec;18(6):988-1028.[Abstract]
Jonklaas J, Bianco AC, Bauer AJ, et al. Guidelines for the treatment of hypothyroidism: prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement. Thyroid. 2014 Dec;24(12):1670-751.[Abstract][Full Text]

Referenced Articles

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