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In the Clinic |1 December 2009

Hypothyroidism

Michael T. McDermott, MD

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Hypothyroidism is a condition in which the thyroid gland cannot make enough thyroid hormone to meet the requirements of peripheral tissues. It is the most common functional disorder of the thyroid gland. Primary hypothyroidism occurs when thyroid failure results from disease of the thyroid gland itself and it accounts for more than 99% of all cases of hypothyroidism (Figure 1). The most common causes of primary hypothyroidism in adults are chronic lymphocytic thyroiditis (Hashimoto disease); radioiodine thyroid ablation; thyroidectomy; high-dose head and neck radiation therapy; and medications, such as lithium, α-interferon, and amiodarone. Central hypothyroidism occurs when thyroid failure results from pituitary or hypothalamic disorders that cause insufficient production of thyroid-stimulating hormone (TSH) by the pituitary gland (Figure 2). The most common causes of central hypothyroidism in adults are tumors, inflammatory conditions, infiltrative diseases, infections, pituitary surgery, pituitary radiation therapy, and head trauma.
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McDermott MT. Hypothyroidism. Ann Intern Med. 2009;151:ITC6–1. doi: 10.7326/0003-4819-151-11-200912010-01006

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Published: Ann Intern Med. 2009;151(11):ITC6-1.

DOI: 10.7326/0003-4819-151-11-200912010-01006

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