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Disorders that cause hypothyroidism

Douglas S Ross, MD
Section Editor
David S Cooper, MD
Deputy Editor
Jean E Mulder, MD


Hypothyroidism can result from a defect anywhere in the hypothalamic-pituitary-thyroid axis. In the vast majority of cases, it is caused by thyroid disease (primary hypothyroidism). Much less often it is caused by decreased secretion of thyroid-stimulating hormone (TSH) from the anterior pituitary gland or by decreased secretion of thyrotropin-releasing hormone (TRH) from the hypothalamus (table 1).

The cause of hypothyroidism should be identified in every patient for the following reasons:

Hypothyroidism may be transient and require no or only short-term therapy, as in patients with painless thyroiditis or postpartum thyroiditis. (See "Overview of thyroiditis".)

It may be caused by a drug, such as lithium or an iodine-containing drug, and disappear when the drug is discontinued.

It may be the first or only manifestation of hypothalamic or pituitary disease.

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Literature review current through: Oct 2017. | This topic last updated: Apr 21, 2017.
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