The Diagnosis and Management of Hypothyroidism

Bhuvana Guha, MD, Guha Krishnaswamy, MD, And Alan Peiris, MD, PhD, MRCP


South Med J. 2002;95(5):475-480. 

In This Article


Primary hypothyroidism remains the prevalent form of hypothyroidism. A variety of disease states can result in hypothyroidism ( Table 4 ). Primary disorders of the thyroid gland are responsible for most cases of hypothyroidism.[1] These include autoimmune thyroid disease, surgical or radiation-induced reduction in thyroid tissue, and, rarely, infiltration or infection of the thyroid. Recently, several new syndromes of thyroid dysfunction have been described and need to be considered in some patients.[13] These include generalized thyroid-hormone resistance, defective conversion of T4 to triiodothyronine (T3), TRH deficiency (autosomal dominant), and TRH- and TSH-inactivating mutations.[13] Molecular diagnosis of these conditions is rarely indicated in the current management of hypothyroidism. Drugs such as iodine (in radiocontrast media) and amiodarone have been associated with the development of hypothyroidism.[14,15]