Pseudo-Central Hypothyroidism

Shehzad Basaria, MD, Kristina Altman, MD, Milena Braga-Basaria, MD

Disclosures

South Med J. 2003;96(2) 

In This Article

Abstract and Introduction

Central hypothyroidism is an exceedingly rare form of hypothyroidism that results from a variety of conditions affecting the hypothalamus and the pituitary gland. The classic biochemical abnormality seen in these patients includes a low serum level of circulating thyroxine (T4) concomitant with an inappropriately low level of thyrotropin. Because patients with isolated triiodothyronine (T3) toxicosis also present with this biochemical pattern, it is important to measure T3 levels in such patients before making a diagnosis of central hypothyroidism.

Central hypothyroidism is a rare form of hypothyroidism in which there is a low serum level of circulating thyroxine (T4) concomitant with an inappropriately low thyrotropin level. Hypothalamic and/or pituitary disease can cause this condition. In patients who have isolated triiodothyronine (T3) toxicosis, suppressed thyrotropin and low T4 levels can suggest central hypothyroidism unless T3 is measured. We describe a patient who was referred to our endocrine clinic for the evaluation of central hypothyroidism and was found to have iatrogenic T3 toxicosis.

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