Reversible Subclinical Hypothyroidism in the Presence of Adrenal Insufficiency

Hussein D. Abdullatif, MD; Ambika P. Ashraf, MD


Endocr Pract. 2006;12(5):572-575. 

In This Article


In patients presenting with lack of adrenarche, hypoglycemia, pubertal delay, and a history of autoimmune disease who have biochemical evidence of adrenal insufficiency and mild hypothyroidism, it may be prudent to wait before initiation of levothyroxine replacement therapy, inasmuch as the thyroid dysfunction may be transient. Clinical signs and symptoms of adrenal insufficiency could be subtle, and the discovery of TSH elevation might deflect the caregiver from attending to the true diagnosis. Hence, physicians should contemplate the hypothalamicpituitary-adrenal axis in patients with mild hypothyroidism or compensated hypothyroidism, regardless of evidence of autoimmunity. It could be inferred that physiologic levels of glucocorticoids and mineralocorticoids are essential for normal thyroid responsivity and hormone synthesis.


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