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Excluding thyroidectomy and radioactive iodine (131I) ablation:
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The most common causes of hypothyroidism in the adult are:
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Hashimoto’s thyroiditis
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The hypothyroid phase of subacute thyroiditis
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Because the long-term treatment is very different:
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The clinicians must distinguish between these conditions.
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The common causes of low circulating thyroid hormone levels are:
- Primary hypothyroidism (thyroid failure with elevated TSH):
- Hashimoto’s thyroiditis (chronic lymphocytic thyroiditis)
- Hypothyroid phase of painful subacute thyroiditis:
- Pseudo-granulomatous–De Quervain’s
- Hypothyroid phase of painless lymphocytic thyroiditis
- Hypothyroid phase of postpartum thyroiditis
- Radioactive iodine ablation
- Thyroidectomy
- Head and neck radiation
- Drugs:
- Lithium
- Amiodarone
- Interleukin
- Interferon
- Propylthiouracil / methimazole
- Iodine excess in patients with thyroiditis
- Iodine deficiency (uncommon in the United States)
- Biosynthetic defects (rare and presents in childhood)
- Congenital hypothyroidism (rare and presents in childhood)
- Secondary (hypothyroidism with low or inappropriately normal TSH):
- Pituitary dysfunction:
- Pituitary damage from tumor, surgery, and / or radiation
- Pituitary dysfunction:
- Tertiary:
- Hypothalamic damage from:
- Tumor, and / or radiation
- Hypothalamic damage from:
- Primary hypothyroidism (thyroid failure with elevated TSH):
#HeadandNeckSurgeon #ThyroidExpert #SurgicalOncologist #EndocrineSurgery #MountSinaiMedicalCenter #Miami #ThyroidNodule #ToxicNodularGoiter #TNG #MultinodularGoiter #Hypothyroidism #Thyroiditis #Goiter
Rodrigo Arrangoiz MS, MD, FACS, FSSO 