What Is Central Hypothyroidism?

When your hypothalamus or pituitary gland isn't working properly, your thyroid hormone levels are low, a condition known as central hypothyroidism.

A hormonal condition known as hypothyroidism, or an underactive thyroid, occurs when the body generates less thyroid hormone than is required. When the thyroid gland isn't stimulated adequately by the hypothalamus or pituitary, central hypothyroidism results.

Put another way, the pituitary or hypothalamus, not the thyroid gland itself, is the issue.

Fatigue, hair loss, and sadness are typical signs of central hypothyroidism. Additionally, you can feel achy or stiff in your joints and muscles.

Central hypothyroidism is uncommon, even though hypothyroidism is somewhat frequent. One in 20,000 to one in 80,000 persons worldwide suffer from central hypothyroidism. Central hypothyroidism affects just 1 out of every 1,000 hypothyroid individuals.

What is central hypothyroidism?

A disorder known as central hypothyroidism occurs when the hypothalamus, pituitary gland, or both aren't working properly, resulting in low thyroid levels.

Hormones that your body needs to function are produced by the thyroid gland. Triiodothyronine (T3) and thyroxine (T4) are the two main thyroid hormones. The function of thyroid hormones in the digestive and cardiovascular systems is significant.

But the following must occur to maintain a healthy level of thyroid hormones:
  • Thyrotropin-releasing hormone (TRH) is secreted by the hypothalamus.
  • Thyroid-stimulating hormone (TSH) is released by the pituitary gland in response to stimulation by TRH.
  • The thyroid gland then produces thyroid hormones in response to TSH stimulation.
Thyroid hormone production is inhibited when the hypothalamus fails to release thyroid stimulating hormone (TSH), the pituitary gland fails to release TSH or both. This is hypothyroidism in the centre.

Hypothyroidism resulting from a malfunctioning thyroid gland is not included in the definition of central hypothyroidism. We refer to this as primary hypothyroidism.

Additionally, doctors classify the illness as primary, secondary, or tertiary hypothyroidism.
  • When the thyroid gland isn't functioning properly, it's called primary hypothyroidism.
  • When there is pituitary gland dysfunction, the result is secondary hypothyroidism.
  • When the hypothalamus fails, it results in tertiary hypothyroidism.
Central hypothyroidism can take the form of either secondary or tertiary hypothyroidism. Compared to primary hypothyroidism, central hypothyroidism is less common.

Symptoms of central hypothyroidism

Each person experiences central hypothyroidism differently. Some people could have symptoms that are more severe than others.

Numerous body processes are significantly impacted by thyroid hormones. They have an impact on the reproductive system, muscles, metabolism, and more.

Central hypothyroidism symptoms include:
  • brain fog and difficulty thinking (cognitive dysfunction)
  • elevated blood cholesterol
  • fatigue
  • feeling cold
  • fertility issues
  • constipation
  • thinning hair or hair loss
  • weight gain
  • weakness, pain, or stiffness in your muscles or joints
  • irregular or heavy menstrual cycle
  • impaired memory
  • reduced libido
  • slow heart rate
  • decreased sweating
  • depression
  • dry skin
Numerous signs of central hypothyroidism may potentially be indicators of other medical disorders.

How is central hypothyroidism diagnosed?

Blood tests are used by medical practitioners to identify hypothyroidism.

They could look for:
  • thyroid antibodies
  • thyroid hormones (especially free T4 levels)
  • TSH
TSH levels are often high in hypothyroidism, although they are typically low in central hypothyroidism. However, it is conceivable to have central hypothyroidism with standard or slightly elevated TSH levels simultaneously. Perhaps this TSH is not biologically active.

To determine if you have central hypothyroidism or another type of hypothyroidism, a medical practitioner may need to perform additional testing. To examine the pituitary and hypothalamus, they may prescribe an MRI of the brain.

What causes central hypothyroidism?

When the hypothalamus, the pituitary gland, or both aren't working properly, it results in central hypothyroidism.

There are several potential causes for this, including:
  • Brain tumours in the hypothalamus or pituitary gland
  • damage resulting from radiation therapy, traumatic brain injury, or surgery on the pituitary gland or hypothalamus
  • immunological or inflammatory conditions that impact the pituitary gland
  • Sheehan syndrome is an uncommon ailment where substantial blood loss, typically during or following childbirth, damages the pituitary gland
  • Some drugs, such as opioids and prednisone
  • traumatic brain injury
A medical expert may do blood tests or brain scans to ascertain the source of your disease.

Risk factors for central hypothyroidism

Some things can make you more susceptible to central hypothyroidism.

Among these are:
  • pituitary tumours in the family history
  • hereditary disorders affecting the hypothalamus or pituitary gland
  • prior instances of brain tumours or brain surgery
  • past use of specific drugs, such as prednisone and opioids
  • radiation treatment for the brain
  • significant damage to the head
A person can acquire central hypothyroidism at any age or gender.

Central hypothyroidism treatment

Thyroid hormone replacement medication, typically in the form of levothyroxine (Levoxyl, Synthroid), is the standard treatment for hypothyroidism.

T4 is synthesised as levothyroxine. Your body can use the synthetic T4 to make T3.

Following several weeks of therapy, you could feel a little better. Your symptoms can become better or perhaps go away completely.

To make sure you're receiving the proper dosage, you might need to undergo routine blood testing. Your doctor may change your dosage in response to the results of your blood tests.

You may need surgery to remove the tumour if it is the source of your central hypothyroidism.

Several lifestyle modifications and self-care techniques may also help manage hypothyroidism symptoms. As an illustration:
  • Therapy may be helpful if you suffer from depression, which is a typical symptom of hypothyroidism.
  • Aim for adequate, high-quality sleep each night to aid in alleviating weariness.
  • Try to control your stress levels in a healthy way to lessen brain fog.
Eating enough iodine-rich foods is crucial for thyroid function even if there isn't a specialised diet for hypothyroidism.

Does central hypothyroidism shorten life expectancy?

The condition of central hypothyroidism alone typically does not reduce life expectancy when treated properly.

However, the underlying cause of central hypothyroidism (pituitary tumour, for example) may have an impact on your life expectancy and standard of living.

Severe central hypothyroidism can cause consequences, such as myxedema coma if it is not addressed. This is a potentially fatal condition that has to be treated urgently. Additionally, cardiac failure may result from untreated hypothyroidism.

However, those who have hypothyroidism can expect to live an average life and have a good quality of life with the correct care.


One uncommon kind of hypothyroidism is central hypothyroidism. It happens when the hormones your thyroid gland requires to function properly aren't produced by the pituitary, brain, or both. This could be the result of a brain injury, tumour, or hereditary problem.

The symptoms of central hypothyroidism may become easier to control or go away completely with the correct care. The first step in treating your problem is to consult with a healthcare provider.


Can central hypothyroidism be cured?

There is no cure for central hypothyroidism

Is central hypothyroidism genetic?

A minority of cases are associated with a known genetic mechanism

Can thyroid run in the family?

Thyroid problems often run in families

Can I get pregnant if my husband has thyroid?

hyperthyroidism can cause a marked reduction in sperm count, resulting in reduced fertility

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