Abstract
Hypothyroidism is the most common endocrine deficiency state. Overt hypothyroidism affects 2% of adult women and 0.2% of adult men, and mild hypothyroidism is present in an additional 7–15% of older adults (1). The most common underlying cause is autoimmune (Hashimoto’s) thyroiditis, followed by previous thyroid radiation with 131I or external-beam therapy. Certain medications can cause hypothyroidism, particularly when given to patients with underlying autoimmune thyroiditis, including lithium carbonate, amiodarone, other iodine-containing compounds, the cytokines interferon (IFN)-α and interleukin (IL)-2, and the antithyroid thionamide drugs. Transient hypothyroidism occurs in forms of thyroiditis caused by presumptive viral infection (subacute thyroiditis) or autoimmunity (postpartum, painless, or silent thyroiditis). Congenital hypothyroidism (CH) caused by thyroid agenesis or defective hormonogenesis affects one in 4000 newborns. Rarely, hypothyroidism results from hypothalamic or pituitary disorders causing deficiencies in thyrotropin-releasing hormone (TRH) and thyroid-stimulating hormone (TSH, thyrotropin) respectively.
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