Central Hypothyroidism: Advances in Etiology, Diagnostic Challenges, Therapeutic Targets, and Associated Risks

Abstract

Objective

Central hypothyroidism is a rare disorder resulting from impaired thyroid hormone production due to deficiencies in TSH secretion from the pituitary or TRH secretion from the hypothalamus. This review aims to summarize recent advances in the etiology, diagnosis, and treatment of central hypothyroidism, with an emphasis on diagnostic and therapeutic challenges.

Methods

A comprehensive review of the literature was conducted, focusing on genetic and acquired causes, particularly those related to hypothalamic–pituitary tumors and the effects of surgical and radiotherapeutic interventions. Diagnostic approaches and treatment strategies, including levothyroxine therapy and monitoring, are analyzed.

Results

Early diagnosis requires simultaneous measurement of free T4 and TSH to prevent neurological sequelae, especially in congenital cases. Central hypothyroidism is associated with risks such as growth and developmental impairment, as well as metabolic and cardiovascular disturbances. Levothyroxine therapy is crucial for correcting hormonal deficits and improving patient outcomes; however, careful dosing is necessary to avoid potential complications, particularly in vulnerable populations.

Conclusions

Personalized treatment and continuous monitoring are essential to optimize clinical outcomes and enhance the quality of life in affected individuals. A thorough understanding of central hypothyroidism's etiology and management is necessary to improve early detection and therapeutic strategies.