Central hypothyroidism (CH) refers to hypothyroidism that is not caused by anatomical or functional defects of the thyroid gland per se (primary hypothyroidism) but by inefficient synthesis of TSH (secondary hypothyroidism). Central hypothyroidism might be congenital (CH-C) or acquired. The TSH values in individuals with central hypothyroidism would be expected to be subnormal. Although that is usually the case, normal or mildly elevated TSH values can also be detected in certain cases, leading to an erroneous diagnosis of primary hypothyroidism. This phenomenon has been attributed to an aberrant TSH molecule, which is measurable by applied methodology but is biologically inactive. Regardless of the mechanism involved one should be aware of this phenomenon in order to avoid misinterpretation and diagnose primary instead of secondary (central) hypothyroidism.
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Last date updated on July, 2014