Hypothyroidism affects millions of people every year, and many doctors claim it is usually irreversible. Much of the time, people referring to hypothyroidism are talking about primary hypothyroidism, or a disorder of the thyroid gland.
However, secondary hypothyroidism is a much rarer disorder. Below, we will talk about what secondary hypothyroidism is, how it’s different from other thyroid diseases, and how to permanently reverse hypothyroidism.
If you may have secondary hypothyroidism, sign up here for a free phone consultation with our team! Continue reading to learn more about this rare disease.
What is secondary hypothyroidism?
Also called “hypothyroidism secondary,” secondary hypothyroidism is a condition in which the pituitary gland is underactive. Your pituitary gland is supposed to secrete a hormone that stimulates your thyroid gland, but sometimes your pituitary gland doesn’t function perfectly.
Your pituitary gland produces and secretes hormones like prolactin (the milk hormone), growth hormone, and thyroid-stimulating hormone (TSH). No surprise, TSH stimulates your thyroid to work correctly.
In secondary hypothyroidism, your pituitary gland does not release enough TSH — also called thyrotropin — to stimulate your thyroid to produce its thyroid hormones. This TSH deficiency leads to adverse symptoms similar to primary hypothyroidism, but treatment for this disorder is very different.
Secondary hypothyroidism due to underactivity of the pituitary gland (or hypothalamus) thyroid-stimulating hormone 1 in 1,000 hypothyroid cases. Its incidence is very low.
How many people are affected by secondary hypothyroidism? Between one in 80,000 and one in 120,000 people are affected by secondary hypothyroidism. The prevalence is quite rare.
What are the other types of hypothyroidism?
There are 4 basic variations of hypothyroidism: primary hypothyroidism, secondary hypothyroidism, tertiary hypothyroidism, and subclinical hypothyroidism.
- Primary hypothyroidism occurs when your thyroid gland does not produce enough thyroid hormones: triiodothyronine (T3) and thyroxine (T4). Hashimoto’s thyroiditis causes 90% of primary hypothyroidism cases.
- Secondary hypothyroidism, as stated above, is a condition in which the pituitary gland malfunctions, decreasing TSH production and, by extension, T3/T4 levels.
- Tertiary hypothyroidism is when your hypothalamus does not secrete enough thyrotropin-releasing hormone (TRH) to stimulate the pituitary gland, which ultimately leads to an underactive thyroid.
- Subclinical hypothyroidism affects the pituitary gland just like secondary hypothyroidism, but subclinical thyroid dysfunction means too much TSH is produced. In subclinical hypothyroidism, your thyroid hormone levels are within a normal range. Subclinical hypothyroidism frequently clears up on its own. It is often caused by inflammation, like that experienced during a hospital stay. All other types of hypothyroidism besides this one can be called “overt hypothyroidism.”
How do primary and secondary hypothyroidism differ? Primary and secondary hypothyroidism differ in that your pituitary gland properly functions in normal primary hypothyroidism, whereas it does not in secondary hypothyroidism.
How can you tell the difference between secondary and tertiary hypothyroidism? Your hypothalamus functions properly in secondary hypothyroidism, whereas it does not function the right way in tertiary hypothyroidism.
What is central hypothyroidism?
The term “central hypothyroidism” refers to thyroid disorders that are caused outside the thyroid gland. This generally affects the pituitary, hypothalamus, or hypothalamic-pituitary portal circulation, causing reduced thyroid-stimulating hormone (TSH), thyrotropin-releasing hormone (TRH), or possibly both.
Central hypothyroidism includes secondary and tertiary hypothyroidism.
Signs of Secondary Hypothyroidism
There are several signs and symptoms of hypothyroidism. Since the end result is the same as primary hypothyroidism — thyroid hormone deficiency — the symptoms of secondary hypothyroidism are basically the same.
What are the symptoms of secondary hypothyroidism?
- Goiter (enlarged thyroid)
- Fatigue
- Weight gain
- Cold intolerance
- Constipation
- Muscle soreness
- Joint pain
- Brittle nails
- Thinning hair
- Depression
- Increased cholesterol (moreso in primary hypothyroidism)
- Cardiovascular risk
If allowed to progress, severe hypothyroidism causes more serious symptoms to develop:
- Slowed speech
- Hearing loss
- Flaky, dry skin
- Puffy face
- Hoarseness
- Snoring
- Menstrual disorders
- Myxedema coma
Common Causes & Risk Factors
What causes secondary hypothyroidism? The most common cause of secondary hypothyroidism is a pituitary tumor (such as a pituitary adenoma). This sets it apart from primary hypothyroidism, which is most often caused by an autoimmune disease called Hashimoto’s disease (also known as lymphocytic thyroiditis).
In rare instances, hypothyroidism secondary may occur when inflammatory cells infiltrate the pituitary gland.
Risk factors for secondary hypothyroidism include:
- Age over 50 years old
- Female gender
- Head trauma
- Chronic stress
- Personal or family history of pituitary dysfunction
Congenital hypothyroidism secondary can also occur in newborns. Fortunately, newborn screenings for congenital hypothyroidism are mandated in the United States, so it’s almost always caught early.
How can your doctor diagnose secondary hypothyroidism?
Doctors and healthcare professionals will need to do blood tests to diagnose secondary hypothyroidism — and any thyroid disorder, really.
Some conventional endocrine doctors may only test for TSH levels and free thyroxine (T4) levels. Other healthcare providers might use a thyroid function test to diagnose thyroid disease.
A thyroid function test makes sure that TSH secretion is at normal serum levels and that you don’t have low thyroid hormone levels.
However, we at PrimeHealth take a more comprehensive approach to diagnosis. With blood tests, we will assess:
- Serum TSH
- Total T4/T3
- Free T4/T3
- Reverse T3
- Thyroid-binding globulin
- Thyroid-stimulating immunoglobulin
- Anti-thyroid peroxidase (TPO) antibody and anti-thyroglobulin antibody (Hashimoto’s antibodies)
The normal range of TSH levels should stay in between 0.4 mIU/L and 4.0 mIU/L (milli-international units per liter). Optimal TSH levels should be between 0.5 mIU/L and 2.5 mIU/L. Abnormalities can mean trouble.
Here are some unique situations which will affect our approach to diagnosing thyroid problems:
- Cancer or history of cancer
- Pregnant women
- Breastfeeding
- Adrenal insufficiency
- Hyperthyroidism medication
Though diagnosis may take hours of medical investigation, we believe plans should be tailored to each individual patient. These more detailed data points allow us to truly personalize medical treatment.
Diagnostic Challenges and Advances
Diagnosing secondary hypothyroidism can be a bit like finding a needle in a haystack. One of the main challenges is that secondary hypothyroidism is quite rare and its symptoms often mimic those of many other conditions. This makes it tricky for both doctors and patients to pinpoint what’s really going on. Imagine you’re feeling tired all the time, gaining weight, or dealing with muscle soreness—these symptoms could be linked to a myriad of health issues, not just hypothyroidism. Due to its rarity, secondary hypothyroidism might not even be on the radar initially, leading to a delayed diagnosis.
However, there has been significant progress in the realm of diagnostic techniques and technologies that are making it easier to get accurate diagnoses. Modern medicine now employs more sensitive assays that can detect even the slightest anomalies in thyroid hormone levels, which was not possible with older testing methods. In addition, advanced imaging techniques, such as high-resolution MRI and CT scans, allow doctors to inspect the pituitary gland more thoroughly for any abnormalities or tumors.
Lean On The Expertise of PrimeHealth Denver
Here at PrimeHealth Denver, our team of functional doctors has access to the latest diagnostic tools and techniques, allowing us to get to the root of your thyroid issues faster. Our holistic approach means we take into account all aspects of your health, working with you as an individual so that we can provide the best possible treatment plan for your unique circumstances.
Looking for integrative healthcare and cutting-edge medical advice that addresses your unique health situation with a balance of dietary changes, supplements, lifestyle adjustments, and medications when necessary? Schedule a free consultation with PrimeHealth in Denver, Colorado. See if we’re the right fit for you.
Treatment of Secondary Hypothyroidism
Here at PrimeHealth in Denver, CO, we believe that you can permanently reverse hypothyroidism. Whereas many conventional endocrinologists say that hypothyroidism is often irreversible, our patients have responded to PrimeHealth’s treatment plans very well.
All of our hypothyroid patients are unique and have very unique needs. Their treatment plans are always personalized to reflect that.
How do you treat secondary hypothyroidism naturally? Natural treatment of hypothyroidism secondary can be broken into 3 parts:
- Dietary changes
- Lifestyle changes
- Medications
Hypothyroidism Diet
For most cases of hypothyroidism, we recommend an Autoimmune Paleo Diet for a period of 1-6 months.
This not only encourages you to eat only the healthiest foods for your body, but it eliminates potential food allergens and inflammatory ingredients.
Foods to Eat
- High quality protein like grass-fed meat and wild-caught fish
- Non-nightshade vegetables
- Cruciferous vegetables
- Herbs like garlic, turmeric
- Gelatin, bone broth
- Green tea
- Kombucha
- Apple cider vinegar
- Small amounts of honey, maple syrup, and fruits
Foods to Avoid
- Dairy
- Grains
- Nuts, seeds
- Beans, legumes (because of lectin)
- Chocolate
- Sugars
- Alternative sweeteners
- Nightshade vegetables
- Vegetable oil, canola oil
- Alcohol
- Processed foods
Join our online Prime Gut Course, which is filled with immediate action steps to help you optimize your thyroid for life.
Lifestyle Changes
Some simple lifestyle changes can bring about noticeable improvements to your quality of life when you live with secondary hypothyroidism.
Stress can trigger a thyroid disorder. Alleviating that stress can be paramount to pituitary and thyroid health.
Meditation is a great way to relieve stress. Also, going outside and breathing fresh air often can combat daily stress.
It’s important to get 7-8 hours of sleep. Here are some tips on how to get the best sleep:
- Turn off technology an hour before bed (because of blue light) (Use code PRIMEHEALTH for 10% off of our favorite blue-light blocking glasses by Ra Optics)
- Don’t exercise within 2 hours of bedtime
- Take a hot epsom salt bath or shower before bed
Medications
Though pharmaceuticals are a last resort, there are several medications that possess few side effects and can be individualized for unique patient cases.
Though side effects can be severe for hormone therapy in the long run, hormone replacement therapy (HRT) may be necessary to get your body the thyroid hormones it requires.
A popular thyroid hormone replacement drug is levothyroxine. It is the most common pharmaceutical prescribed for hypothyroidism of any kind. However, levothyroxine can come with a whole host of side effects in certain people:
- Heart attack
- Migraine
- Anxiety
- Alopecia
- Heat intolerance
- Diarrhea
- Fatigue
- Insomnia
If we feel medication is safe and necessary, we might suggest a compounded synthetic combination of T3 and T4 hormones, levothyroxine, or dessicated thyroid medication, depending on the situation.
Thyroid hormone receptor-β selective agonists may also treat metabolic disorders, but animal models exhibit some toxicity. We realize there are risks associated with thyroid hormone medication
It’s important to consider these other options when trying to optimize thyroid medication and function.
Thyroid Hormone Replacement Therapy: Risks and Benefits
HRT is a treatment used to supplement the body with hormones it no longer produces naturally. It’s particularly common for treating conditions such as hypothyroidism, where the thyroid gland doesn’t produce enough hormones, but it’s also used in a variety of other hormonal imbalances.
Types of HRT
There are different types of HRT to suit different needs and preferences. The most common ones for thyroid issues include:
- Levothyroxine: This is a synthetic form of the thyroid hormone thyroxine (T4). It’s designed to mimic the function of the natural hormone and is usually taken orally in tablet form.
- Combination Therapy (T3 and T4): This involves a mix of two thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It can be especially useful for patients who don’t respond well to T4-only therapy.
- Desiccated Thyroid Extracts: Derived from animal thyroid glands, these contain a balanced mix of T3 and T4. Some patients prefer this natural form, but the dosage can be less consistent compared to synthetic hormones.
Administration and Monitoring
The administration of HRT is pretty straightforward for most people. Oral tablets are the most common form, but there are also options for injections and transdermal preparations, such as patches or gels. Once you start HRT, it’s crucial to have regular follow-up appointments with your healthcare provider.
Monitoring involves blood tests to measure the levels of thyroid hormones (T3, T4) and Thyroid Stimulating Hormone (TSH) in your body. These tests help to ensure that you’re on the right dosage. Adjustments to the dosage can be expected, especially in the initial stages of treatment.
Adjustments and Long-Term Management
Adjusting your HRT dosage is a bit of a balancing act. Too much thyroid hormone could cause symptoms of hyperthyroidism, like anxiety, weight loss, and insomnia, while too little could leave you feeling sluggish and down. That’s why ongoing monitoring and adjustments are key to finding that sweet spot where you feel your best.
Long-term outcomes for those on HRT can vary. Most people find significant symptom relief and can manage their condition effectively with the right hormone levels. Regular check-ins with your healthcare provider, lifestyle adjustments, and perhaps some dietary tweaks can all play a part in optimizing your long-term health.
Patient management strategies often include educating patients on the importance of medication adherence and recognizing symptoms of over- or under-treatment. Tools like medication reminders, support groups, and regular consultations can be invaluable for a successful HRT journey.
Role of Nutrition and Supplements in Managing Secondary Hypothyroidism
When it comes to managing secondary hypothyroidism, diet and nutrition are like secret weapons in your arsenal. Sure, medications play a huge role, but what you eat can make a significant difference too.
Key Nutrients for Thyroid Health
- Iodine: Think of iodine as the rockstar of thyroid health. Your thyroid needs iodine to make hormones. No iodine, no hormones. Simple as that. Foods rich in iodine that can help with iodine deficiency include seaweed, fish, dairy, and even iodized salt. A balanced iodine intake can help keep your thyroid functioning efficiently, but it’s important not to overdo it as too much iodine can have adverse effects.
- Selenium: Selenium is like the thyroid’s sidekick. It helps convert the inactive thyroid hormone (T4) into its active form (T3). Brazil nuts, sunflower seeds, and fish are fantastic sources. Selenium is vital for reducing thyroid inflammation and optimizing hormone levels. Incorporating selenium-rich foods can be a game-changer for thyroid patients.
- Zinc: Zinc is another unsung hero, aiding in thyroid hormone production and overall immune function. You can find zinc in foods like oysters, beef, and pumpkin seeds. Ensuring you get enough zinc through your diet can help maintain healthy thyroid function.
- Iron: Iron is essential for the production of thyroid hormones. Think spinach, red meat, and lentils. Iron deficiency is common but easily addressed with a balanced diet. It’s critical for anyone dealing with thyroid issues.
Best Dietary Practices
A nutrient-rich diet is a cornerstone of thyroid health. Incorporating a variety of fruits, vegetables, lean proteins, and whole grains ensures you get a broad spectrum of essential nutrients. Here are some tips to keep your thyroid happy:
- Go Gluten-Free: Some people with thyroid issues find that gluten can be problematic. Gluten sensitivity can exacerbate thyroid problems. So it’s worth trying a gluten-free diet to see if it alleviates any symptoms.
- Avoid Goitrogens: These are substances that can interfere with thyroid function found in foods like soy, broccoli, and cauliflower. You don’t need to eliminate these foods, but cooking them can deactivate goitrogens, making them safer to eat.
Supplements: Yay or Nay?
Supplements can fill in the nutritional gaps, but they aren’t a magic bullet. A well-balanced diet should be your first line of defense, but supplements can be beneficial, especially if you’re struggling to get enough of certain nutrients.”
Some experts recommend:
- Multivitamins: A high-quality multivitamin can provide a balanced mix of essential nutrients.
- Vitamin D: Particularly for those with limited sun exposure, as it’s crucial for overall endocrine health.
- Fish Oil: Rich in omega-3 fatty acids, which can help reduce inflammation and support thyroid function.
Whether you’re tweaking your diet or adding some supplements, the goal is to create an environment where your thyroid—and by extension, you—can thrive.
Before Diagnosing Secondary Hypothyroidism…
Other conditions may exhibit similar symptoms. Physicians should look into these before deciding you have secondary hypothyroidism:
- Seasonal affective disorder
- Peritonitis
- Intestinal obstruction, ileus
- Anemia
- Drug allergy
Future Outlook
Although many conventional endocrinology professionals claim that hypothyroidism is incurable, our evidence to the contrary speaks volumes.
Many of our patients are euthyroid (healthy thyroid function) by the end of our treatment plan. It may take a year, but the future outlook is much brighter than conventional medicine would have you believe.
If you think you have hypothyroidism, sign up here for a free phone consultation with our team!
In Summary, Recovery Is Possible.
Secondary hypothyroidism is a rare disorder that describes an underactive pituitary gland causing an underactive thyroid.
The pituitary gland produces thyroid-stimulating hormone, also called thyrotropin. As you can tell from the name, this pituitary hormone is needed for normal thyroid function.
Symptoms of secondary hypothyroidism include:
- Fatigue
- Muscle and joint pain
- Depression
- Sensitivity to cold
- Constipation
- Puffy face
- Thinning hair, eyebrows
- Hearing loss
- Myxedema coma, in extreme cases
The most common cause of secondary hypothyroidism is a pituitary tumor. Other risk factors include being older than 50, being female, and having a history of pituitary dysfunction.
Diagnosing secondary hypothyroidism should include comprehensive blood testing.
Treatment of secondary hypothyroidism includes a hypothyroidism diet, lifestyle changes, and perhaps medication.
Hypothyroidism is almost always treatable and often reversible. Our patients are our evidence.
Sources
- Persani, L. (2012). Central hypothyroidism: pathogenic, diagnostic, and therapeutic challenges. J Clin Endocrinol Metab, 97(9), 3068-3078. Full text: https://academic.oup.com/jcem/article/97/9/3068/2536827
- Klose, M., Marina, D., Hartoft-Nielsen, M. L., Klefter, O., Gavan, V., Hilsted, L., … & Feldt-Rasmussen, U. (2013). Central hypothyroidism and its replacement have a significant influence on cardiovascular risk factors in adult hypopituitary patients. The Journal of Clinical Endocrinology & Metabolism, 98(9), 3802-3810. Full text: https://academic.oup.com/jcem/article/98/9/3802/2833494
- Benvenga, S., Klose, M., Vita, R., & Feldt-Rasmussen, U. (2018). Less known aspects of central hypothyroidism: Part 1–Acquired etiologies. Journal of clinical & translational endocrinology, 14, 25-33. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6205405/
- Freed, D. L. (1999). Do dietary lectins cause disease?: The evidence is suggestive—and raises interesting possibilities for treatment. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1115436/
- Olivares, E. L., Silva-Almeida, C., Pestana, F. M., Sonoda-Côrtes, R., Araujo, I. G., Rodrigues, N. C., … & Rocha, F. F. (2012). Social stress-induced hypothyroidism is attenuated by antidepressant treatment in rats. Neuropharmacology, 62(1), 446-456. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/21903114
- Thompson, C. W., Roe, J., Aspinall, P., Mitchell, R., Clow, A., & Miller, D. (2012). More green space is linked to less stress in deprived communities: Evidence from salivary cortisol patterns. Landscape and urban planning, 105(3), 221-229. Full text: https://www.sciencedirect.com/science/article/pii/S0169204611003665
- Hirotsu, C., Tufik, S., & Andersen, M. L. (2015). Interactions between sleep, stress, and metabolism: From physiological to pathological conditions. Sleep Science, 8(3), 143-152. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4688585/
- Hatori, M., Gronfier, C., Van Gelder, R. N., Bernstein, P. S., Carreras, J., Panda, S., … & Furukawa, T. (2017). Global rise of potential health hazards caused by blue light-induced circadian disruption in modern aging societies. npj Aging and Mechanisms of Disease, 3(1), 1-3. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5473809/
- Eghtedari, B., & Correa, R. (2019). Levothyroxine. In StatPearls [Internet]. StatPearls Publishing. Full text: https://www.ncbi.nlm.nih.gov/books/NBK539808/
Pantos, C., Mourouzis, I., Malliopoulou, V., Paizis, I., Tzeis, S., Moraitis, P., … & Cokkinos, D. V. (2005). Dronedarone administration prevents body weight gain and increases tolerance of the heart to ischemic stress: a possible involvement of thyroid hormone receptor α1. Thyroid: official journal of the American Thyroid Association, 15(1), 16-23. Abstract: https://pubmed.ncbi.nlm.nih.gov/15687816/
