Skip to main content

Classification and Etiopathogenesis of Hypothyroidism

  • Living reference work entry
  • First Online:
Thyroid Diseases

Part of the book series: Endocrinology ((ENDOCR))

  • 1049 Accesses

Abstract

Hypothyroidism is a graded phenomenon characterized by a deficient thyroidal production of thyroid hormone. This condition comprises multiple functional or structural disorders, both congenital and acquired. The clinical expression of hypothyroidism varies between individuals, depending on the cause, duration, and severity of the hypothyroid state, but almost all organs and systems may be affected by a deficiency of thyroid hormone production. This chapter describes the epidemiology, multiple etiologies, and clinical manifestations of hypothyroidism.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

References

  • Abrahamsen B, Jørgensen HL, Laulund AS, Nybo M, Bauer DC, Brix TH, Hegedüs L. The excess risk of major osteoporotic fractures in hypothyroidism is driven by cumulative hyperthyroid as opposed to hypothyroid time: an observational register-based time-resolved cohort analysis. J Bone Miner Res. 2015;30:898.

    Article  CAS  PubMed  Google Scholar 

  • Aghini-Lombardi F, Antonangeli L, Martino E, Vitti P, Maccherini D, Leoli F, Rago T, Grasso L, Valeriano R, Balestrieri A, Pinchera A. The spectrum of thyroid disorders in an iodine-deficient community: the Pescopagano survey. J Clin Endocrinol Metab. 1999;84:561.

    CAS  PubMed  Google Scholar 

  • Ajjan RA, Weetman AP. The Pathogenesis of Hashimoto’s Thyroiditis: Further Developments in our Understanding. Horm Metab Res. 2015;47:702.

    Article  CAS  PubMed  Google Scholar 

  • Amino N, Tada H, Hidaka Y. Postpartum autoimmune thyroid syndrome: a model of aggravation of autoimmune disease. Thyroid. 1999;9:705.

    Article  CAS  PubMed  Google Scholar 

  • Anasti JN, Flack MR, Froehlich J, Nelson LM, Nisula BC. A potential novel mechanism for precocious puberty in juvenile hypothyroidism. J Clin Endocrinol Metab. 1995;80:276.

    CAS  PubMed  Google Scholar 

  • Anwar S, Gibofsky A. Musculoskeletal manifestations of thyroid disease. Rheum Dis Clin N Am. 2010;36:637.

    Article  Google Scholar 

  • Bassett JH, Boyde A, Howell PG, Bassett RH, Galliford TM, Archanco M, Evans H, Lawson MA, Croucher P, St Germain DL, Galton VA, Williams GR. Optimal bone strength and mineralization requires the type 2 iodothyronine deiodinase in osteoblasts. Proc Natl Acad Sci USA. 2010;107:7604.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Biondi B, Cooper DS. The clinical significance of subclinical thyroid dysfunction. Endocr Rev. 2008;29:76.

    Article  CAS  PubMed  Google Scholar 

  • Boelen A, Kwakkel J, Fliers E. Beyond low plasma T3: local thyroid hormone metabolism during inflammation and infection. Endocr Rev. 2011;32:670.

    Article  CAS  PubMed  Google Scholar 

  • Bonnema SJ, Hegedüs L. Endocr Rev. 2012;33:920.

    Article  CAS  PubMed  Google Scholar 

  • Brix TH, Kyvik KO, Hegedüs L. A population-based study of chronic autoimmune hypothyroidism in Danish twins. J Clin Endocrinol Metab. 2000;85:536.

    CAS  PubMed  Google Scholar 

  • Calvino C, Imperio GE, Wilieman M, Costa ESRH, Souza LL, Trevenzoli IH, Pazos-Moura CC. Hypothyroidism Induces Hypophagia Associated with Alterations in Protein Expression of Neuropeptide Y and Proopiomelanocortin in the Arcuate Nucleus, Independently of Hypothalamic Nuclei-Specific Changes in Leptin Signaling. Thyroid. 2016;26:134.

    Article  CAS  PubMed  Google Scholar 

  • Canaris GJ, Manowitz NR, Mayor G, Ridgway EC. The Colorado thyroid disease prevalence study. Arch Intern Med. 2000;160:526.

    Article  CAS  PubMed  Google Scholar 

  • Coles AJ, Wing M, Smith S, Coraddu F, Greer S, Taylor C, Weetman A, Hale G, Chatterjee VK, Waldmann H, Compston A. Pulsed monoclonal antibody treatment and autoimmune thyroid disease in multiple sclerosis. Lancet. 1999;354:1691.

    Article  CAS  PubMed  Google Scholar 

  • Constant EL, de Volder AG, Ivanoiu A, Bol A, Labar D, Seghers A, Cosnard G, Melin J, Daumerie C, Clin J. Cerebral blood flow and glucose metabolism in hypothyroidism: a positron emission tomography study. Endocrinol Metab. 2001;86:3864.

    Article  CAS  Google Scholar 

  • Correia N, Mullally S, Cooke G, Tun TK, Phelan N, Feeney J, Fitzgibbon M, Boran G, O’Mara S, Gibney J, Clin J. Evidence for a specific defect in hippocampal memory in overt and subclinical hypothyroidism. Endocrinol Metab. 2009;94:3789.

    Article  CAS  Google Scholar 

  • Curran PG, DeGroot LJ. The effect of hepatic enzyme-inducing drugs on thyroid hormones and the thyroid gland. Endocr Rev. 1991;12:135.

    Article  CAS  PubMed  Google Scholar 

  • Daniels GH, Vladic A, Brinar V, Zavalishin I, Valente W, Oyuela P, Palmer J, Margolin DH, Hollenstein J. Alemtuzumab-related thyroid dysfunction in a phase 2 trial of patients with relapsing-remitting multiple sclerosis. J Clin Endocrinol Metab. 2014;99:80.

    Article  CAS  PubMed  Google Scholar 

  • Danzi S, Klein I. Thyroid disease and the cardiovascular system. Endocrinol Metab Clin N Am. 2014;43:517.

    Article  Google Scholar 

  • Devdhar M, Ousman YH YH, Burman KD. Hypothyroidism. Endocrinol Metab Clin N Am. 2007;36:595.

    Article  CAS  Google Scholar 

  • Duntas LH, Brenta G. The effect of thyroid disorders on lipid levels and metabolism. Med Clin North Am. 2012;96:269.

    Article  CAS  PubMed  Google Scholar 

  • Ebert EC. The thyroid and the gut. J Clin Gastroenterol. 2010;44:402.

    CAS  PubMed  Google Scholar 

  • Effraimidis G, Wiersinga WM. Mechanisms in endocrinology: autoimmune thyroid disease: old and new players. Eur J Endocrinol. 2014;170:R241.

    Article  CAS  PubMed  Google Scholar 

  • Fliers E, Bianco AC, Langouche L, Boelen A. Thyroid function in critically ill patients. Lancet Diabetes Endocrinol. 2015;3:816.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Garber JR, Cobin HR, Gharib H, Hennessey JV, Klein I, Mechanick J, Pessah-Pollack R, Singer PA, Woeber KA. Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Thyroid. 2012;22:1220.

    Article  Google Scholar 

  • Gereben B, Zavacki AM, Ribich S, Kim BW, Huang SA, Simonides WS, Zeöld A, Bianco AC. Cellular and molecular basis of deiodinase-regulated thyroid hormone signaling. J Endocr Rev. 2008;29:898.

    Article  CAS  Google Scholar 

  • Guastamacchia E, Triggiani V, Aglialoro A, Aiello A, Ianni L, Maccario M, Zini M, Giorda C, Guglielmi R, Betterle C, Attanasio R, Borretta G, Garofalo P, Papini E, Castello R, Ceriello A. Italian Association of Clinical Endocrinologists (AME) & Italian Association of Clinical Diabetologists (AMD) Position Statement : Diabetes mellitus and thyroid disorders: recommendations for clinical practice. Endocrine. 2015;49:339.

    Article  CAS  PubMed  Google Scholar 

  • Haddow JE, Palomaki GE, Allan WC, Williams JR, Knight GJ, Gagnon J, O’Heir CE, Mitchell ML, Hermos RJ, Waisbren SE, Faix JD, Klein RZ, Engl N. Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child. J Med. 1999;341:549.

    CAS  Google Scholar 

  • Hancock SL, McDougall IR, Constine L-S. Thyroid abnormalities after therapeutic external radiation. Int J Radiat Oncol Biol Phys. 1995;31:1165.

    Article  CAS  PubMed  Google Scholar 

  • Hannon MJ, O’Halloran DJ. Isolated acquired ACTH deficiency and primary hypothyroidism: a short series and review. Pituitary. 2011;14:358.

    Article  CAS  PubMed  Google Scholar 

  • Hassan MM, Kaseb A, Li D, Patt YZ, Vauthey JN, Thomas MB, Curley SA, Spitz MR, Sherman SI, Abdalla EK, Davila M, Lozano RD, Hassan DM, Chan W, Brown TD, Abbruzzese JL. Association between hypothyroidism and hepatocellular carcinoma: a case-control study in the United States. Hepatology. 2009;49:1563.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hennessey JV. Clinical review: Riedel’s thyroiditis: a clinical review. J Clin Endocrinol Metab. 2011;96:3031.

    Article  CAS  PubMed  Google Scholar 

  • Herwig A, Campbell G, Mayer CD, Boelen A, Anderson RA, Ross AW, Mercer JG, Barrett P. A thyroid hormone challenge in hypothyroid rats identifies T3 regulated genes in the hypothalamus and in models with altered energy balance and glucose homeostasis. Thyroid. 2014;24:1575.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Heuer H. The importance of thyroid hormone transporters for brain development and function. Best Pract Res Clin Endocrinol Metab. 2007;21:265.

    Article  CAS  PubMed  Google Scholar 

  • Hollowell NW, Staehling WD, Flanders WH, Hannon EW, Gunter CA, Spencer LE. Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab. 2002;87:489.

    Article  CAS  PubMed  Google Scholar 

  • Iglesias P, Diez JJ. Thyroid dysfunction and kidney disease. Eur J Endocrinol. 2009;160:503.

    Article  CAS  PubMed  Google Scholar 

  • Iwama S, De Remigis A, Callahan MK, Slovin SF, Wolchok JD, Caturegli P. Pituitary expression of CTLA-4 mediates hypophysitis secondary to administration of CTLA-4 blocking antibody. Sci Transl Med. 2014;6:230ra45.

    Article  PubMed  Google Scholar 

  • Jereczek-Fossa BA, Alterio D, Jassem J, Gibelli B, Tradati N, Orecchia R. Radiotherapy-induced thyroid disorders. Cancer Treat Rev. 2004;30:369.

    Article  CAS  PubMed  Google Scholar 

  • Jha A, Sharma SK, Tandon N, Lakshmy R, Kadhiravan T, Handa KK, Gupta R, Pandey RM, Chaturvedi PK. Thyroxine replacement therapy reverses sleep-disordered breathing in patients with primary hypothyroidism. Sleep Med. 2006;7:55.

    Article  PubMed  Google Scholar 

  • Jonklaas J, Bianco AC, Bauer AJ, Burman KD, Cappola AR, Celi FS, Cooper DS, Kim BW, Peeters RP, Rosenthal MS, Sawka AM. Guidelines for the treatment of hypothyroidism: prepared by the american thyroid association task force on thyroid hormone replacement. Thyroid. 2014;24:1670.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kanaya AM, Harris F, Volpato S, Pérez-Stable EJ, Harris T, Bauer DC. Association between thyroid dysfunction and total cholesterol level in an older biracial population: the health, aging and body composition study. Arch Intern Med. 2002;162:773.

    Article  PubMed  Google Scholar 

  • Kappers MHW, van Esch JHM, Smedts FMM, de Krijger RR, Eechoute K, Mathijssen RHJ, Sleijfer S, Leijten F, Danser AHJ, van den Meiracker AH, Visser TJ. Sunitinib-induced hypothyroidism is due to induction of type 3 deiodinase activity and thyroidal capillary regression. J Clin Endocrinol Metab. 2011;96:3087.

    Article  CAS  PubMed  Google Scholar 

  • Knudsen N, Jùrgensen T, Rasmussen S, Christiansen E, Perrild H. The prevalence of thyroid dysfunction in a population with borderline iodine deficiency. Clin Endocrinol. 1999;51:361.

    Article  CAS  Google Scholar 

  • Krassas GE, Pontikides N. Male reproductive function in relation with thyroid alterations. Best Pract Res Clin Endocrinol Metab. 2004;18:183.

    Article  CAS  PubMed  Google Scholar 

  • Krassas GE, Poppe K, Glinoer D. Thyroid function and human reproductive health. Endocr Rev. 2010;31:702.

    Article  CAS  PubMed  Google Scholar 

  • Kyriakakis N, Lynch J, Ajjan R, Murray RD. The effects of pituitary and thyroid disorders on haemostasis: potential clinical implications. Clin Endocrinol. 2016;84:473.

    Article  CAS  Google Scholar 

  • Laurberg P, Cerqueira C, Ovesen L, Rasmussen LB, Perrild H, Andersen S, Pedersen IB, Carlé A. Iodine intake as a determinant of thyroid disorders in populations. Best Pract Res Clin Endocrinol Metab. 2010;24:13.

    Article  CAS  PubMed  Google Scholar 

  • Lazarus JH. Lithium and thyroid. Best Pract Res Clin Endocrinol Metab. 2009;23:723.

    Article  CAS  PubMed  Google Scholar 

  • Leung AM, Braverman LE. Consequences of excess iodine. Nat Rev Endocrinol. 2014;10:136.

    Article  CAS  PubMed  Google Scholar 

  • Lio S. In: Monaco F, editor. Thyroid diseases. Boca Raton: CRC Press; 2012. p. 49.

    Chapter  Google Scholar 

  • Luongo C, Trivisano L, Alfano F, Salvatore D. Type 3 deiodinase and consumptive hypothyroidism: a common mechanism for a rare disease. Front Endocrinol (Lausanne). 2013;4:115.

    Google Scholar 

  • Magri F, Buonocore M, Oliviero A, Rotondi M, Gatti A, Accornero S, Camera A, Chiovato L. Intraepidermal nerve fiber density reduction as a marker of preclinical asymptomatic small-fiber sensory neuropathy in hypothyroid patients. Eur J Endocrinol. 2010;163:279.

    Article  CAS  PubMed  Google Scholar 

  • Mariotti S. In: Monaco F, editor. Thyroid diseases. Boca Raton: CRC Press; 2012a. p. 77.

    Chapter  Google Scholar 

  • Mariotti S. In: Monaco F, editor. Thyroid diseases. Boca Raton: CRC Press; 2012b. p. 97.

    Chapter  Google Scholar 

  • Mariotti S, Martino E, Francesconi M, Ceccarelli C, Grasso L, Lippi F, Baschieri L, Pinchera A. Serum thyroid autoantibodies as a risk factor for development of hypothyroidism after radioactive iodine therapy for single thyroid ‘hot’ nodule. Acta Endocrinol. 1986;113:500.

    CAS  PubMed  Google Scholar 

  • Martino E, Bartalena L, Bogazzi F, Braverman LE. The effects of amiodarone on the thyroid. Endocr Rev. 2001;22:240.

    CAS  PubMed  Google Scholar 

  • Menconi F, Hasham A, Tomer Y. Environmental triggers of thyroiditis: hepatitis C and interferon-α. J Endocrinol Investig. 2011;34:78.

    Article  CAS  Google Scholar 

  • Metso S, Jaatinen P, Huhtala H, Luukkaala T, Oksala H, Salmi J. Long-term follow-up study of radioiodine treatment of hyperthyroidism. Clin Endocrinol. 2004;61:641.

    Article  CAS  Google Scholar 

  • M’Rabet-Bensalah K, Aubert CE, Coslovsky M, Collet TH, Baumgartner C, den Elzen WP, Luben R, Angelillo-Scherrer A, Aujesky D, Khaw KT, Rodondi N. Thyroid dysfunction and anaemia in a large population-based study. Clin Endocrinol. 2016;84:627.

    Article  Google Scholar 

  • Nagamachi S, Jinnouchi S, Nishii R, Ishida Y, Fujita S, Futami S, Kodama T, Tamura S, Kawai K. Cerebral blood flow abnormalities induced by transient hypothyroidism after thyroidectomy--analysis by tc-99m-HMPAO and SPM96. Ann Nucl Med. 2004;18:469.

    Article  PubMed  Google Scholar 

  • Nakamura H, Yamashita S, Ashizawa K, Kitahara A, Natsume H, Andoh S, Nagasawa S, Nishiyama K, Chida K, Sato A, Yoshimi T. High incidence of positive autoantibodies against thyroid peroxidase and thyroglobulin in patients with sarcoidosis. Clin Endocrinol. 1997;46:467.

    Article  CAS  Google Scholar 

  • Ortiga-Carvalho TM, Sidhaye AR, Wondisford FE. Thyroid hormone receptors and resistance to thyroid hormone disorders. Nat Rev Endocrinol. 2014;10:582.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Pani F, Atzori F, Baghino G, Boi F, Tanca L, Ionta MT, Mariotti S. Thyroid dysfunction in patients with metastatic carcinoma treated with sunitinib: Is thyroid autoimmunity involved?. Thyroid. 2015;25:1255.

    Article  CAS  PubMed  Google Scholar 

  • Parle JV, Franklyn JA JA, Cross KW, Jones SC, Sheppard MC. Prevalence and follow-up of abnormal thyrotrophin (TSH) concentrations in the elderly in the United Kingdom. Clin Endocrinol. 1991;34:77.

    Article  CAS  Google Scholar 

  • Pearce EN, Braverman LE. Environmental pollutants and the thyroid. Best Pract Res Clin Endocrinol Metab. 2009;23(6):801–13.

    Article  CAS  PubMed  Google Scholar 

  • Poppe K, Glinoer D, Tournaye H, Maniewski U, Haentjens P, Velkeniers B. Is systematic screening for thyroid disorders indicated in subfertile men?. Eur J Endocrinol. 2006;154:363.

    Article  CAS  PubMed  Google Scholar 

  • Refetoff S, Dumitrescu AM. Syndromes of reduced sensitivity to thyroid hormone: genetic defects in hormone receptors, cell transporters and deiodination. Best Pract Res Clin Endocrinol Metab. 2007;21:277.

    Article  CAS  PubMed  Google Scholar 

  • Refetoff S, Weiss RE, Usala SJ. The syndromes of resistance to thyroid hormone. Endocr Rev. 1993;14:348.

    CAS  PubMed  Google Scholar 

  • Rodriguez-Gutierrez R, Gonzalez-Velazquez C, Gonzalez-Saldivar G, Villarreal-Perez JZ, Gonzalez-Gonzalez JG. Glucocorticoid functional reserve in full-spectrum intensity of primary hypothyroidism. Int J Endocrinol. 2014;2014:313519.

    PubMed  PubMed Central  Google Scholar 

  • Rønjom MF, Brink C, Bentzen SM, Hegedüs L, Overgaard J, Johansen J. Hypothyroidism after primary radiotherapy for head and neck squamous cell carcinoma: normal tissue complication probability modeling with latent time correction. Radiother Oncol. 2013;109:317.

    Article  PubMed  Google Scholar 

  • Rønjom MF, Brink C, Lorenzen FL, Hegedüs L, Johansen J. Variation of normal tissue complication probability (NTCP) estimates of radiation-induced hypothyroidism in relation to changes in delineation of the thyroid gland. Acta Oncol. 2015;54:1188.

    Article  PubMed  Google Scholar 

  • Rose NR, Bona C. Defining criteria for autoimmune diseases (Witebsky’s postulates revisited). Immunol Today. 1993;14:426.

    Article  CAS  PubMed  Google Scholar 

  • Ross DS. Radioiodine therapy for hyperthyroidism. N Engl J Med. 2011;364:542.

    Article  CAS  PubMed  Google Scholar 

  • Safer JD. Thyroid hormone action on skin. Curr Opin Endocrinol Diabetes Obes. 2012;19:388.

    Article  CAS  PubMed  Google Scholar 

  • Salvatore D, Simonides WS, Dentice M, Zavacki AM, Larsen PR. Thyroid hormones and skeletal muscle–new insights and potential implications. Nat Rev Endocrinol. 2014;10:206.

    Article  CAS  PubMed  Google Scholar 

  • Santini F, Marzullo P, Rotondi M, Ceccarini G, Pagano L, Ippolito S, Chiovato L, Biondi B. Eur J Endocrinol. 2014;171:R137.

    Article  CAS  PubMed  Google Scholar 

  • Santos-Palacios S, Brugos-Larumbe A, Guillen-Grima F, Galofre JC. Clin Endocrinol. 2013;79:874.

    Article  CAS  Google Scholar 

  • Singer PA. Werner & Ingbar’s thyroid. A fundamental and clinical text. 10th ed. Philadelphia: Wolters Kluver/Lippincot Williams & Wikins; 2013. p. 552.

    Google Scholar 

  • Singh S, Rana P, Kumar P, Shankar LR, Khushu S. J Neuroendocrinol. 2016;28:1.

    Google Scholar 

  • Sorensen JR, Winther KH, Bonnema SJ, Godballe C, Hegedus L. Respiratory Manifestations of Hypothyroidism: A Systematic Review. Thyroid. 2016;26:1519.

    Article  PubMed  Google Scholar 

  • Stagnaro-Green A, Schwartz A, Gismondi R, Tinelli A, Mangieri T, Negro R. High rate of persistent hypothyroidism in a large-scale prospective study of postpartum thyroiditis in southern Italy. J Clin Endocrinol Metab. 2011;96:652.

    Article  CAS  PubMed  Google Scholar 

  • Surks MI, Hollowell JG. Age-specific distribution of serum thyrotropin and antithyroid antibodies in the US population: implications for the prevalence of subclinical hypothyroidism. J Clin Endocrinol Metab. 2007;92:4575.

    Article  CAS  PubMed  Google Scholar 

  • Taylor JC, Gough SC, Hunt PJ, Brix TH, Chatterjee K, Connell JM, Franklyn JA, Hegedüs L, Robinson BG, Wiersinga WM, Wass JA, Zabaneh D, Mackay I, Weetman AP. A genome-wide screen in 1119 relative pairs with autoimmune thyroid disease. J Clin Endocrinol Metab. 2006;91:646.

    Article  CAS  PubMed  Google Scholar 

  • Thvilum M, Brandt F, Almind D, Christensen K, Brix TH, Hegedüs L. Type and extent of somatic morbidity before and after the diagnosis of hypothyroidism. a nationwide register study. PLoS One. 2013;16:e75789.

    Article  Google Scholar 

  • Thvilum M, Brandt F, Almind D, Christensen K, Brix TH, Hegedüs L. Increased psychiatric morbidity before and after the diagnosis of hypothyroidism: a nationwide register study. Thyroid. 2014;24:802.

    Article  PubMed  Google Scholar 

  • Tomer Y, Menconi F. Interferon induced thyroiditis. Best Pract Res Clin Endocrinol Metab. 2009;23:703.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Torino F, Barnabei A, Paragliola R, Baldelli R, Appetecchia M, Corsello SM. Thyroid dysfunction as an unintended side effect of anticancer drugs. Thyroid. 2013;23:1345.

    Article  CAS  PubMed  Google Scholar 

  • Tunbridge WM, Evered DC, Hall R, Appleton D, Brewis M, Clark F, Evans JG, Young E, Bird T, Smith PA. The spectrum of thyroid disease in a community: the Whickham survey. Clin Endocrinol. 1977;7:481.

    Article  CAS  Google Scholar 

  • Vanderpump MPJ. The epidemiology of thyroid disease. Br Med Bull. 2011;99:39.

    Article  PubMed  Google Scholar 

  • Vanderpump MPJ, Tunbridge WMG, French JM, Appleton D, Bates D, Clark F, Grlmley Evans J, Hasan DM, Rodgers H, Tunbridge F, Young ET. The incidence of thyroid disorders in the community: a twenty-year follow-up of the Whickham Survey. Clin Endocrinol. 1995;43:55.

    Article  CAS  Google Scholar 

  • Verloop H, Louwerens M, Schoones JW, Kievit J, Smit JWA, Dekkers OM. Risk of hypothyroidism following hemithyroidectomy: systematic review and meta-analysis of prognostic studies. J Clin Endocrinol Metab. 2012;97:2243.

    Article  CAS  PubMed  Google Scholar 

  • Vogelius IR, Bentzen SM, Maraldo MV, Petersen PM, Specht L. Risk factors for radiation-induced hypothyroidism: a literature-based meta-analysis. Cancer. 2011;117:5250.

    Article  PubMed  Google Scholar 

  • Yaylali O, Kirac S, Yilmaz M, Akin F, Yuksel D, Demirkan N, Akdag B. Does hypothyroidism affect gastrointestinal motility?. Gastroenterol Res Pract. 2009;2009:529802.

    Article  PubMed  Google Scholar 

  • Zhou JY, Xu B, Lopes J, Blamoun J, Li L. Hashimoto encephalopathy: literature review. Acta Neurol Scand. 2017;135:285.

    Article  CAS  PubMed  Google Scholar 

  • Zimmermann MB. Iodine deficiency. Endocr Rev. 2009;30:376.

    Article  CAS  PubMed  Google Scholar 

  • Zimmermann MB, Boelaert K. Iodine deficiency and thyroid disorders. Lancet Diabetes Endocrinol. 2015;3:286.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Luca Chiovato .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this entry

Cite this entry

Chiovato, L., Mariotti, S., Magri, F. (2017). Classification and Etiopathogenesis of Hypothyroidism. In: Vitti, P., Hegedus, L. (eds) Thyroid Diseases. Endocrinology. Springer, Cham. https://doi.org/10.1007/978-3-319-29195-6_10-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-29195-6_10-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-29195-6

  • Online ISBN: 978-3-319-29195-6

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics