primary or secondary?

[tee27]

sorry to sound a bit dim but what is primary/secondary hypo? I have CH and have never heard of this term before?

[SeasideSusie Remembering]

Tee27

Primary hypothyroidism is where the problem lies with the thyroid and it fails for whatever reason.

Central Hypothyroidism is where the problem isn't with the thyroid but with either the Pituitary or the Hypthalamus and this can either be:

Secondary Hypothyroidism - Pituitary

Tertiary Hypothyroidism - Hypothalamus

[helvella Administrator in reply to SeasideSusie]

Congenital Hypothyroidism would usually be regarded as primary.

[SeasideSusie Remembering in reply to helvella]

Is that what the OP means by CH? I thought s/he meant Central Hypothyroidism. It does help when things are clearly stated.

[helvella Administrator in reply to SeasideSusie]

And I have just realised that both possibilities were missing from my Abbreviations and Acronyms document! Now updated:

dropbox.com/s/og3lmxa1dqadb...

[tee27 in reply to helvella]

thanks helvella. Sorry for confusion Susie, hadn't heard of central either so didn't realise I wasn't being clear.

[helvella Administrator in reply to tee27]

Don't worry - these things happen and there has been an increase in understanding all round!

[s123sharma in reply to SeasideSusie]

I have been diagnosed with central hypothyroidism. Waiting to be further diagnosed for secondary or tertiary hythrodism. Will you please guide me about further possible tests. Whether treatment exists for central hypothyroidism,?

[helvella Administrator in reply to s123sharma]

There are plenty who have not been tested to find out whether they have secondary or tertiary hypothyroidism - which is why the term central hypothyroidism is so widely used.

The tests possibly include a Thyrotropin Releasing Hormone (TRH) stimulation test. They give you some TRH and see if TSH rises. It is also possible that they would do an MRI scan which can detect (some) pituitary and hypothalamus issues.

Further, other pituitary hormones should be tested:

Human growth hormone (HGH)

Adrenocorticotropic hormone (ACTH)

Luteinizing hormone (LH)

Follicle-stimulating hormone (FSH)

Prolactin (PRL)

Treatment exists for the hypothyroidism - pretty much the same as for any other form - levothyroxine (T4) and, if needed and lucky, liothyronine (T3). Deficiencies of the other hormones need to be looked at, if any are identified.

I encourage you to post your own, brand new post. It will likely get better exposure than questions buried in responses on another question.

[Hidden in reply to helvella]

I had to look up TRH - either forgot or never knew what it stands for.

It's Thyrotropin Releasing Hormone.

Produced by the hypothalamus (a part of the brain) to get the pituitary to release thyrotropin, aka TSH.

And of course if anything goes wrong with that chain of events the thyroid has problems

[helvella Administrator in reply to Hidden]

Have edited my response to include that bit of information.

[Hidden in reply to helvella]

Thanks. I am not good at remembering abbreviations anyway!

[strawberryflower]

I am on NDT for secondary hypothyroidism, prescribed privately.

I was dismissed for years by my GP and local NHS consultant ( who said I had CFS ) as my bloods were "within range." However, going to my private endo in a completely different health authority was a revelation. He immediately identified secondary and ran an MRI. There was nothing wrong with my pituitary, thankfully. My bloods may have been "within range" but totally imbalanced.

Helvella: those tests sound interesting. I will ask my endo if he ran them on the original diagnosis. Also, do they need checking regularly? Can the NHS do them, or should I get them done privately?

[helvella Administrator in reply to strawberryflower]

The TRH test is usually a one-off to decide whether secondary or tertiary.

The other hormone tests are possibly one-off unless other signs and symptoms indicate the possibility of continuing or new issues.

If you are doing OK, possibly no reason to do any of them.

[Peroxideblader in reply to strawberryflower]

hi there all my blood results point to hypopitituarism but as I'm in range like you I've been told I'm fine for 6 years. please can you tell me your tsh t4 t3 levels for you to be diagnosed thank you

[strawberryflower]

Helvella, thank you for the information. I get more info on here than through the GP!

My blood test results on diagnosis in 2014, quote from endo's letter: " the biochemical picture is typical of secondary hypothyroidism.... "

Free T4 low at 11.4 (7.8 - 14.4)

TSH 1.68 (0.3 - 5.6)

Negative TPO bodies

Glucose 4.8

Testosterone 1.5

FSH 6.5

LH 9.2

Prolactin 141

Cortisol 318

IGF-1 level 25.1

DHEA sulphate 5.

I hope that makes sense. Perhaps one of the mods can explain it???