Hypothyroidism is one of the most common disorders encountered in an endocrine office practice. Hypothyroidism results from reduced thyroid hormone actions at the peripheral tissues. This reduction in thyroid hormone action is, in the vast majority of cases, secondary to reduced thyroid hormone synthesis and secretion by the thyroid gland. Occasionally, peripheral resistance to thyroid hormone is the culprit. The availability of sensitive biochemical tests and effective therapies has simplified the diagnosis and management of this endocrine condition. This article reviews the epidemiology, etiology, clinical presentation, diagnosis, and treatment of hypothyroidism.We emphasize some of the more recent issues, such as combination thyroid hormone therapy, management of hypothyroidism during pregnancy, and the management of subclinical hypothyroidism.
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