All are true about Central hypothyroidism except?
The value of TSH may never normalize in central hypothyroidism since the gland is already damaged. Hence, dose adjustment is based on thyroid hormone levels and clinical parameters rather than the TSH level. Craniopharyngioma is a common para-sellar tumor that can frequently infiltrate surrounding brain structures and lead development of Central hypothyroidism. The Thyroid gland in Central hypothyroidism can produce biologically inactive TSH . Hence the values of TSH can be normal amount wise but fails to produce any effects. Hence TSH is not a good marker for diagnosis. The Patient is under endocrine stress and coisol is the stress hormone that is going to help tide over the stress. The entire stockpile of coisol is exhausted in trying to cope with endocrine trauma of absent thyroid hormones .
Craniopharyngioma
Treatment is done according to TSH level in plasma
TSH level is not a good marker for diagnosis
Before staing treatment check for adrenal insufficiency
Diseases of Thyroid