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July 08, 2023 9 min read

Defined in the simplest terms, hypothyroidism refers to a thyroid disease where the thyroid gland underperforms. Imagine your thyroid gland as your body's control center for energy and metabolism - when it slacks, various body functions slow down. Hypothyroidism is one of the most common thyroid disorders.

But here's what you need to know: hypothyroidism is not always primary, originating from the thyroid gland itself. Sometimes, it hides in the shadow of other conditions, leading us to secondary hypothyroidism.

What is secondary hypothyroidism?

To begin, it is important to understand the difference between primary and secondary hypothyroidism. Primary hypothyroidism relates to an inability of the thyroid gland itself to produce adequate amounts of thyroid hormones for the body's metabolic needs.

Conversely, secondary hypothyroidism concerns another regulator in the body's hormonal system—the pituitary gland. In instances of secondary hypothyroidism, the thyroid gland is normal and healthy but is understimulated because the pituitary gland doesn't produce or release thyroid-stimulating hormone (TSH) or thyrotropin in normal amounts.

The thyroid gland's primary role lies in the production and release of two critical thyroid hormones, thyroxine (T4) and triiodothyronine (T3), in response to TSH. These hormones enter the bloodstream and are transported throughout the body, influencing crucial processes like metabolism, body temperature regulation, heart rate, appetite, blood sugar control, cholesterol levels, and the function of the central nervous system.

The causes of secondary hypothyroidism are typically associated with abnormalities in the pituitary gland. Most commonly, secondary hypothyroidism occurs due to the development of a pituitary tumor. Although these growths are generally benign, they can disrupt the pituitary gland's ability to produce and release sufficient levels of thyroid-stimulating hormone (TSH), which in turn affects hormone production by the thyroid and other endocrine glands. Thus, causing thyroid hormone deficiency.

In some cases, the impetus behind secondary hypothyroidism may lie with the hypothalamus, the part of your brain that signals the pituitary. Defects in this part of the brain can also lead to hypothyroidism but are usually classified separately as tertiary hypothyroidism.

Certain factors might increase an individual's chances of developing secondary hypothyroidism. They include being over age 50, being female, and having a family history of either pituitary or thyroid dysfunction. Recognizing these risk factors can help identify those at greater risk, thus facilitating early detection and effective treatment.

What are the causes of secondary hypothyroidism?

Understanding secondary hypothyroidism

Again, secondary hypothyroidism is not about a problem in the thyroid itself but more about a lack of instruction from the pituitary gland that messes up the flow.

Let's look at what causes secondary hypothyroidism:

1. Pituitary tumors

A growth or tumor in the pituitary gland is one of the common causes. These tumors might affect the pituitary gland's ability to send the right amount of thyroid-stimulating hormone (TSH) to the thyroid.

2. Problems in the hypothalamus

The hypothalamus, a part of the brain, oversees the big jobs of the body, and one of them is to keep the pituitary gland in check. So, a problem in the hypothalamus, such as a hypothalamic lesion, could create a sort of miscommunication, causing the pituitary gland to send the wrong signals, leading to secondary hypothyroidism.

3. Gene-related issues

In some cases, secondary hypothyroidism could come from your genes. Genetics or gene mutations might cause a malfunction in the body's hormone system, which includes the pituitary and thyroid glands.

4. Delivery complications

A baby being born feet or buttocks first (breech delivery) can sometimes be linked with secondary hypothyroidism. This connection is particularly significant if the newborn shows signs of the condition.

5. Radiation therapy on the brain

Undergoing radiation therapy, specifically to the brain, can also bring about secondary hypothyroidism. Since the pituitary gland is located in the brain, the radiation could potentially affect how it works.

6. Sheehan's syndrome

Sheehan's syndrome is a rare condition where a woman's pituitary gland gets damaged due to massive blood loss during childbirth. This syndrome can lead to hypopituitarism, which may prompt secondary hypothyroidism.

Secondary hypothyroidism is a bit complicated, but it boils down to something disrupting the dialog between the pituitary gland and the thyroid.

What are the signs and symptoms of secondary hypothyroidism?

Secondary hypothyroidism, despite being triggered by a different cause, presents a similar picture to primary hypothyroidism when it comes to symptoms. Ultimately, both types result in a deficiency of thyroid hormone, leading to a shared array of symptoms.

Here are the signs that may suggest secondary hypothyroidism:

1. Early Symptoms

  • Weakness: One of the initial symptoms may be a generalized feeling of weakness, an unexpected lack of strength or energy in your muscles.

  • Fatigue: You may often feel worn out and tired despite adequate rest.

  • Cold Intolerance: You might find yourself feeling unusually chilly, even when others around you are comfortable.

  • Constipation: Difficulty in bowel movements or having infrequent bowel movements for an extended period may be an early symptom.

  • Weight Gain: Unexplained increase in weight, even without changes in diet or exercise, may indicate secondary hypothyroidism.

  • Depression: The hormone imbalance could also affect your mood, leading to feelings of sadness, low mood, or even depression.

  • Joint or Muscle Pain: Unusual aches and pains in the joints or muscles may also be a telling sign.

  • Brittle Fingernails: Fingernails may become brittle and break easily.

  • Hair Changes: There might be changes in your hair's texture—it could become coarse and start thinning.

2. Late Symptoms:

  • Slow Speech: As the condition progresses, your speech might become noticeably slower.

  • Dry, Flaky Skin: Changes in the skin are also common; your skin may feel dry and appear flaky.

  • Thickening of the Skin: In some instances, the skin might become noticeably thicker.

  • Swelling: You might notice puffiness on your face, hands, and feet.

  • Decreased Hearing: Your ability to hear might be reduced.

  • Thinning of Eyebrows: Hair loss from the outer part of your eyebrows may be a late symptom.

  • Hoarseness: Your voice may become hoarse.

  • Menstrual Disorders: Women may experience changes in their menstrual cycle, marked by irregular periods or heavier than-usual bleeding.

The symptoms of secondary hypothyroidism can be many and varied, reflecting the broad role of thyroid hormones in maintaining bodily functions. Early recognition and treatment can prevent the progression of symptoms, hence getting acquainted with these signs will allow for prompt medical attention.

How is secondary hypothyroidism diagnosed?

Proper diagnosis is the first step toward managing any health issue. If you're demonstrating symptoms typically seen in hypothyroidism, it's crucial to consult your healthcare provider, who will set out to crack the hypothyroidism code.

1. Physical examination

Your healthcare provider will kickstart the diagnostic process with a physical examination, which involves checking your vitals and manually examining the size of your thyroid gland.

2. Blood tests

Blood tests form an integral part of diagnosing hypothyroidism, aiding in assessing thyroid functionality. Here are a few key tests:

  • Free T4 index: This test measures the amount of thyroxine, or T4, in your blood. T4 is one of the hormones produced by the thyroid gland.

  • Total T3 levels: Much like the T4 index, this test measures the amount of triiodothyronine, or T3, in your bloodstream. T3 is the other main hormone produced by the thyroid.

  • Serum TSH: This test gauges the levels of thyroid-stimulating hormone (TSH) in your blood—a low TSH level can signal a dysfunction in the pituitary gland and hence, an indication of secondary hypothyroidism.

It's interesting to note that in secondary hypothyroidism, you might see an apparently contradictory picture: low TSH levels usually seen in hyperthyroidism (an overactive thyroid) accompanied by low T4 and T3 levels that paint a picture of hypothyroidism (an underactive thyroid).

3. Additional Lab Tests

To ensure nothing is overlooked, your doctor might order further lab tests to check if other pituitary hormones show any abnormalities.

4. Imaging Tests

If secondary hypothyroidism is diagnosed, your healthcare provider may recommend imaging tests, most commonly a Magnetic Resonance Imaging (MRI) scan, to inspect the pituitary gland for any tumors.

5. Genetic Testing

In some cases, genetic testing might come into play. This diagnostic tool helps scrutinize if gene mutations are behind the onset of secondary hypothyroidism.

What are the treatment options for secondary hypothyroidism?

Understanding secondary hypothyroidism

The journey to managing secondary hypothyroidism begins with a diagnosis, paving the way for a well-targeted treatment plan.

1. Primary treatment approach: thyroid hormone replacement therapy

Hormone replacement therapy holds center stage when we talk about treating secondary hypothyroidism. The objective? Replenish the body with much-needed thyroid hormones to restore optimal thyroid functionality. Among the lineup of medications available, Levothyroxine and natural desiccated thyroid (NDT) are the stars.

Levothyroxine: The Traditional Choice

Depicting the gold standard of hypothyroid treatment, we have Levothyroxine, a synthetic version of thyroxine or T4. T4 is one of the main hormones that the thyroid gland naturally makes.

Using Levothyroxine aims to fill the gap in thyroid hormone levels in the body, thus stepping up for the underactive thyroid.

In cases where the foundational treatment with Levothyroxine falls short of completely managing hypothyroid conditions, your doctor might prescribe an additional medication, such as Cytomel, a synthetic form of the triiodothyronine or T3 hormone.

Natural Desiccated Thyroid (NDT): Nature's Helping Hand

On the other side of the spectrum, we have Natural Desiccated Thyroid or NDT. Derived from the dried thyroid glands of pigs, NDT offers a more natural approach to thyroid hormone replacement therapy.

NDT differs markedly from Levothyroxine in its composition. It includes both T3 and T4 hormones, unlike Levothyroxine, which only provides synthetic T4. This can be a deal-changer because some individuals have trouble converting T4 into T3, the active form of thyroid hormone that the body readily uses.

NDT is available to patients in a variety of forms that include both prescribed medications and health supplements. Two well-known NDT medication brands—Armour Thyroid and NP Thyroid—are widely recognized and used in the United States.

In addition to its pharmaceutical versions, you can also buy desiccated thyroid online as a health supplement. For instance, VitaliThy, an NDT supplement, offers a unique combination of ingredients. What singles out NDT supplements like VitaliThy is not just their supply of T4 and T3 but also the inclusion of potentially beneficial components like spica prunellae siccus extract, ashwagandha extract, and selenium yeast. This mix of ingredients might elevate the health of your thyroid.

Moreover, the benefits of VitaliThy extend beyond its ingredient profile. The supplement is considerate of various dietary needs—it's gluten-free, lactose-free, and free from artificial colors and flavors. Additionally, it doesn't contain any beef, eggs, fish, or shellfish. This thoughtfulness towards those with specific dietary needs and allergies makes VitaliThy, a natural desiccated thyroid you can buy online, a potentially suitable choice for various individuals.

NDT vs. Levothyroxine: Which One is Better?

While both Levothyroxine and NDT aim to replace deficient thyroid hormones, NDT is considered superior by some due to its natural composition and its inclusion of both T3 and T4 hormones.

Since NDT provides both T3 and T4 hormones directly, it can offer a wider scope of benefits, especially to those patients who struggle with the T4 to T3 conversion process.

This isn't to say that Levothyroxine doesn't hold merit. It remains the standard treatment for a reason and works effectively for many individuals. However, those finding less than optimal improvements with Levothyroxine might feel the difference with a switch to NDT.

2. Personalized treatment adjustments

While the primary aim of treatment is to replenish the scarce thyroid hormones, if any other organs, like your adrenal glands, have been affected, treatment will be necessary to restore the full functionality of your endocrine gland system.

Moreover, individuals who have hypothyroidism due to a pituitary tumor may need to undergo surgery. However, it's important to note that surgical intervention might not completely resolve the hypothyroidism and thyroid hormone replacement therapy may still be needed.

3. Lifelong treatment

Since hypothyroidism doesn't currently have a cure, continued treatment might be a lifelong necessity. This involves taking your prescribed medication continually, even after your symptoms have receded.

4. Regular monitoring and adjustments

Your healthcare provider will check your TSH levels six to 10 weeks following the start of treatment to evaluate its effectiveness and tweak the dosage as required. After stabilizing thyroid hormone levels, your healthcare provider will likely check your levels annually to monitor your progress.

5. Lifestyle adjustments

Alongside medical treatment, adopting certain lifestyle measures can help manage the symptoms of secondary hypothyroidism better. For instance, a high-fiber, low-calorie diet can help combat constipation and support weight management, while staying active can help maintain a healthy weight.

In conclusion, secondary hypothyroidism requires a robust and individualized treatment approach. By combining specialist medical treatment with supportive lifestyle changes, the signs and symptoms of secondary hypothyroidism can be effectively managed, enabling individuals to lead healthy and fulfilling life.

Living with Secondary Hypothyroidism

Being diagnosed with secondary hypothyroidism is no picnic, but it's not a life sentence either. With tailored treatment and careful management, individuals can lead healthy and normal lives. Ensuring regular health check-ups, maintaining an open dialogue with your healthcare providers, having a nutritionally balanced diet, and prioritizing adequate rest are all crucial elements on your path to wellness.

Dealing with secondary hypothyroidism is not just about understanding the condition but also about finding the right tools to manage it effectively. Patience, perseverance, and accurate information are your allies in this journey.

Aiding you along the way could be supplements like VitaliThy, a natural desiccated thyroid you can buy online. Designed as a natural desiccated thyroid health supplement, its unique blend of ingredients provides not only vital thyroid hormones, T4 and T3, but also includes beneficial components such as spica prunellae siccus extract, ashwagandha extract, and selenium yeast. Moreover, VitaliThy caters to various dietary requirements—being free from gluten, lactose, beef, eggs, fish, and shellfish, besides having no artificial colors or flavors.

VitaliThy could make an excellent addition to your healthcare regimen, offering potentially supportive benefits for your thyroid health while fitting in with myriad dietary needs. In the end, remember, you are in charge of your wellness journey—not secondary hypothyroidism.

Wojciech Majda
Wojciech Majda


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