Central Hypothyroidism, a Novel Laboratory Measurement
Central Hypothyroidism, a Novel Laboratory Measurement
Medical management of central hypothyroidism is controversial due to lack of reference for
 evaluation of pituitary negative feedback. Therefore, titration of medical treatment is based
 on T4 levels, measured with variable laboratory methods. Patients who have central
 hypothyroidism usually have concomitant deficiencies in other pituitary hormones for which
 they need replacement therapy such as steroids, testosterone and growth hormone. This
 combined hormone deficiency makes clinical and laboratory evaluation challenging among these
 patients. Symptomatically, central hypothyroidism is relatively mild and lack non-specific
 and it might be overlooked due to other hormonal deficiencies. Replacement therapy for
 central hypothyroidism is titrated by arbitrary target free T4 levels of above 50th
 percentile of normal. The goal of our study is to compare the standard results from well
 known measure methods to a new method for measuring Ft4 using Liquid chromatography - tandem
 mass spectrometry.
Inclusion Criteria:

 -  Clinical evidence of central hypothyroidism: status post pituitary surgery and/or
 radiotherapy plus laboratory documentation of central hypothyroidism, with or without
 concurrent hormonal deficiencies in other axes, such as ACTH, LH, FSH

 Exclusion Criteria:

 -  Primary hypothyroidism