Primary hypothyroidism is characterized by abnormally low levels of thyroid hormone (T₃ and T₄) production, where the defect is at the level of the thyroid gland itself.

In primary hypothyroidism, the circulating levels of the thyroid hormones are low, however, the levels of the thyroid stimulating hormone (TSH) are high due a lack of thyroid hormone negative feedback on the anterior pituitary.

Common causes of primary hypothyroidism include iodine deficiency (which leads to goiter), and Hashimoto's disease, in which autoimmune antibodies destroy the ability of the thyroid gland to produce the thyroid hormones.

Hypothyroidism
Secondary hypothyroidism
Tertiary hypothyroidism