Hypothyroidism refers to a pathophysiological condition in which the thyroid gland does not produce sufficient amounts of the thyroid hormones (underactive thyroid), leading to abnormally low levels of the thyroid hormones (T₃ and T₄).

The symptoms of hypothyroidism may include reduced metabolic rate, chronic fatigue, weight gain, myxedema, and depression.

Three main forms of hypothyroidism exist: (1) Primary hypothyroidism, (2) Secondary hypothyroidism, and (3) Tertiary hypothyroidism.

In primary hypothyroidism, the thyroid gland itself is incapable of producing normal levels of the thyroid hormones.

Secondary hypothyroidism is caused by low levels of thyroid stimulating hormone (TSH). TSH, produced by the anterior pituitary gland, is required to stimulate the thyroid gland to produce the thyroid hormones.

Tertiary hypothyroidism is caused by low levels of thyrotropin releasing hormone (TRH). TRH, produced by the hypothalamus, is required to stimulate the anterior pituitary gland to produce TSH which, in turn, is required to stimulate the thyroid gland to produce the thyroid hormones.

Primary hypothyroidism
Secondary hypothyroidism
Tertiary hypothyroidism

Hyperthyroidism
Euthyroidism