Central Hyperthyroidism

Central hyperthyroidism occurs when a TSH-secreting pituitary adenoma (tumor) produces too much thyroid-stimulating hormone. This causes the thyroid gland to produce high levels of the hormone thyroxine. Too much thyroxine means the thyroid is overactive and speeds up the body’s metabolism.

Symptoms of central hyperthyroidism may include: 

• Weight loss
• Heart palpitations
• Tremors or shakiness
• Anxiety
• Insomnia
• Frequent bowel movements
• Irregular menstrual cycles
• Excessive sweating

If left untreated, complications can include: 

• Atrial fibrillation or heart arrhythmia
• Congestive heart failure
• Osteoporosis

Lab Testing
Your doctor will run a blood test to measure your thyroid-stimulating hormone, free T4, and T3. In central hyperthyroidism, TSH is usually slightly elevated or normal, whereas free T4 and T3 are typically higher than normal.

Imaging
Imaging scans, like an MRI, help your doctor assess your pituitary gland for a TSH-secreting pituitary adenoma. 

Transsphenoidal Surgery
Transsphenoidal surgery is the most common treatment for central hyperthyroidism. During this minimally invasive procedure, a doctor inserts a tube through your nasal passage and the sphenoid sinus to access the pituitary gland at the base of your brain. Your surgeon will remove all or as much of the tumor as possible. Minimally invasive procedures require smaller incisions than open surgery and mean you experience less pain, faster recovery, and fewer complications.

Medication
If surgery does not correct central hyperthyroidism, medications called somatostatin analogs may be prescribed. They can reduce the production of TSH and shrink the tumor.

Pituitary Center of Excellence
Duke Health experts are leaders in advanced treatment for people with all types of pituitary disorders. Collectively, our pituitary disorder clinics in Durham are designated a Pituitary Center of Excellence by the Pituitary Network Association, an international non-profit organization created to help people with pituitary tumors and disease.

Leading Experts in Rare Pituitary Gland Disorders
Duke is one of the few hospitals equipped to treat central hyperthyroidism and other rare pituitary gland disorders. People are referred to our neuroendocrinologists and specialized surgeons from all over the United States.

Collaborative, All-In-One Pituitary Clinic
For your convenience, we offer a special pituitary clinic that allows you to see an endocrinologist, neurosurgeon, and ophthalmologist in one day and in one location. These experts meet with you to review your case, order tests, and offer recommendations for next steps.