It is classified as congenital, describing a newborn with reduced or very rarely absence of thyroid hormone production; primary, caused by intrinsic defect of thyroid structure; secondary to a pituitary insufficiency; and tertiary from insufficient secretion of hypothalamic
thyrotrophic releasing hormone. The most frequent type is the primary type, characterized by the presence of low free plasma T4 (thyroxin), below 0.8 ng/dl and high TSH (Thyrotrophic) above 4.0 mIU/ml.
A multitude of defects at all levels of hypothalamic-pituitary-thyroid-peripheral axis does seem to exist in uremia (13), which include impaired release of TSH in response to TRH (
thyrotrophic releasing hormone), impaired thyroid hormone secretion in response to TSH.