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Hypothyroid causes can include: Autoimmune disease Surgical removal of the thyroid (thyroidectomy) Radiation exposure as a treatment for hyperthyroid (overactive thyroid) Exposure to radiation in your environment (like at your job) Certain medications Environmental toxins Infections Too much or too little iodine Congenital disease Pituitary gland conditions Risk Factors for Hypothyroidism When it comes to the development of hypothyroidism, it's not just about what's happening inside your thyroid gland