A patient has a goiter associated with high plasma levels of both TRH and TSH. Her hea rate is elevated. This patient most likely has which condition?

A hypothalamic tumor secreting large amounts of TRH would stimulate the pituitary gland to secrete increased amounts of TSH. As a result, the secretion of thyroid hormones would increase, which would result in an elevated hea rate. In comparison, a patient with either a pituitary tumor secreting large amounts of TSH or Graves' disease would have low plasma levels of TRH because of feedback. Both TRH and TSH levels would be elevated in an endemic goiter, but the hea rate would be depressed because of the low rate of T4 secretion.