Summary
Definition
History and exam
Other diagnostic factors
- weakness
- lethargy
- cold sensitivity
- constipation
- weight gain
- depression
- menstrual irregularity
- myalgia
- dry or coarse skin
- eyelid edema
- thick tongue
- facial edema
- coarse hair
- bradycardia
- deep voice
- diastolic hypertension with or without narrow pulse pressure
- delayed relaxation of tendon reflexes
- goiter
Risk factors
- iodine deficiency
- female sex
- middle age
- family history of autoimmune thyroiditis
- autoimmune disorders
- Graves disease
- postpartum thyroiditis
- Turner and Down syndromes
- type 1 diabetes
- primary pulmonary hypertension
- multiple sclerosis
- radiation therapy
- infiltrative disease
- iodine excess
- amiodarone use
- lithium use
- textile workers
Diagnostic investigations
Investigations to consider
- free serum T4
- serum cholesterol
- CBC
- fasting blood glucose
- serum creatine kinase
- serum sodium
- antithyroid peroxidase antibodies
Treatment algorithm
Contributors
Authors
Adjunct Clinical Professor
Department of Family Medicine
University of North Carolina
Chapel Hill
NC
Disclosures
WM declares that he has no competing interests.
Peer reviewers
Professor of Medicine
Chair of Family Medicine
University of Chicago Medical Center
Chicago
IL
Disclosures
BE declares that he has no competing interests.
Consultant Endocrinologist
Queen Elizabeth Hospital
Gateshead
UK
Disclosures
SR declares that he has no competing interests.
Consultant Physician
Caerphilly Miners' Hospital
Caerphilly
UK
Disclosures
LP declares that he has no competing interests.
Associated Professor
Consultant Endocrinologist
Herlev Hospital
University of Copenhagen
Denmark
Disclosures
BN declares that she has no competing interests.
Professor of Internal Medicine
Endocrinology Division Chief
Texas Tech University Health Sciences Center - School of Medicine
Lubbock
TX
Disclosures
JL declares that he has no competing interests.
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