Hypothyroidism; secondary

Symptoms:

Early symptoms:

• weakness
• fatigue
• cold intolerance
• constipation
• weight gain
• depression
• joint or muscle pain
• thin, brittle fingernails
• thinning of hair
• pale color

Late symptoms:

• slow speech
• dry flaky skin
• thickening of the skin
• puffy face, hands and feet
• decreased taste and smell
• thinning of eyebrows
• hoarseness
• menstrual disorders

Signs and tests:

A physical exam that reveals a small thyroid gland. Vital signs (temperature, pulse, rate of breathing, blood pressure) reveal a slow heart rate, low blood pressure, and low temperature.

A chest X-ray reveals an enlarged heart.

Laboratory tests to determine thyroid function include:

• T4 test
• T3 resin uptake
• serum TSH
• serum TRH stimulation response is negative

Additional laboratory abnormalities may include:

• increased cholesterol levels
• increased liver enzymes
• increased serum prolactin
• low serum sodium
• low blood glucose
• a CBC that shows anemia