Fast Five Quiz: Hypothyroidism Practice Essentials

Romesh Khardori, MD, PhD

Disclosures

April 11, 2022

Hypothyroidism commonly manifests as a slowing in physical and mental activity but may be asymptomatic. Symptoms and signs of this disease are often subtle and neither sensitive nor specific. Classic signs and symptoms (eg, cold intolerance, puffiness, decreased sweating, and coarse skin) may not be present as commonly as was once believed.

The following are symptoms of hypothyroidism:

  • Fatigue, loss of energy, lethargy

  • Weight gain

  • Decreased appetite

  • Cold intolerance

  • Dry skin

  • Hair loss

  • Sleepiness

  • Muscle pain, joint pain, weakness in the extremities

  • Depression

  • Emotional lability, mental impairment

  • Forgetfulness, impaired memory, inability to concentrate

  • Constipation

  • Menstrual disturbances, impaired fertility

  • Decreased perspiration

  • Paresthesias, nerve entrapment syndromes

  • Blurred vision

  • Decreased hearing

  • Fullness in the throat, hoarseness

Physical signs of hypothyroidism include:

  • Weight gain

  • Slowed speech and movements

  • Dry skin (rarely yellow hued from carotene)

  • Jaundice

  • Pallor

  • Coarse, brittle, straw-like hair

  • Loss of scalp hair, axillary hair, pubic hair, or a combination

  • Dull facial expression

  • Coarse facial features

  • Periorbital puffiness

  • Macroglossia

  • Goiter (simple or nodular)

  • Hoarseness

  • Decreased systolic blood pressure and increased diastolic blood pressure

  • Bradycardia

  • Pericardial effusion

  • Abdominal distention, ascites (uncommon)

  • Hypothermia (only in severe hypothyroid states)

  • Nonpitting edema (myxedema)

  • Pitting edema of lower extremities

  • Hyporeflexia with delayed relaxation, ataxia, or both

Learn more about clinical presentations of hypothyroidism.

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