Hypothyroidism - primary

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Primary and secondary hypothyroidism Thyroid gland

Overview Symptoms Treatment Prevention

Hypothyroidism - primary

Early symptoms:

• weakness
• fatigue
• cold intolerance
• constipation
• weight gain
• depression
• joint or muscle pain
• thin, brittle fingernails
• thin, brittle hair
• paleness

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

Physical examination may reveal a smaller than normal gland, though sometimes the gland is normal in size or even enlarged (goiter). Other physical findings include pale, yellow, and dry skin; thin, brittle hair; loss of the edges of the eyebrows; coarse facial features; firm swelling of the arms and legs; and slow muscle relaxation when reflexes are tested. Vital signs may reveal a slow heart rate, low blood pressure, and low temperature.

A chest X-ray sometimes reveals an enlarged heart.

Laboratory tests to determine thyroid function include:

• Free T4 test (low)
• Total T3 or free T3 (low)
• Serum TSH (high)

Additional laboratory abnormalities may include:

• increased cholesterol levels
• increased liver enzymes
• increased serum prolactin
• low serum sodium
• a complete blood count (CBC) shows anemia

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