Hypothyroidism is a condition that comes from your thyroid gland producing inadequate amounts of thyroid hormones in the bloodstream. Common symptoms of hypothyroidism include fatigue, sensitivity to cold, constipation, dry skin, weight gain, puffy face, hoarseness, muscle weakness, elevated cholesterol, muscle aches, tenderness, stiffness, joint pain, swelling, irregular or heavy menstrual periods in women, thinning hair, depression, impaired memory, and slowed heart rate (Mayo Clinic, 2018).

Clinical manifestations:

• Fatigue and lethargy
• Weight gain
• Complaints of cold hands and feet
• Temperature and pulse become subnormal; patient cannot tolerate cold and desires increased room temperature
• Reduced attention span; impaired short-term memory
• Severe constipation
• Generalized appearance of thick, puffy skin; subcutaneous swelling in hands, feet, and eyelids
• Thinning hair, loss of the lateral one-third of eyebrow
• Menorrhagia or amenorrhea
• Neurologic signs include polyneuropathy, cerebellar ataxia, muscle aches or weakness, clumsiness, prolonged deep tendon reflexes
• Hyperlipoproteinemia and hypercholesterolemia
• Enlarged heart on chest x-ray
• Increased susceptibility to all hypnotic and sedative drugs and anesthetic agents
• Syndrome of subclinical hypothyroidism: state in which the patient is asymptomatic and the free T4 level is within the normal range; however, the TSH level is elevated, suggesting impending thyroid gland failure. Therefore, many clinicians may elect to treat this condition as if the patient were symptomatic.

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