Hypothyroidism history and symptoms

Hypothyroidism Main page
Patient Information
Overview
Classification Primary hypothyroidism Hashimoto's thyroiditis Secondary hypothyroidism Tertiary hypothyroidism
Differentiating different causes of hypothyroidism
Screening
Diagnosis
History and symptoms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]

Overview

The ability of Hypothyroidism to mimic a number of medical conditions originates in the vast functions of the thyroid hormones, which are reduced or absent in this case. The functions of thyroid hormones include modulation of carbohydrate, protein and fat metabolism, vitamin utilization, mitochondrial function, digestive process, muscle and nerve activity, blood flow, oxygen utilization, hormone secretion and sexual and reproductive health to mention a few. Thus, when the thyroid hormone content gets out of balance, systems covering the whole body are affected, and that's why hypothyroidism can look like other diseases. Conversely, sometimes other conditions can be mistaken for hypothyroidism.

History

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Symptoms

Symptoms can be classified by age, and the stage the symptoms appear:

Adults

In adults, hypothyroidism is associated with the following symptoms:

Early symptoms

• Poor muscle tone (muscle hypotonia)
• Fatigue
• Cold intolerance, increased sensitivity to cold
• Constipation
• Weight gain
• Muscle cramps and joint pain
• Thin, Brittle fingernails
• Thin, brittle hair
• Paleness

Late symptoms

• Slowed speech and a hoarse, breaking voice. Deepening of the voice can also be noticed.
• Dry puffy skin, especially on the face
• Thinning of the outer third of the eyebrows
• Abnormal menstrual cycles
• Low basal body temperature

Less common symptoms

• Heat intolerance, increased sensitivity to heat
• Impaired memory
• Impaired cognitive function (brain fog) and inattentiveness
• Urticaria (hives)
• Migraine headache
• A slow heart rate with ECG changes including low voltage signals. Diminished cardiac output and decreased contractility.
• Reactive (or post-prandial) hypoglycemia
• Pericardial effusions may occur.
• Sluggish reflexes
• hair loss
• Anemia caused by impaired hemoglobin synthesis (decreased EPO levels), impaired intestinal iron and folate absorption or B12 deficiency from pernicious anemia
• anxiety/panic attacks
• difficulty swallowing
• Shortness of breath with a shallow and slow respiratory pattern.
• Impaired ventilatory responses to hypercapnia and hypoxia.
• Increased need for sleep
• Osteopenia or Osteoporosis
• Irritability and mood instability
• Yellowing of the skin due to impaired conversion of beta-carotene to vitamin A
• Impaired renal function with decreased GFR.
• Thin, fragile or absent cuticles
• Elevated serum cholesterol
• Acute psychosis (myxedema madness) is a rare presentation of hypothyroidism
• Decreased libido
• Decreased sense of taste and smell (late, less common symptoms)
• Puffy face, hands and feet (late, less common symptoms)

Pediatric

Hypothyroidism in pediatric patients can cause the following additional symptoms:

• short stature
• mental retardation if present at birth, and untreated.

Severity

The severity of hypothyroidism varies widely. Some have few overt symptoms, others with moderate symptoms can be mistaken for having other diseases and states. Advanced hypothyroidism may cause severe complications including cardiovasular and psychiatric myxedema.