clinical features
Last reviewed 01/2018
An insidious onset with vague, non-specific and diverse features is characteristic. Diagnosis is often made incidentally. Mild cases may be completely asymptomatic.
General:
- fatigue, weight gain, and cold intolerance; less commonly, goitre and hyperlipidaemia
Dermatological:
- dry, scaly, cold and thickened skin; malar flush imposed against a generally pale complexion; alopecia with coarse and brittle hair; occasionally, vitiligo
Neuromuscular:
- hoarse voice; aches and pains in the muscles and joints; syndromes such as carpal tunnel and cerebellar ataxia; deafness; depression or more bizarre psychiatric features - myxoedema madness; delayed ankle jerk reflex
Haematologic:
- anaemia - usually normocytic, normochromic; but may be microcytic and hypochromic due to blood loss from menorrhagia; or macrocytic due to vitamin B12 deficiency associated with pernicious anaemia
Cardiovascular:
- bradycardia, angina, cardiac failure, pericardial and pleural effusions
Gastrointestinal:
- constipation, ileus, ascites
Reproductive:
- impotence, menorrhagia, galactorrhoea, hyperprolactinaemia
Developmental:
- growth and mental retardation; delayed puberty
diagram of the clinical features of hypothyroidism
metabolic myopathy in hypothyroidism