Thyroid

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Onset of Hypothyroidism

Determining the Onset of Hypothyroidism
	Childhood	Adulthood
Height	Short	Normal
Body	Thick trunk Larger chest and abdomen Smaller limbs Obese	Relatively normal trunk but swollen and obese
Hands	Smaller Hyperlaxity of fingers	Normal size Normal laxity
Feet	Flat Feet	Normal arch of foot
Spine	Scoliosis, hyperlordosis	Hyperlordosis
Skin, bones & muscles	Thick	Normal to thick
Sexual	Poor sexual characteristics	Normal-sized but atrophic
Past Medical History	Heavy birth weight Delayed growth, development, puberty Recurrent infections as a child (possibly tuberculosis, pneumonia) Learning disabilities	Normal health as a child

Complaints of Hypothyroidism

Physical complaints of Hypothyroidism
Health	Prone to ear, nose and throat infections Phone to weight gain, but difficult weight loos when dieting
Appearance	Overweight, obesity Swollen all over
Energy/ Vitality	Morning fatigue, fatigue when taking a rest Feels best in the evening and when physically or mentally active Lethargy, apathy
Temperature	Intolerance to cold, easily shivers ( because of the cold) Needs to wear supplementary warm clothes in all seasons Poor circulation (when fingers in winter) Intolerance to heat, inability to seat in a hot climate
Sleep	Snoring when sleeping at night (sleep apnea) Difficulties getting out of bed in the morning Somnolence (sleepy during the day, especially when resting)
Food	Poor appetite for food (a certain degree of anorexia but with obesity) Excessive intake of caffeinated drinks (used for energy)
Water Balance	Oligodipsia (decreased thirst) Oliguria (decreased urination)
Hair	Dry hair Slow growing hair Diffuse hair loss
Head	Diffuse headaches; Migraine headaches Tinnitus (ear buzzing)
Voice	Morning hoarse voice
Skin	Dry skin
Nails	Brittle, slow growing nails
Digestive	Bloated abdomen (often dolichocolon), dyspepsia (slow digestion) Constipation
Joints and muscles	Muscle and joint stiffness upon waking Diffuse myalgia and arthralgia, more important in the morning Feet and leg cramps at night Carpal tunnel syndrome Low back pain
MENTAL complaints of Hypothyroidism
Behavior	Slowness Apathy (lack of interest, intiative)
Mood	Morning depression
Memory	Slow thinking and slow reactions Easily distracted, poor concentration, poor attention Poor memory, poor school performance

Physical Signs of Hypothyroidism

Physical Signs of Hypothyroidism
Body	Puffy Overweight	Behavior	Sluggish, slow thinking and moving
Hair	Dry, thick, brittle hair Diffuse hair loss	Mental	Memory loss Attention deficit Concentration difficulties Apathy
Face	Puffy face Loss of outer third of the eyebrow Swollen eyelids Swollen lips, tongue	Mood	Depression
Neck: Thyroid	Abnormal-sized thyroid gland: Atrophic Thyroid hyperplasia Goiter Nodule(s)	Voice	Hoarseness in the morning
Arms	Dry, rough skin (follicular hyperkeratosis) Thick muscles	Hearing	Otosclerosis (hearing loss)
Elbows	Keratosis (dry, scaly skin)	Lungs	Dyspnea Slow and superficial breathing (hypoventilation)
Hands	Cold hands Swollen hands Excessive laxity of the fingers Yellowish palms (carotenemia) Brittle, slow growing nails	Heart	Bradycardia Faint heart sounds
Abdomen	Bloating due to achlorhydria Constipation	Blood Pressure	High diastolic blood pressure Narrow differential blood pressure (small difference between systolic and low diastolic blood pressure) Slow pulse rate
Calves	Thick swollen calves Non-pitting edema	Skin	Carotenemia (yellowing of the palms and soles) Dry skin on face, elbows, legs Follicular keratosis
Feed	Cold feet Swollen feet(pitting) or non-pitting edema) Carotenemia Flat Feet	Tendon Reflexes	Slow Achilles tendon reflexes (pathognomonic) Other slow reflexes: patellar (knee) reflex)