Hypothyroidism and Hyperthyroidism - Symptoms and Signs
Hypothyroidism:
- General - From asymptomatic to myxedema coma, “Like everything is slowed down”
• Low exercise tolerance
• Hyperlipidemia
• Cold intolerance
• Weight gain (modest)
- Neuro
• Depression
• Memory loss
• Fatigue
- Face/Neck
• Hair is coarse, brittle and is lost
• Thinning of lateral 1/3 of eye brows
• Puffy Face
• Enlarged tongue
• Hoarseness
• ± Goitre
- Cardiovascular
• bradycardia
• cardiomegaly
• pericardial effusion
• hypertension
- GI
• Constipation
- Gu:
• Menorrhagia
- Skin
• Skin is dry, coarse, thick, cold, pale
- Muscles
• Weakness, cramps
• Tendon Reflex Delay (relaxation phase)
Hyperthyroidism:
- General “Like running a marathon all the time”
• Appear to have high energy but are fatigued
• poor exercise tolerance
• Heat intolerance
• Weight loss (despite appetite)
- Neuro:
• Nervousness
• Restlessness
• Insomnia
• Tremour
• Increased Reflexes
- Face/Neck
• ophthalmopathy
ocular changes (periorbital swelling, lid retraction and lid lag, stare and infrequent blinking)
infiltrative (proptosis/exophthalmos, increased edema of lids and conjunctiva, chemosis, ophthalmoplegia)
• ± Diffuse goitre
• Bruit (when osculating over thyroid)
- Cardiovascular
• Palpitations, Afib
- GI
• Diarrhea
- Gu:
• Infertility, amenorrhea
- Skin
• Sweating
• Warm, moist skin
• Dermatopathy
Ø Hands: Acropachy
Ø Legs: “pretibial myxedema
- Amy Chung, MD, MSc @AmyChung
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