Diagnosing and treating hypothyroidism

Hypothyroidism is a common endocrine disorder affecting 1.4% to 2.0% of women and 0.1% to 0.2% of men. The prevalence of both overt and subclinical hypothyroidism increases with age, affecting 5% to 10% of women over age 50 and 1.25% of men over age 60, with an increasing incidence in women ages 40 to 50. Typical symptoms are consistent with declining metabolic functions and range from vague complaints of fatigue in subclinical deficiency to overt clinical symptoms involving changes in mentation and memory, lethargy, weight gain, cold intolerance, constipation, and goitrous enlargement of the thyroid gland. Atypical presentations such as weight loss, hearing impairment, tinnitus, and carpal tunnel syndrome may occur, especially in the elderly. This case report reviews the presenting symptomatology of an otherwise healthy 43-year-old woman who exhibited typical and atypical symptoms of underlying thyroid deficiency.