Hypothyroidism: The Daily PANCE Blueprint

The answer is E. Heat intolerance

Hypothyroidism is a very common condition. The most common cause of hypothyroidism worldwide is dietary iodine deficiency; in the U.S. it is Hashimoto’s thyroiditis. Clinical features of hypothyroidism include fatigue, bradycardia, constipation, weight gain, cognitive dysfunction, periorbital edema, loss of eyebrows, depression, diminished tendon reflexes, and dry skin. You would expect these people to have cold intolerance, not heat intolerance. Diagnosis is made by looking at TSH and free T4 levels. To diagnose Hashimoto thyroiditis specifically, antibodies can be drawn, and also fine needle aspiration can be done (revealing Hurthle cells and lymphocytes). In general, the dosage of levothyroxine should be about 1.6 mcg/kg/day. It’s important for patients to know how they should take their medication on an empty stomach ideally 1 hour before breakfast.