138 Hypothyroidism
Salient features
History
• Hair dryness or loss (Fig. 138.1)
• Change in the voice (hoarse, husky)
• Moderate weight gain in spite of loss of appetite
• Menstrual irregularity especially menorrhagia
• Radioiodine therapy for previous Graves’ disease (the patient may have associated eye signs of Graves’ disease)
• Medications and other compounds such as lithium carbonate and iodine-containing compounds (e.g. amiodarone, radiocontrast agents, expectorants containing potassium iodide and kelp)
• Family history of thyroid dysfunction, pernicious anaemia, diabetes mellitus, primary adrenal insufficiency
• Obtain history of hypercholesterolaemia, angina pectoris and hypertension (remember hypertension occurs in 10% of these patients and disappears with thyroxine replacement).
