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Neurocognitive deficits
- Lethargy, somnolence, cognitive dysfunction, and memory defects
- Psychosis, depression.
Cardiac manifestations
- Cardiomegaly
- Bradycardia
- Left ventricular diastolic dysfunction
Gastrointestinal manifestations
- Decreased food intake (due to decreased appetite) and decreased peristalsis leading to constipation, and possibly fecal impaction.
- Weight gain.
Musculoskeletal manifestation
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Musculoskeletal manifestations of hypothyroidism include:
- Fatigue, stiffness and myalgias, worsened in cold.
Reproductive system manifestations
- Women may have excessive or irregular menstrual bleeding, reduced fertility, possibly increased rates of spontaneous abortion and preterm delivery.
Myxedema coma
- Usually presents in elderly women with untreated Hypothyroidism, more commonly in winter.
- Severe, life threatening (mortality rate 50%-60%)
- Symptoms and signs include hypothermia, severe myxedema, severe hypotension, alterations in mental status ranging from lethargy to delirium or coma, possibly seizures, hypoventilation.
Newborn screening
Newborns routinely screened for congenital hypothyroidism
Following women at high risk for overt hypothyroidism in pregnancy:
- History of thyroid dysfunction or prior thyroid surgery
- >30 years old
- Symptoms of thyroid dysfunction or presence of goiter
- Thyroid peroxidase antibody positivity
- Diabetes mellitus type 1 or other autoimmune disorders
- History of miscarriage or preterm delivery
- History of head or neck radiation
- Family history of thyroid dysfunction
- Morbid obesity (body mass index ≥ 40 kg/m2)
- Use of amiodarone or lithium, or recent administration of iodinated radiologic contrast
- Infertility
- Residing in area of known moderate-to-severe iodine insufficiency
