Hypothyroidism: common symptoms
* Weakness; fatigue; cold intolerance; constipation; weight change; depression; menorrhagia; hoarseness
* Dry, cold, yellow, puffy skin; scanty eyebrows; thick tongue; bradycardia (slow heartbeat); delayed return of deep tendon reflexes
* Anaemia; hyponatraemia
* T4 and radioiodine uptake usually low
* TSH elevated in primary myxoedema (characteristic swelling, especially of the face, associated with hypothyroidism).
Early symptoms
* Weakness; fatigue; arthralgias or myalgias; muscle cramps; cold intolerance; constipation; lethargy; dry skin; headache; menorrhagia
* Outstanding features: thin, brittle nails; thinning of hair; pallor with slack skin; delayed return of deep tendon reflexes. Other physical findings may be few or absent.
Late symptoms
* Slow speech; absence of sweating; constipation; peripheral oedema; pallor; hoarseness; decreased sense of taste and smell; muscle cramps; aches and pains; dyspnoea (laboured breathing); weight change (usually gain, but weight loss is not rare); deafness. Women may have menstrual irregularities
* Physical findings include puffiness of face and eyelids; yellow skin colour; thinning of outer halves of eyebrows; thickening of tongue; hard, pitting oedema (swelling) and fluid leakage into the lung, chest and/or heart cavities, enlargement of the heart (‘myxoedema heart’) and joints; slow heartbeat; possible hypothermia; pituitary enlargement.
Hyperthyroidism: symptoms and signs
* Nervousness; restlessness; heat intolerance; increased sweating; fatigue; weakness; muscle cramps; frequent bowel movements; weight change (usually loss)
* Possibly palpitations or angina pectoris; menstrual irregularities; hypokalaemic periodic paralysis; possible stare and lid lag; tachycardia or atrial fibrillation; fine, resting finger tremour; moist, warm skin; exaggerated reflexes; fine hair; onycholysis (loss of nails); rarely, heart failure; possible clubbing and swelling of fingers (acropachy); osteoporosis may result from chronic thyrotoxicosis
* Men may experience decreased libido; impotence; decreased sperm count and gynaecomastia (excessive growth of mammary glands)