- Usually from Hashiomoto's thyroiditis
- Can also occur s/p Graves, following thyroiditis, or after treatment of hyperthyroidism
- Constipation
- Weakness
- Fatigue
- Cold intolerance
- Depression/mood change
- Rarely SOB/DOE from compression of trachea
- Often no findings aside from wt gain
- Sometimes decreased relaxation phase of reflexes
- Pre-tibial edema or generalized fluid retention
- Lateral thinning of eyebrows
- Thyroid gland can be normal (or enlarged)
- Elevated TSH, decreased T4; Unless central cause (i.e. hypothalamic/pituitary), in which case TSH low
- W/Hashimoto's, anti-TPO ab +; sometimes helpful in setting sub-clinical hypothyroidism (TSH elevated, T4 nl)