Ailments
Acne/Pimples
Allergy
Ankylosing Spondylitis
Anxiety Neurosis
Atopic Dermatitis
Thyroid
Endocrinological Diorders
Metabolic Disorders
Teething Troubles
Loose Motions
Colic Attacks
General Irritability
PCOD
ADHD
 
Thyroid
Thyroid

The most common presentations of thyroid disease are thyrotoxicosis (i.e. hyperthyroidism), hypothyroidism and goitre (i.e. enlargement of the thyroid).

 

20.6 CLINICAL FEATURES OF THYROID DYSFUNCTION

 

 

Thyrotoxicosis

Hypothyroidism

 

 

 

 

Symptoms

Signs

Symptoms

Signs

 

 

 

 

General

 

 

 

 

Weight loss
despite
normal
or increased
appetite
Heat intolerance
Fatigue
, apathy2
Osteoporosis
(fracture, loss of height)

Weight loss
Goitre with bruit1

Weight gain
Cold intolerance
Fatigue, somnolence

Hoarseness

Weight gain
Hoarse voice
Goitre

 

 

 

 

Gastrointestinal

 

 

 

 

Diarrhoea,
steatorrhoea, hyperdefecation
Anorexia2
Vomiting3

 

Constipation

Ileus3
Ascites3

 

 

 

 

Cardiorespiratory

 

 

 

 

Palpitations
Dyspnoea
on exertion
Angina
Ankle swelling
Exacerbation of asthma3

Sinus tachycardia
Atrial fibrillation
Systolic hypertension/
increased pulse pressure
Cardiac failure

 

Bradycardia
Hypertension
Pericardial and pleural effusions3

 

 

 

 

Haematological

 

 

 

 

 

Lymphadenopathy3

 

Macrocytosis
Anaemia
Iron deficiency (pre-menopausal women) Normochromic

 

 

 

 

Neuromuscular

 

 

 

 

Anxiety,
irritability,
emotional lability
, psychosis
Tremor
Muscle weakness
Periodic paralysis
(predominantly in Chinese)

Tremor
Hyper-reflexia
Ill-sustained clonus
Proximal myopathy
Bulbar myopathy2

Carpal tunnel syndrome
Aches and pains
Muscle stiffness
Deafness
Depression
Psychosis (myxoedemamadness)3

Delayed relaxation of tendon reflexes
Cerebellar ataxia3
Myotonia3

 

 

 

 

Dermatological

 

 

 

 

Sweating
Pruritis
Alopecia

Palmar erythema
Pretibial myxoedema1
Finger clubbing (thyroid acropachy)1
Spider naevi3
Onycholysis3
Pigmentation3
Vitiligo1

Dry skin
Dry hair

Alopecia

Myxoedema
Purplish lips
Malar flush
Carotenaemia
Vitiligo
Erythema ab igne (Granny's tartan)

 

 

 

 

Reproductive

 

 

 

 

Amenorrhoea
oligomenorrhoea
Infertility
spontaneous abortion
Loss of libido, impotence

Gynaecomastia

Menorrhagia
Infertility
Galactorrhoea3
Impotence3

 

 

 

 

 

Ocular

 

 

 

 

Grittiness, red eyes
Excessive lacrimation
Diplopia1
Loss of acuity1

Lid retraction, lid lag
Chemosis1
Exophthalmos1
Periorbital oedema1
Corneal ulceration1
Ophthalmoplegia1
Papilloedema1

 

Periorbital oedema/myxoedema
Loss of lateral eyebrows

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