Question

W.M is a 32 year-old female who comes into the clinic today complaining of fatigue, difficulty concentrating, body aches, and weight gain of 10 lbs over the last 2 months. W.M has a sit down job and does not get much exercise. W.M. has also been noticing hair loss for 3 months and is always cold even in warm temperatures. She has been noticing swelling under her eyes. Vital signs are: t: 96.9, P: 56, rr:14, bp: 144/88.

Questions to Answer:

1. List 7 questions you can ask her to determine what may be going on.
2. What are potential problems that W.M. could be experiencing ?
3. What diagnostic testing would you consider for W.M ?

Answer 1

7 questions to ask

any palpitations

skin roughness

mensural disturbance

reduced sweating

elevated cholesterol

recent surgery for thyroid

recent exposure to radiation or radiothera[y

Family history of thyroid disease

family history of cancer

excessive intake of cabbage

whether using iodised salt

Any endocrine disturbance

As per the symptoms explained here, she would be suffering from hypothyroidsm. symptoms include

• fatigue
• depression
• constipation
• feeling cold
• dry skin
• weight gain
• muscle weakness
• decreased sweating
• slowed heart rate
• elevated blood cholesterol
• pain and stiffness in your joints
• dry, thinning hair
• impaired memory
• fertility difficulties or menstrual changes
• muscle stiffness, aches, and tenderness
• hoarseness
• puffy, sensitive face

Blood tests

Blood tests are the only way to reliably confirm a diagnosis of hypothyroidism.

A thyroid-stimulating hormone (TSH) test measures how much TSH your pituitary gland is creating:

• If your thyroid isn’t producing enough hormones, the pituitary gland will boost TSH to increase thyroid hormone production.
• If you have hypothyroidism, your TSH levels are high, as your body is trying to stimulate more thyroid hormone activity.
• If you have hyperthyroidism, your TSH levels are low, as your body is trying to stop excessive thyroid hormone production.

A thyroxine (T4) level test is also useful in diagnosing hypothyroidism. T4 is one of the hormones directly produced by your thyroid. Used together, T4 and TSH tests help evaluate thyroid function.

Typically, if you have a low level of T4 along with a high level of TSH, you have hypothyroidism. However, there is a spectrum of thyroid disease, and other thyroid function tests may be necessary to properly diagnose your condition.