A 50-year-old housewife complains of progressive weight gain of 9.07 kg in 1 year, fatigue, postural dizziness, loss of memory, slow speech, deepening of her voice, dry skin, constipation, and cold intolerance. Physical examination: Vital signs include a temperature 96.8F, pulse 58/minute and regular, BP 110/60. She is moderately obese and speaks slowly and has a puffy face, with pale, cool, dry, and thick skin. The thyroid gland is not palpable. The deep tendon reflex time is delayed.
Laboratory studies: CBC and differential WBC are normal. The serum T4 concentration is 3.8 ug/dl (N=4.5-12.5), the serum TSH is 1 uU/ml (N=0.2-3.5), and the serum cholesterol is 255 mg/dl (N<200). What is the likely diagnosis? What are the treatment options? *This case is by Docplexus Editorial Team for educative purpose only.
