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Indications to test for hypothyroidism

Indications to test for hypothyroidism
Clinical symptoms and signs
Fatigue
Cold intolerance
Constipation
Impaired memory
Slowed mental processing
Depression
Nerve entrapment syndromes
Ataxia
Muscle weakness
Muscle cramps
Menstrual disturbance
Infertility
Bradycardia
Diastolic hypertension
Hoarseness
Goiter
Periorbital edema
Weight gain
Galactorrhea
Laboratory test abnormalities
Hypercholesterolemia
Hyponatremia
Hyperprolactinemia
Hyperhomocysteinemia
Anemia
Creatine phosphokinase elevation
Radiological abnormalities
Pericardial and pleural effusions
Pituitary gland enlargement
Risk factors for hypothyroidism
Autoimmune thyroiditis
Established serological or tissue diagnosis
Diffuse goiter
Previous Graves' disease, de Quervain thyroiditis, or painless (postpartum) thyroiditis
Family history of autoimmune thyroid disease
Down syndrome
Turner syndrome
Personal or family history of associated autoimmune disorders (eg, vitiligo, pernicious anaemia, adrenal insufficiency, diabetes mellitus type 1, ovarian failure, celiac disease, Sjögren syndrome)
Primary pulmonary hypertension
Multiple sclerosis
Previous thyroid injury
Thyroidectomy or other neck surgery
Radioactive iodine therapy
External radiotherapy
Exposure to polybrominated and polychlorinated biphenyls, and resorcinol
Postpartum status
Drugs impairing thyroid function
Lithium carbonate
Amiodarone
Aminoglutethimide
Interferon alfa
Thalidomide
Betaroxine
Stavudine
Hypothalamic disorders
Hypothalamic or suprasellar mass
History of hypothalamic radiotherapy or surgery
Disorders causing hypothalamic dysfunction (eg, sarcoidosis, hemochromatosis, Langerhans cell histiocytosis)
Pituitary disorders
Known pituitary tumour
Other elements of hypopituitarism
Manifestations of a sellar mass (eg, headache, bitemporal hemianopsia, or diplopia)
History of pituitary surgery of radiotherapy
History of head trauma
History of pituitary apoplexy, including Sheehan syndrome
History of other disorders causing hypopituitarism (eg, metastatic cancer and lymphocytic hypophysitis)
Reproduced with permission from: Roberts, CG, Ladenson, PW. Hypothyroidism. Lancet 2004; 363:793. Copyright © 2004 Elsevier.
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