What are the physical signs of hypothyroidism?

Updated: Mar 03, 2021
  • Author: Philip R Orlander, MD, FACP; Chief Editor: George T Griffing, MD  more...
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Signs found in hypothyroidism are usually subtle, and their detection requires a careful physical examination. Moreover, such signs are often dismissed as part of aging; however, clinicians should consider a diagnosis of hypothyroidism when they are present.

Physical signs of hypothyroidism include the following:

  • Weight gain

  • Slowed speech and movements

  • Dry skin

  • Jaundice

  • Pallor

  • Coarse, brittle, straw-like hair

  • Loss of scalp hair, axillary hair, pubic hair, or a combination

  • Dull facial expression

  • Coarse facial features

  • Periorbital puffiness

  • Macroglossia

  • Goiter (simple or nodular)

  • Hoarseness

  • Decreased systolic blood pressure and increased diastolic blood pressure

  • Bradycardia

  • Pericardial effusion

  • Abdominal distention, ascites (uncommon)

  • Hypothermia (only in severe hypothyroid states)

  • Nonpitting edema (myxedema)

  • Pitting edema of lower extremities

  • Hyporeflexia with delayed relaxation, ataxia, or both

Additional signs specific to different causes of hypothyroidism, such as diffuse or nodular goiter and pituitary enlargement or tumor, can occur.

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