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