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  1. Failure of the thyroid in the newborn is called cretinism with marked mental retardation
  2. Spontaneous hypothyroidism in the adult is frequently a manifestation of lymphocytic thyroiditis (Hashimoto’s disease – an autoimmune disease); 80% of adults with spontaneous hypothyroidism are female
  3. Symptoms in mild cases are weight gain and tiredness; in more severe cases the condition is called myxedema with increasing fatigue and apathy (a reversible dementia may also develop), skin becomes dry, thickened and puffy with dry and brittle hair; reduced cardiac output and hemodynamic alterations resemble that of congestive heart failure (a.k.a. myxedema madness); constipation and changes in bowel habits are also common
    1. in women, diminished libido, failure of ovulation and menorrhagia may occur and in men there may be decreased libido, impotency and oligospermia
    2. on EKG see sinus bradycardia, diminished voltage, and inverted or flattened T waves
    3. diffuse myalgia, stiffness and slowness of muscle contraction and relaxation are common in hypothyroidism; may also have increased levels of creatinine kinase
  4. treatment: L-thyroxine
  5. NOTE: hypothyroid patients have an increased risk of mortality from surgery
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