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55 y/o CM present with complaints of fatigue, dry brittle

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hair with shedding, and states...
55 y/o CM present with complaints of fatigue, dry brittle hair with shedding, and states "I can't seem to keep warm." Thyroid panel: TSH: 10mU/L, FT4: 0.3ng/dl
3 differential diagnoses, definitive diagnosis, management plan based on evidence-based practice guidelines be?
Submitted: 1 year ago.Category: Medical
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Answered in 8 minutes by:
1/23/2016
Doctor: Dr Basu, Experienced Specialist replied 1 year ago
Dr Basu
Dr Basu, Experienced Specialist
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Hi there,
This is Dr Basu, experienced Internal Medicine Specialist.
I am here to address your concerns and provide great service.

The symptoms are suggestive of primary hypothyroidism.

Differential diagnosis can be: secondary or tertiary hypothyroidism, primary adrenal gland insuffciency; Resistance to TSH or thyroid hormones.

Definitive diagnosis is likely primary hypothyroidism since TSH is high in appropriate response to low free T4.

The treatment will be levothyroxine supplementation and then recheck of TSH after 6 weeks for adjusting the dose.
Best wishes,
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