Primary Hypothyroid Primary hypothyroidism occurs when disease of the thyroid gland prevents it from producing adequate amounts of thyroid hormone. Symptoms may vary from mild to severe and from nonspecific to very specific. In general, all metabolic processes slow down. Patients are often fatigued, and may also have depression, decreased intellectual function, and, rarely, overt psychosis.
Patients frequently complain of cold intolerance, dry skin, and constipation.
The heart rate is often slowed, as is the relaxation phase of deep tendon reflexes. The T4 and Free T4 is low and the TSH is always high. T3 may be normal. She complains of fatigue, inability to finish tasks, sleeping more, yet always being tired. She has also noticed a decreased cold tolerance, constipation, and dryness of the skin.