Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ 244 Acquired hypothyroidism244.0 Postsurgical hypothyroidism244.1 Other postablative hypothyroidism244.2 Iodine hypothyroidism244.3 Other iatrogenic hypothyroidism244.8 Other specified acquired hypothyroidism244.9 Unspecified acquired hypothyroidismAssociated ICD-9-CM PT diagnoses/treatment diagnoses that may be directly related315.4 Developmental coordination disorder718.45 Contracture of joint, pelvic region and thigh719.70 Difficulty in walking involving joint site unspecified728.2 Muscular wasting and disuse atrophy not elsewhere classified728.89 Other disorders of muscle, ligament, and fascia729.9 Other and unspecified disorders of soft tissue780.7 Malaise and fatigue781.2 Abnormality of gait782.3 Edema786.0 Dyspnea and respiratory abnormalities786.05 Shortness of breath ++ E03.9 Hypothyroidism, unspecifiedE89.0 Post-procedural hypothyroidism ++ 4D: Impaired joint mobility, motor function, muscle performance, and range of motion associated with connective tissue dysfunction4E: Impaired joint mobility, motor function, muscle performance, and range of motion associated with localized inflammation6B: Impaired aerobic capacity/endurance associated with deconditioning +++ Description ++ A deficiency of thyroid gland activityCharacterized by decreased basal metabolic rate, fatigue and lethargy, sensitivity to cold, and menstrual disturbancesIn infants, severe hypothyroidism leads to cretinismThyroid regulates metabolism and produces three types of thyroid hormone2 +++ Essentials of Diagnosis ++ Gradual onsetPalpation of thyroid/neck for enlargement of thyroid or any abnormalitiesThyroid function test3 types of hypothyroidismPrimary: thyroid gland dysfunctionSecondary: pituitary gland dysfunctionTertiary: hypthalamus dysfunction +++ General Considerations ++ Can progress to myxedema if untreatedThyroid needs iodine as a critical element2May cause pathology in multiple organ systemsGI: liverCardiovascular: heart, peripheral circulation, blood pressureIntegumentaryMay result in secondary problems indicating the need for PT intervention depending on severityAerobic capacity and muscle endurance impairmentSarcopeniaWeakness/impaired muscle performanceMusculoskeletal problemsNeuromuscular problemsWeight gain, indicating the need for PT intervention depending on severityHyperlipidemia +++ Demographics ++ Affects individuals through lifespan, starting at birth (1 in 4,000 infants)Estimated 5 million in the U.S. and possibly double that are undiagnosedHigher incidence in womenHigher incidence in those greater than age 60 +++ Signs and Symptoms ++ Cold sensitivityFatigueWeight gainSlowed heart rateConstipationJoint painMuscle painMuscle crampsPalenessDry skinHair thinning, including eyebrowsBrittleness of fingernailsWeaknessUnexplained weight gain with inability to lose itDepressionHeavier menstrual periodsDecreased ability to smellDecreased tastePuffiness of hands, feet, and facePeripheral neuropathy/numbnessSlowness of speechThickening of skinLiver dysfunctionHeart diseaseWorsening of angina if history of anginaAnemiaIn severe casesBelow normal body temperatureDepressed breathingLow blood pressureLow blood sugarUnresponsiveness +++ Functional Implications ++ Severe symptoms such as immediacy of need to urinate may be disabling, resulting in the inability to leave homeFatigueInfertilityMiscarriageHeart diseaseDecreased ... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.