Scenario:A 42-year-old woman who is an established patient comes to an appointment complaining of sudden and unexpected weight gain, fatigue, and heavy menses for the past 3 months. The woman has a history of allergies, Guillain-BarrÃ© syndrome at age 18, depression, and some difficulty getting pregnant in the past. Her maternal grandmother had a history of thyroid problems, but no specific information was available.
- What additional subjective and objective assessments should be included in the patient examination?
- Explain whether this patient should have had a routine screening of thyroid function prior to todayâ€™s visit.
- Which testing is needed to diagnose hypothyroidism?
- Why is the measurement of free T4 always preferred over the total T4?
- Under what circumstances should this patient be referred to an endocrinologist for treatment?