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June 1981

Agitation and Heat Intolerance in Hypothyroidism

Author Affiliations

Gainesville, Fla

Arch Intern Med. 1981;141(7):959-960. doi:10.1001/archinte.1981.00340070139035

To the Editor.  —Hypothyroidism in the adult has been characterized clinically by cold intolerance, lethargy, constipation, and overall slowing of intellectual and motor activities. Conversely, classic clinical hyperthyroidism has been recognized by heat intolerance, palpitations, hyperkinesis, and emotional lability. A less classic presentation can occur in elderly patients with hyperthyroidism who have been described as "masked" or "apathetic" hyperthyroid patients.1 The patient described herein became hypothyroid after discontinuation of replacement therapy. Her clinical presentation was noted by symptoms of heat intolerance, agitation, insomnia, and nervous irritability, which improved as she became euthyroid.

Report of a Case.  —A 64-year-old woman was initially seen complaining of notable intolerance to hot weather, nervousness, emotional irritability, crying spells, and insomnia. She had been treated intermittently for a thyroid disorder with desiccated thyroid, 130 mg/day, for 30 years. She had finished the thyroid tablets eight weeks earlier while attending her sister's funeral in a

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