Symptoms: mrret Smith is a 61-year-old black female who presents with complaints of depression, weight gain,

sensitivity to cold, joint and muscle pain, and fatigue. She states that she feels tired even after getting a good night’s sleep. In addition, she has gained 20 pounds over the past 3 months, which she says is atypical for her because she has maintained a relatively constant weight of 140 pounds over the course of the past 30 years. She finds that she must wear a jacket whenever she stays in an air-conditioned room, even if the room temperature is moderate. She also notes dry and cracked skin, especially around her heels and must apply moisturizers twice a day, which have not seemed to alleviate the excessive dryness.

Question: Discuss possible causes of Margaret’s hypothyroidism. What are some early symptoms of this disorder? What are the risk factors for developing hypothyroidism?

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