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A physical examination reveals delayed relaxation of muscles during tests of reflexes. Pale, yellow skin; loss of the outer edge of the eyebrows; thin and brittle hair; coarse facial features; brittle nails; firm swelling of the arms and legs; and mental slowing may be noted. Vital signs may reveal slow heart rate, low blood pressure, and low temperature.
A chest X-ray may reveal an enlarged heart.
Laboratory tests to determine thyroid function include:
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T4 test (low)
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serum TSH (high in primary hypothyroidism, low or low-normal in secondary hypothyroidism)
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