Possible hypothyroidism
Mental status changes including confusion and memory loss, and
general tiredness, are common presenting symptoms in hypothyroidism.
It is particularly important to recognize the possibility of this
diagnosis in the elderly, because these mental changes are curable
with appropriate treatment. It is well-known that elderly "demented"
patients have been placed in nursing homes or other facilities, only
to have their underlying hypothyroidism diagnosed some years later.
Hypothyroidism is also associated with decreased bowel motility,
tendency to gain weight, and cold intolerance, which are present in
this patient. Some forms of hypothyroidism have a familial association.
The physical exam, including the relatively slow resting heart rate,
the characteristic facies, and the delayed relaxation phase of the deep
tendon reflexes is characteristic of hypothyroidism.
A simple blood test can verify this and other conditions and treatment
can relieve the symptoms.
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