A 45-year old woman with a known history of rheumatoid arthritis presents to her primary care physician with fatigue, weight gain and cold intolerance. Examination reveals an enlarged thyroid gland ( goiter), coarse skin and bradycardia. Her thyroid function tests show elevated TSH levels and low levels of total T3 and T4. What is the most likely diagnosis?
Answer: Primary hypothyroidism. Likely etiology- autoimmune process such as Hashimoto’s thyroiditis
virtualPath 