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A.J is a 50-year-old housewife who complains of progressive weight gain of 20 pounds in 1 year, fatigue, postural dizziness, loss of memory, slow speech, deepening of her voice, dry skin, constipation, and cold intolerance.
Physical examination: Vital signs include a temperature of 96.8 °F, pulse 58/minute and regular, BP 110/60. She is moderately obese, speaks slowly, and has a puffy face with pale, cool, dry, and thick skin. The thyroid gland is not palpable. The deep tendon reflex time is delayed.
CBC and differential WBC are normal.
The serum T4 concentration is 3.8 ug/dl (Normal = 4.5-12.5),
The serum TSH is 1 uU/ml (Normal = 0.2-3.5),
The serum cholesterol is 255 mg/dl (Normal <200). Discussion Questions 1. What are the priority patient teachings for levothyroxine? 2. Explain the importance of iodine in this patient’s diet.