Clinical presentation of spontaneous primary hypothyroidism in adults.

In a retrospective study of 309 cases of hypothyroidism seen at King Fahd Hospital of the University (KFHU), Al-Khobar, 124 (90 Saudis and 34 non-Saudis) adult patients with spontaneous primary hypothyroidism satisfied the inclusion criteria for detailed analysis. Their male:female ratios for Saudis and non-Saudis were 1:4.6 and 1:3.9 respectively. The majority were diagnosed in their third and fourth decades. The prevalence of previously undiagnosed spontaneous and biochemically overt primary hypothyroidism in Saudis was 5.2/1000 females and 0.94/1000 males. FT4I was normal in 43 (35%) and low in 81 (65%). FT4I correlated with cold intolerance, constipation, dry skin, hoarseness, delayed reflex relaxation, and coarse and cold skin. In rank order, presenting symptoms in those with low FT4I were tiredness (56%), cold intolerance (38%), constipation, weight gain, menstrual disturbance - especially amenorrhea - (36% each), dry skin (35%), hoarseness (31%); signs were coarse skin (53%), delayed reflex relaxation (32%), cold skin and goiter (24% each). The above clinical findings may help physicians in the early detection of primary hypothyroidism. Population-based studies are necessary to provide more data on this disease in this country.