Musculoskeletal symptoms and signs are common and may be the only presenting complaint in hypothyroidism. There are no published studies on this aspect of thyroid disease in our population Aim: To assess the prevalence of various musculoskeletal manifestations of hypothyroidism. Methods: Eighty eight consecutive patients with hypothyroidism and no other underlying chronic diseases were evaluated with questionnaire on musculoskeletal symptoms and physical examination for any abnormality in musculoskeletal system Results: 76.1 % had some symptom with our questionnaire and 45.5% had some physical abnormality. 77.8 % of patients with overt hypothyroidism were symptomatic whereas 72% patients with sub clinical hypothyroidism were symptomatic. 49.2%> of patients with overt hypothyroidism had some abnormality in physical examination, the corresponding figure was 36% for sub clinical hypothyroidism. Conclusion : Signs and symptoms of musculoskeletal involvement are very common in hypothyroidism.

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The clinical presentation of hypothyroidism often masquerades several illnesses. Dyslipidemia is a common accompaniment of hypothyroidism and these patients are more prone for statin induced myopathy. Treatment with levothyroxine itself is sufficient to correct the dyslipidemia We report a case of primary hypothyroidism that presented with hyperuricemia, intractable hyperlipidemia and developed myopathy with usage of lipid lowering agents.

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The occurrence of Hypothyroidism in pregnancy is linked to adverse effects on mother and the fetus. Recent research has indicated that in the first half of pregnancy, an adequate thyroid hormone level could play an important role in fetal brain development. Clinical signs of hypothyroidism in pregnancy are not very specific and sensitive. Therefore, serum TSH estimation is the best way to make a diagnosis. Hypothyroidism in pregnancy, whether overt or subclinical, requires therapy with levothyroxine. Frequent monitoring and precise dose titration are required. The aim of therapy is to achieve a TSH value that is < 2.5 mu/L, and this is important to ensure a successful pregnancy outcome.

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