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[5] As lymphocytic infiltration progresses, patients may exhibit signs of hypothyroidism in multiple bodily systems, including, but not limited to, a larger goiter, weight gain, cold intolerance, fatigue, myxedema, constipation, menstrual disturbances, pale or dry skin, and dry, brittle hair, depression, and ataxia

Those on long-term metformin or PPIs should discuss monitoring requirements with their healthcare provider

doi: 10.1093/humrep/15.7.1552

University of Oxford

Individualized therapy for hypothyroidism: is T4 enough for everyone