Central hypothyroidism

Case history

A 40-year-old woman visits her physician with a 4-month history of chronic headaches and visual problems. She has no past medical history. Review of symptoms reveals easy fatigability, cold intolerance, galactorrhoea, and amenorrhoea for the past 6 months. Physical examination findings include a bitemporal hemianopia, periorbital oedema, normal-sized thyroid, bradycardia, galactorrhoea, and vaginal atrophy.