W is for Woltmans Sign

June 26, 2022

Woltmans sign is the delayed recover of the Achilles muscle/tendon reflex often seen in hypothyroidism.

Hypothyroidism is a medical condition characterized by an underactive thyroid gland, which is responsible for producing hormones that regulate the body’s metabolism. When the thyroid gland does not produce enough thyroid hormones, it can lead to various symptoms and health problems.


  • Primary hypothyroidism: The most common cause of hypothyroidism is an autoimmune condition called Hashimoto’s thyroiditis, in which the body’s immune system mistakenly attacks the thyroid gland. Other causes include thyroid surgery, radiation therapy, certain medications, and congenital factors.
  • Secondary hypothyroidism: It occurs when the thyroid gland is not stimulated properly by the pituitary gland or hypothalamus, usually due to dysfunction or damage in these areas.


  • Fatigue and weakness
  • Weight gain or difficulty losing weight
  • Cold intolerance
  • Dry skin and hair
  • Constipation
  • Muscle aches and stiffness
  • Joint pain
  • Depression or low mood
  • Memory problems and difficulty concentrating
  • Menstrual irregularities
  • Decreased heart rate
  • Puffiness in the face
  • Hoarse voice

Diagnosis: Hypothyroidism is diagnosed through a combination of medical history, physical examination, and blood tests. The primary blood test is the measurement of thyroid-stimulating hormone (TSH) levels, which is elevated in hypothyroidism. Additionally, levels of the thyroid hormones T4 (thyroxine) and T3 (triiodothyronine) may be measured.

Treatment: The main treatment for hypothyroidism is hormone replacement therapy, typically in the form of synthetic thyroid hormone medication called levothyroxine. The medication is taken orally, and it provides the body with the necessary thyroid hormones to normalize hormone levels and alleviate symptoms. Regular monitoring of thyroid hormone levels and adjustment of medication dosage may be required to ensure optimal thyroid function.


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