A 65-year-old woman presents with fatigue, hypothermia, pericardial effusions, and hair loss. Her thyroid function tests show a significantly elevated TSH and a low free T4. All of the following laboratory test abnormalities may be associated with her underlying condition EXCEPT

A 65-year-old woman presents with fatigue, hypothermia, pericardial effusions, and hair loss. Her thyroid function tests show a significantly elevated TSH and a low free T4. All of the following laboratory test abnormalities may be associated with her underlying condition EXCEPT

• A. Elevated WBC
• B. Elevated cholesterol level
• C. Anemia
• D. Elevated CPK levels

Answer: (A)

Severe hypothyroidism, often due to autoimmune Hashimoto thyroiditis, slows metabolism everywhere in the body. The pattern of high TSH with low free T4 confirms the diagnosis. In this state, you commonly see lipid abnormalities such as elevated cholesterol because thyroid hormones help regulate hepatic lipoprotein metabolism and LDL clearance. Anemia can occur with hypothyroidism, and elevated CK levels may reflect hypothyroid myopathy. Leukocytosis is not a typical feature of hypothyroidism and would more likely point to an infection or another inflammatory process. Hence, an elevated white blood cell count is the lab abnormality not typically associated with this condition.

Severe hypothyroidism, often due to autoimmune Hashimoto thyroiditis, slows metabolism everywhere in the body. The pattern of high TSH with low free T4 confirms the diagnosis. In this state, you commonly see lipid abnormalities such as elevated cholesterol because thyroid hormones help regulate hepatic lipoprotein metabolism and LDL clearance. Anemia can occur with hypothyroidism, and elevated CK levels may reflect hypothyroid myopathy. Leukocytosis is not a typical feature of hypothyroidism and would more likely point to an infection or another inflammatory process. Hence, an elevated white blood cell count is the lab abnormality not typically associated with this condition.