A nurse is assisting with the care of a client in a provider's clinic For each finding of the client, click to specify if the finding is consistent with Hyperthyroidism or Hypothyroidism. Each finding may support more than one disease process.

• Report of menstrual cycle: Amenorrhea or infrequent menstrual cycles commonly occur in hyperthyroidism due to disruption of the hypothalamic-pituitary-ovarian axis. Excess thyroid hormones alter estrogen metabolism and ovulation patterns. Hypothyroidism typically causes menorrhagia (heavy periods). • Weight change: Unplanned weight loss despite a good appetite is a hallmark feature of hyperthyroidism. Increased thyroid hormone levels accelerate metabolism, leading to increased energy expenditure. The client’s three-month history of weight loss strongly reflects this hypermetabolic state. Hypothyroidism more commonly causes weight gain. • Skin condition: Warm, moist skin is characteristic of hyperthyroidism due to increased heat production and peripheral vasodilation. Excess thyroid hormone raises basal metabolic rate, resulting in sweating and warmth. This finding contrasts with the dry, cool skin typically seen in hypothyroidism. • Neck exam: The presence of a goiter indicates thyroid gland enlargement, which is common in Graves’ disease. A goiter (enlarged thyroid) can be present in both conditions. In hyperthyroidism, it's often due to overstimulation (Graves'); in hypothyroidism, it can be due to a lack of iodine or compensatory growth (Hashimoto's). • Laboratory results: Elevated T3 and free T4 levels confirm excess circulating thyroid hormones. The increased TSI level indicates an autoimmune process stimulating the thyroid gland. These laboratory values are diagnostic for Graves’ disease, a form of hyperthyroidism. Hypothyroidism would show low T3 and T4 levels. • Eye appearance: Exophthalmos is a classic manifestation of Graves’ disease and results from autoimmune inflammation of orbital tissues. It is not seen in hypothyroidism. This finding directly points to hyperthyroidism with autoimmune involvement. The eye changes further reinforce the diagnosis.