A 40-year-old woman was admitted for investigation of weakness and angina 
pectoris. She had generalised weakness of muscles, cold intolerance and a 
reduced physical performance. A previous neurological examination had already 
revealed a carpal-tunnel syndrome of the right hand. This syndrome, combined 
with a rough, cool skin and a periorbital edema, lead to the assumption of 
hypothyroidism. The diagnosis was confirmed by a combination of very high 
concentrations of TSH and decreased concentrations of the thyroid hormones. 
Replacement therapy by oral administration of L-thyroxin resulted in a gradual 
improvement of the patient's state.