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A 66-year-old woman presented to the emergency department after being found unconscious in her home. She lived alone and had no contact with the healthcare system for the past 20 years. On presentation, her vital signs included a temperature of 31.2°C (88.2°F), heart rate of 46 bpm and blood pressure of 109/64 mm Hg. On examination, she had thin and brittle hair, loss of the lateral third of her eyebrows, macroglossia and doughy periorbital oedema (figure 1). Laboratory data revealed a thyroid-stimulating hormone of …
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