Thyroid obstacle course: Many challenges from a single gland

Thyroid obstacle course: Many challenges from a single glandA man in his 30s presented to his primary care cli- nician for new irritability, anxiety, and insomnia, without suicidal ideation.Symptoms began after an increase in job-related stress and the anniversary of his mother's death.His medical history included obesity, depression, attention-defi cit hyperactivity disorder, irritable bowel syndrome, and erectile dysfunction.He was a lifelong nonsmoker and did not use illicit drugs.Current medications were vitamin D and sildenafi l.In addition, he had been treated with chemotherapy (unknown regimen; no radiation) at age 3 years for acute lymphoblastic leukemia.