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Hypothyroidism is a common clinical entity encountered frequently in most adult primary care settings. The reported prevalence in the general population is approximately 3% in men, but as high as 10% in women (Sawin, Geller, Hershman, Castelli, & Bacharach, 1989). The disease process affects every major organ system, contributing to a broad range of symptoms. Clinicians need to be familiar with the signs, the symptoms, and the appropriate laboratory studies, so that timely and accurate diagnoses can be made. This article reviews normal thyroid physiology and thyroid pathophysiology, as well as the diagnosis and treatment of several important clinical entities resulting in hypothyroidism. Research findings are included insofar as they relate to current clinical practice.