Mrs L is a 40 year old housewife with no medical history. She has tried every possible diet to lose weight, but she cannot stop gaining, despite all her efforts.
Over the past three months she has noticed that she feels tired for most of the day.
Winter is the worst time
She also experiences occasional headaches, is always sweaty and has also noticed occasional pain in her right wrist.
She recently had a bout of cold with flu-like symptoms, but thought it might be due to the fact that she doesn't dress warmly enough during the cold weather. Winter is the worst time for Mrs L as her skin tends to become very dry (although this doesn't only happen in winter); her hair also becomes dry and she is generally not in a good mood.
While she was waiting for the doctor, the nurse did her side-room tests:
Heart rate: 56 bpm
Blood pressure: 135/89 mmHg
Urine test: clear
Using the information above, what will be the most likely diagnosis, and what tests, if any, will the doctor consider to comfirm his suspicion?
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