**3. Hypothyroidism**

In hypothyroidism, patient has a puffy and pallor look. Skin is dry, BP may be increased, and tongue is bigger and voice is hoarse and has constipation due to poor bowel moments. In hypothyroidism, PTH and vitamin D are increased due to low urinary calcium excretion. Decreased bone resorption and formation occurs. Serum osteocalcin and alkaline phosphatase are decreased. Bone turnover is also decreased.
