Rebecca is a 43-year-old Hispanic female that presents to your clinic as a new patient and a yearly physical exam.

Rebecca is a 43-year-old Hispanic female that presents to your clinic as a new patient and a yearly physical exam. She has a history of hypothyroidism that was diagnosed 6 years ago and had previously been treated with levothyroxine. She has been off her medications for 2 years because she did not have insurance. She has been having progressively worsening fatigue over the past year. Sleeps a lot and has trouble concentrating. It has significantly worsened over the past 3-4 months. She has also noted some hair loss, dry skin, and has gained 30 lbs. in the past year. Rebecca has also noticed that she has been craving ice. She read that could be a sign of anemia. She has her menses twice a month with heavy bleeding that lasts for up to 6 days. Has frequent yeast infections. Also, c/o urinary frequency, no dysuria. Says she drinks a lot of water. She was told several years ago that she had prediabetes. Has had some occasional tingling in her feet.