Patient presents with symptoms suggestive of thyroid gland dysfunction.  Presenting complaints include fatigue, weight changes, changes in bowel habits, temperature intolerance, mood disturbances, and alterations in hair and skin.  Physical examination reveals potential signs such as goiter, thyroid nodules, changes in heart rate, tremor, and skin changes.  Differential diagnosis includes hypothyroidism, hyperthyroidism, thyroiditis, Graves disease, Hashimoto thyroiditis, thyroid nodules, thyroid cancer, and goitrous conditions.  Laboratory evaluation may include thyroid stimulating hormone TSH, free T4, free T3, thyroid peroxidase antibodies TPO antibodies, thyroglobulin antibodies Tg antibodies, and calcitonin levels.  Imaging studies such as thyroid ultrasound and radioactive iodine uptake scan RAIU may be indicated depending on clinical presentation and laboratory results.  Assessment will focus on determining the specific thyroid disorder, evaluating disease severity, and assessing for complications.  Plan includes further investigation with laboratory or imaging studies as warranted.  Treatment options may include thyroid hormone replacement therapy levothyroxine for hypothyroidism, antithyroid medications methimazole, propylthiouracil for hyperthyroidism, radioactive iodine therapy, or surgical intervention thyroidectomy depending on the diagnosis and severity.  Patient education regarding the nature of thyroid disorders, medication management, lifestyle modifications, and potential complications will be provided.  Follow-up appointments are scheduled to monitor treatment response, adjust medication dosages as needed, and address any emerging concerns. Medical coding will be based on the specific diagnosis and procedures performed, utilizing appropriate ICD-10 and CPT codes for billing and documentation purposes.