Ladies and gentlemen, I present the “warm room” sign.
Last month I saw a woman in her sixties who had come for her annual hypertension review. As she walked in she mentioned that my room was cooler than the waiting room, and said “that's nice”. I didn't think anything of it at first, but while checking her blood pressure I noticed that her heart was beating rapidly and her pulse was 108. This was particularly unusual because one of her drugs was a beta-blocker which would tend to slow the heart. I was starting to suspect that she might have an over-active thyroid, and in response to my questions she told me that she had noticed her hands trembling a little and had lost a little weight. I sent off blood tests which duly confirmed that she has hyperthyroidism.
A little later in the month I saw a woman in her fifties who complained mainly of aching shoulders, but had also lost some weight. She also mentioned that my consulting room was too hot. When I examined her I found her pulse was slightly raised at 92 and she also had a slight tremor. Blood tests have now confirmed that she also has hyperthyroidism, though not as severe as that of the first woman.
I like my room to be comfortably warm, not too hot and not too cold, and go to some trouble to make it so. Patients who complain about the temperature may therefore have a problem with their thyroid. It's certainly worth considering.