• Hypothyroidism is a prevalent condition in the general population.1 42 million people in India have thyroid disorders and hypothyroidism is the most common, affecting one in ten adults.

• Myxedema coma is a rare and life threatening emergency with a high mortality rate.2 It results from severe hypothyroidism and affects almost every organ

• Patients will present with myxedema coma, characterized by hypothermia, hypotension, bradycardia, and altered mental status in the setting of severe hypothyroidism.3 Myxedema coma has also been known to manifest in a number of unusual and dangerous forms.

• A high index of suspicions is needed among clinicians in order to rapidly recognize the condition and make an early diagnosis. Treatment should be commenced on clinical grounds while waiting for laboratory results.

• Here, we present the case of a male who presented to the emergency department with altered mental status, Anasarca and in abilty to walk.