List possible causes of this case.

Human Anatomy & Physiology (11th Edition)
11th Edition
ISBN:9780134580999
Author:Elaine N. Marieb, Katja N. Hoehn
Publisher:Elaine N. Marieb, Katja N. Hoehn
Chapter1: The Human Body: An Orientation
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CASE #1. Alicia is 48 year old female of 76 kilograms and height of 161.5 centimetres. Although she attempted reduced weight, but she has gained instead 11.4 kilograms in the previous months. She also sleeps for 14-16 hours a day. Her movements were slothful, and she has slight enlargement of the neck area, coarse textured hair and dry skin. When her blood sample was analyzed it showed that the hormone T4 (thyroxin) levels were 3.2 micrograms/millilitre which is lower than the normal range, 4.2-11.2 micrograms/millilitre. In addition to this her TSH (thyroid stimulating hormone) levels were high. 

1. List possible causes of this case.

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