A 45-year-old female presented with gradually progressive proximal muscle weakness over 6 months. On examination, she had facial puffiness, macroglossia, hyporeflexia, and delayed ankle jerk relaxation. Investigations revealed hypothyroidism with a high TSH and low T3 and T4. An EMG showed a myopathic pattern. She was diagnosed with hypothyroid myopathy and started on levothyroxine treatment.