What Are the Risks for — and Symptoms of — Hypothyroidism?

Patient Expert

Your thyroid is a small, butterfly-shaped gland, but it packs a punch in terms of the many symptoms it can cause when it isn’t working properly. The thyroid gland produces essential hormones that help oxygen and energy reach every cell, tissue, gland, and organ in your body. When your thyroid is underactive (or when you’ve had your gland surgically removed or radioactively disabled), you don’t have enough of this crucial thyroid hormone — a condition known as hypothyroidism.

Risk factors for hypothyroidism

There are a number of factors that put you at greater risk of hypothyroidism. These include:

  • A personal or family history of thyroid disease
  • A personal or family history of autoimmune disease
  • Pregnancy or childbirth within the last year
  • Use of certain medications, including lithium (for bipolar disease) and amiodarone (for heart disease)
  • Past or current cigarette smoking
  • Past exposure to medical radiation, such as radiation treatments to the neck or head
  • Past exposure to environmental radiation, especially being downwind from a nuclear fallout (i.e., Chernobyl, Fukushima)

In addition, there are a number of conditions that either increase your risk for, or may be a result of, hypothyroidism. These include:

  • Infertility
  • Recurrent miscarriage
  • Carpal tunnel syndrome
  • Tarsal tunnel syndrome
  • Plantar fasciitis
  • Frozen shoulder
  • Premature menopause
  • Epstein-Barr virus
  • Reynaud’s syndrome
  • Hives (Urticaria)
  • Polycystic ovary syndrome (PCOS)
  • Celiac disease
  • Type 2 diabetes
  • Autoimmune diseases, including alopecia, vitiligo, Sjogren’s syndrome, multiple sclerosis, psoriasis, rheumatoid arthritis, type 1 diabetes, pernicious anemia, and many others

Symptoms of hypothyroidism

Hypothyroidism symptoms often result in a slowdown of key bodily functions. Everything from thinking, heart rate, metabolism, hair growth, and elimination can be affected, as evident by the following list.


  • Fatigue and exhaustion, unrelieved by sleep


  • Unrefreshing sleep
  • Snoring
  • Sleep apnea


  • Weight gain, despite no change to diet or exercise
  • An inability to lose weight, even after cutting calories and increasing exercise
  • An increase in your blood sugar or Hemoglobin A1C (HA1C) levels
  • A lower basal metabolism (you need fewer calories than someone else at the same body weight)

Abdominal area and stomach

  • Ascites (abdominal fluid accumulation)
  • Excess belly fat

Mood and cognition

  • Depression, especially when it does not respond to antidepressant drugs
  • Anxiety
  • Mood changes
  • Brain fog, or difficulty remembering, focusing, or concentrating

Neck and thyroid area

  • A swollen or full feeling in your neck
  • A visible enlargement of your neck
  • A visible lump in your neck
  • A lump in your neck that you can’t see but can feel
  • Discomfort with things around your neck, such as scarves, ties, or turtlenecks
  • Difficulty or discomfort swallowing
  • Neck tenderness
  • A sore throat
  • A raspy, hoarse voice


  • Hair loss from your head or body
  • Hair loss from the outer edge of your eyebrows
  • Hair that is dry, coarse, and tangles more easily


  • Fingernails that split or break easily
  • Thinning fingernails


  • Dry skin
  • Scaly skin or persistent callouses on your heels, knees, and elbows

Digestion and elimination

  • Chronic constipation

Menstrual period

  • Heavier menstrual periods
  • More frequent menstrual periods
  • More painful menstrual periods


  • A low sex drive / low libido

Pregnancy and postpartum

  • Difficulty breastfeeding
  • Low milk supply
  • Postpartum depression

Body, muscles, and joints

  • Slowed reflexes
  • Muscle and joint aches and pains
  • Pain and weakness in the hands and fingers
  • Heel and foot pain
  • Shoulder pain

Heart and blood pressure

  • Unusually slow heart rate
  • Unusually low blood pressure


  • Lower resistance to infections
  • More frequent infections


  • Elevated cholesterol levels, especially when they do not lower with changes in diet and exercise, or medications to lower cholesterol


  • A dry, gritty feeling in your eyes
  • A recurrent tic in your eye(s)


  • An unusually low body temperature, especially the basal (early morning) body temperature
  • Feeling cold, especially when others feel warm, or feeling cold in warm rooms and climates
  • Cold hands and feet


  • Swelling and puffiness in your hands and feet
  • Swelling and puffiness in your face, especially around your eyes

Note that you don’t need to have all of the listed symptoms, or even many of them. Experiencing just a few of these symptoms may point to undiagnosed hypothyroidism, or may indicate that your hypothyroidism warrants better and more effective treatment.

See more helpful articles:

The Causes of Hypothyroidism

You Might Be Hypothyroid If...

How Hypothyroidism is Diagnosed