Let’s Talk About Symptoms of Hypothyroidism
Worried your weight gain, constipation, or fatigue are pointing to a bigger problem? Here’s what you need to know about the signs of hypothyroidism.
What does it feel like to have hypothyroidism? There are many possible signs of this condition, from fatigue to constipation. The catch? Those symptoms don’t mean you definitely have this most-common thyroid disorder, since red flags for this condition could also be signs of other health problems. That said, knowing the signs and symptoms to watch for can help you catch changes early—and the sooner you get checked out by your doctor, the sooner you can get a diagnosis and start on treatment. This is a must since hypothyroidism can wreak havoc on your body and even lead to severe complications if left unmanaged. Get started here.
Our Pro Panel
We went to some of the nation’s top hypothyroidism experts to bring you the most scientific and up-to-date information possible. Look who’s on your side:
Jennifer Mammen, M.D.
Assistant Professor of Medicine in the Division of Endocrinology, Diabetes, and Metabolism
Johns Hopkins University School of Medicine
Debbie Chen, M.D.
Clinical Lecturer in Endocrinology
Ann Arbor, MI
Thayer Idrees, M.D.
Assistant Professor of Medicine in the Division of Endocrinology, Metabolism, and Lipids
Emory University School of Medicine
You may have a bunch of the symptoms, but the only way to confirm your diagnosis is to see your doctor. They’ll typically use a couple of blood tests, such as the TSH test, to measure the levels of thyroid hormones in your body to determine whether you have hypo.
There’s no way to guarantee you won’t get hypothyroidism. But you can learn about your risk factors and the signs that you may be developing this condition—that way you can get diagnosed and treated sooner rather than later and minimize the negative effects.
Anyone can develop hypothyroidism, but some of the most-common risk factors are being a woman, being over age 70, having a family history of thyroid problems, or having other autoimmune conditions.
If your hypothyroidism goes untreated, in rare cases it can become an extreme form of the condition called myxedema coma. When this happens, your body functions slow down to the degree that it becomes life-threatening, which is why people in this state should get treatment right away.
What Is Hypothyroidism, Again?
The thyroid is a butterfly-shaped gland on the lower part of the front of your neck. A healthy thyroid performs an important job: Making enough thyroid hormone for your body to function properly. But when your thyroid doesn’t make enough of this hormone, it’s called hypothyroidism, or having an underactive thyroid. This can lead to a slew of problems as the systems throughout your whole body slow down without the thyroid hormone there to help them use energy efficiently—for example, the digestive system may slow down, causing constipation, and the cardiovascular system may slow down, causing a slow or irregular heartbeat.
Around 5% of Americans over age 12 have hypothyroidism. The most-common form of hypothyroidism is an autoimmune condition called Hashimoto’s disease, which is when the immune system accidentally attacks the thyroid and causes hypothyroidism. Many cases of hypo are mild and may not have obvious symptoms, while others can be severe. Left untreated, it can lead to serious complications—so that’s why it’s important to know the signs of this condition so you can get it under control.
Without the thyroid hormones it needs, your body’s basic functions can slow down, like a car struggling to drive up a steep hill. That’s what leads to the symptoms of hypothyroidism. At first, they may be so minor you don’t even notice them. Over time—months to years—they can become more severe. Depending on your symptoms and how bad they are, you may find they start to disrupt your ability to live your life the way you want to. So what should you keep an eye out for? These are some of the common signs to watch for.
Feel like you’re so tired you can barely function? That crushing fatigue could be a sign that your body’s thyroid levels are too low, leaving you with little energy to spare. In fact, people with hypothyroidism often report that fatigue is one of the most debilitating symptoms they experience, per a recent study in Advances in Therapy.
Difficulty Tolerating Cold
Brrr… is it cold in here? That may be your thyroid crying out for help, as another one of the most-common symptoms of hypothyroidism is feeling colder more often. The lack of thyroid hormone makes it hard for your body to stay warm because without that hormone, your body lacks the energy it needs to regulate your body temperature properly.
Low thyroid levels can slow down your digestive system, leaving you backed up. One study found that 20% of hypothyroid folks reported worsening constipation as one of their symptoms.
Dry Skin and Hair Loss
Without enough thyroid hormone, your skin cells and hair follicles don’t renew themselves as often as they should. This can result in flaky skin and hair that breaks off and thins.
Heart and Circulatory Issues
Hypothyroidism can affect your cardiovascular system, slowing your heartbeat down. You also may experience higher blood pressure as the condition can cause your body to have to work harder to circulate blood.
With hypothyroidism, you may notice certain changes to your voice and speech, such as speaking more slowly than you used to or having a hoarse voice. For example, it may take you longer to process and answer a question after someone asks you something.
Depression and Anxiety
If you’re feeling more than blue, hypothyroidism could be the cause. In fact, about 64% of women and 57% of men with hypo may be depressed and anxious, according to a study in the Indian Journal of Endocrinology.
Stuck in a brain fog and can’t keep your focus? It could be hypo. Some people with this condition may experience difficulties with focus and memory.
For many, one of the most-frustrating signs of hypothyroidism is weight gain. Weight gain can occur because an underactive thyroid affects your metabolism. Without the energy it needs, your body may tend to store more fat. Plus, you may be hungrier with hypo, contributing to potential pounds gained. In general, most people can attribute about five to 10 pounds of extra weight gained to their underactive thyroid. You may also find your face gets puffy if you’re dealing with this condition.
Joint and Muscle Pain
Achy joints and muscles ruining your day? That may be the result of an underactive thyroid. For example, a recent article in StatPearls found that muscle pain and weakness affects up to 80% of people with hypothyroidism. While it’s not fully understood why this happens, it likely has something to do with the role thyroid hormone plays in healthy functioning of muscle cells.
If your thyroid doesn’t make enough hormones, your thyroid may start to grow larger, which is called a goiter. In Hashimoto’s—the most common form of hypothyroidism—the inflammation in the gland is what causes the goiter to occur. When the body lacks thyroid hormone, your pituitary gland produces more thyroid stimulating hormone (TSH), which causes the thyroid to grow into a goiter. Thankfully, though, it usually gets better over time on its own. Goiter isn’t usually dangerous, but it can be uncomfortable and cause hoarseness, a feeling of tightness, or dizziness if you raise your arms over your head. More rarely, the gland may grow so large that you experience difficulty breathing or swallowing. In the most-severe cases, you may need surgery to help alleviate symptoms.
Fertility Problems or Heavy or Irregular Periods
If you’re dealing with difficulty getting pregnant, it’s a wise move to get your thyroid check to see if that’s the culprit. Low thyroid levels can cause your period to be heavier than usual or irregular, which can make it harder to get pregnant. One study in the International Journal of Endocrinology found that nearly 50% of women with Hashimoto’s struggled to get pregnant, and most of these women were not yet being treated for the condition.
A recent study in Clinical Thyroidology for the Public found that four in 10 patients with thyroid disorders reported that it negatively impacted their sex life. Many women with hypothyroidism experience sexual dysfunction, which may manifest in pain during sex, lack of desire, lack of vaginal lubrication, difficulty reaching orgasm, and more. Men may also experience trouble with sex, including erectile dysfunction and other ejaculation problems.
Understanding Hypothyroidism Symptoms
To help manage these symptoms, the best route is to get started on medication for your hypothyroidism. Luckily, these meds are highly effective in addressing any symptoms that may be related to your underactive thyroid.
But while it’s common to experience these symptoms when you have hypothyroidism, having these symptoms doesn’t mean you definitely have the disease. That’s because these symptoms are what’s called “non-specific,” meaning they could have many other potential causes. For example, one of the most-common symptoms of hypo—fatigue—can come with so many other health issues that it would be hard to even list them all. That said, the more of the above symptoms you have, the more likely you are to actually have hypothyroidism, per a population-based study in the European Journal of Endocrinology. But the only way to know for sure is to see your doctor and get tested.
And remember: If you get treated and your thyroid hormones are well-balanced, but you’re continuing to experience the above symptoms, they may not be related to your thyroid at all. In this case, talk with your doctor about other causes of those symptoms and strategies to manage them.
Symptoms of Hypothyroidism in Children
Kids, teens, and even babies can develop hypothyroidism. In fact, about one in 2,000-4,000 babies is born with the condition. In kids and teens, the symptoms are basically the same as in adults, but they may experience other signs, too.
Delays in puberty
Delays in getting adult teeth
Poor mental development
Growth impairment, which may result in shorter height
Babies with hypo may not have obvious signs or symptoms, but if they do, they may include:
Jaundice, which is yellowing of the skin and whites of the eyes
A large tongue
Crying that sounds hoarse
It’s important that kids and babies get treated ASAP if they have hypothyroidism since the condition can cause problems with development. For babies, untreated hypo can even lead to severe physical and mental impairment.
How Do Hypothyroidism Symptoms Affect Mental Health?
When your thyroid gland isn’t doing its job, it can mess with your mood. Hypothyroidism can affect your ability to think and lead to fatigue, depression, and anxiety. While the link between thyroid and mood isn’t fully understood, it’s likely related to the fact that thyroid hormone plays a key role in brain function.
For example, some research suggests that a system in the body called the hypothalamic-pituitary-thyroid (HPT) axis, which involves the part of pituitary gland and hypothalamus in the brain as well as the thyroid, plays a role in the development of depression, per a study in The Indian Journal of Endocrinology and Metabolism. A change in thyroid hormone levels at this axis may result in mood problems like a depressive episode.
On top of how the lack of thyroid hormone may raise depression risk, people with chronic illnesses are more likely to experience mental-health problems in general. Living with a condition like hypothyroidism can be overwhelming, stressful, and isolating. If you’re experiencing depression or other mood problems, it’s important to take action so you can get the help you need:
Get treatment. Because mental-health problems can be the result of an underactive thyroid, getting treated with thyroid medication is a key step in helping to reduce these symptoms. Your doctor may also prescribe medication specifically for your mood problems, such as antidepressants for depression or anxiety.
Talk to a therapist. Seeing a mental-health professional, such as a therapist or psychiatrist, is proven to help decrease symptoms of depression and anxiety. A therapist can help you feel supported and even teach you skills to help cope with your symptoms better. In fact, a 2020 study in Thyroid Research found that emotional health, physical health, and spiritual health all significantly improved in hypothyroidism patients after receiving cognitive-behavioral therapy (CBT). There are even therapists who specialize in treating people who live with chronic illnesses like thyroid disease—don’t be afraid to seek them out and ask about their experience!
Connect with others who understand. Follow other people living with thyroid disease on social media, explore resources offered by nonprofit organizations, and consider joining an online or in-person support group to help you feel less alone in your struggles.
Prioritize rest and stress relief. Let’s face it—living with hypothyroidism can be stressful. It’s important to take steps to reduce your stress levels, whether that means seeing a therapist, improving your sleep hygiene, or taking up a mindfulness practice like yoga or meditation.
Can You Prevent Hypothyroidism Symptoms?
These symptoms can be scary, so you may be wondering if there are steps you can take to avoid getting hypothyroidism in the first place. Unfortunately, there is no way to prevent it. But knowing the above signs and symptoms, along with your potential risk factors, can help you catch hypothyroidism early.
Early detection and treatment is key in helping you to avoid severe complications and get back to feeling your best sooner. While hypothyroidism is a chronic condition, thankfully it is very manageable.
When Should I See a Thyroid Specialist?
Don’t delay—if you are experiencing any of the above symptoms of hypothyroidism, the time to see a doctor is now. They can test you for thyroid problems and get you started on treatment to help you start feeling better and reduce the risk of complications.
You can start with your primary-care provider, or they may refer you to an endocrinologist. An endocrinologist is a doctor that specializes in hormone disorders, including thyroid disease
Living With Hypothyroidism Symptoms
We won’t lie—a diagnosis of hypothyroidism can be overwhelming, and if left untreated, the symptoms can disrupt your life. That’s why it’s important to know your body, pay attention to anything that feels “off,” and get a proper diagnosis and start treatment as soon as you can.
Thankfully, the treatments available for hypo are highly effective. Once you get started on a treatment to get those hormone levels back into a healthy range, you should see a reduction in all of your hypothyroid-related symptoms, too. With the right treatment regimen, most people with hypo are able to get their energy back and find their footing. So don’t delay on seeing a healthcare professional—with time and perseverance, you can get back in the driver’s seat of your life with this chronic disease.
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Thyroid Disease Symptom Study: European Journal of Endocrinology. (2014.) “Hypothyroid symptoms and the likelihood of overt thyroid failure: a population-based case–control study.” https://eje.bioscientifica.com/view/journals/eje/171/5/593.xml
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Thyroid Disease and Mood: The Mayo Clinic. (2020.) “Can thyroid disease affect my mood?” https://www.mayoclinic.org/diseases-conditions/hyperthyroidism/expert-answers/thyroid-disease/faq-20058228
Thyroid Disease and Mental Health Symptoms Study: Indian Journal of Endocrinology and Metabolism. (2016.) “Prevalence of anxiety and depressive symptoms among patients with hypothyroidism.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4911835/
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Hypothyroidism in Pregnancy: National Institute of Diabetes and Digestive and Kidney Diseases. (2017.) “Thyroid Disease & Pregnancy.” https://www.niddk.nih.gov/health-information/endocrine-diseases/pregnancy-thyroid-disease
Infertility in Hypothyroidism Study: International Journal of Endocrinology. (2014.) “High prevalence of infertility among women with Graves’ disease and Hashimoto’s thyroiditis.” https://www.hindawi.com/journals/ije/2014/982705/
CBT for Hypothyroidism Study: Thyroid Research. (2020.) “The effectiveness of cognitive-behavioral therapy on quality of life in women with hypothyroidism in reproductive age: a randomized controlled trial.” https://thyroidresearchjournal.biomedcentral.com/articles/10.1186/s13044-020-00080-z