10 Warning Signs That Your Thyroid is Undertreated

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If you are being treated for hypothyroidism — an underactive thyroid — or hyperthyroidism — an overactive thyroid — it’s likely that at some point in the course of your condition, you will be undertreated, and need a change in your medication. Let’s take a look at the most common signs and symptoms that you are not getting sufficient treatment for your thyroid disease.

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You have unexpected weight changes

Are you gaining weight without a change in your diet and exercise program? This can be a sign that (1) you are not getting enough thyroid hormone to treat your hypothyroidism, or (2) you are getting too much antithyroid medication for your hyperthyroidism. Similarly, if you are losing weight, you may be getting too much medication for your hypothyroidism, or too little medication to resolve your hyperthyroidism.

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It’s hard to lose or gain weight

If you are on a diet and exercise program that should result in weight loss, but you aren’t losing any weight (or you’re even gaining!) you may need an increased dosage of thyroid hormone medication for your hypothyroidism, or a reduction in antithyroid drugs. If you are trying to gain weight, and despite increased caloric intake, you are not gaining — or you’re losing weight — you may need to increase your dosage of antithyroid drugs to treat your hyperthyroidism.

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You have diarrhea or are constipated

Constipation — common in hypothyroidism — can be a sign that you need more thyroid hormone when you’re hypothyroid, or that you are taking too much antithyroid medication. Diarrhea or loose stools — associated with hyperthyroidism — can be signs that your dosage of thyroid hormone is too high or that you need to increase your dose of antithyroid medication.

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You have joint and muscle aches/pains

General joint and muscle pains are common when hypothyroidism is not sufficiently treated, and your dosage of thyroid hormone needs to be increased. Joint and muscle weakness and pain, especially in the arms and legs, can be evidence that you need an increased dose of antithyroid drugs for your hyperthyroidism.

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You are anxious and/or depressed

If you are experiencing increasing anxiety and/or depression, this could be a sign that you need more thyroid hormone or antithyroid drugs. Anxiety can also be a sign of medication-induced hyperthyroidism, indicating that you may be on too high a dosage of thyroid hormone replacement medication. If you are taking a thyroid drug with T3, such as natural desiccated thyroid or liothyronine, you may need to reduce the dosage.

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You’re exhausted

Exhaustion is a common symptom of both hypothyroidism and hyperthyroidism. Increased exhaustion can be a sign that you need an increased dosage of thyroid hormone or antithyroid drugs. In some cases, if you’re hyperthyroid and taking too much antithyroid medication, you can shift into hypothyroidism. In this case, your dosage of antithyroid drugs needs to be reduced.

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You’re having changes in your hair

Increasing hair loss and breakage — including loss of the outer edge of your eyebrows — are common signs of both hypothyroidism and hyperthyroidism. You may need an increased dosage of thyroid hormone for your hypothyroidism, or a reduced dose of antithyroid medication for your hyperthyroidism.

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You’re noticing skin changes

Skin changes can be signs that your treatment needs an adjustment. Very dry skin — especially your hands, elbows, and feet — can be a sign that you are not getting enough thyroid hormone when you are hypothyroid. Unusually smooth skin, a bumpy rash on your face called miliaria, or a patch of rough skin on your shins can all be signs that your hyperthyroidism treatment is insufficient, and you need an increased dosage of antithyroid medication.

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You’re having menstrual problems

If your menstrual periods are heavier, more frequent, longer in length, or erratic in their timing, you may need more treatment for your hypothyroidism or a reduction in your antithyroid medication dosage. If your menstrual periods are lighter, less frequent, shorter, or have stopped — common signs of hyperthyroidism — you may need an increased dose of antithyroid medication or a reduction in your dose of thyroid hormone.

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You can’t get pregnant

Fertility problems are common in both hypothyroidism and hyperthyroidism. You may need a change in your dose of either thyroid hormone replacement medication or antithyroid drugs to reach an optimal thyroid stimulating hormone (TSH) level for fertility, usually a TSH between .5 and 2.5 µIU/mL.

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See your health care provider

If you have any of the above signs and symptoms that your thyroid is undertreated, it’s time to check back in with your health care provider for a follow-up consultation. Be sure to discuss how best to get optimal treatment for your hypothyroidism to help resolve your lingering symptoms.