19 Signs and Symptoms of Hypothyroidism
Your thyroid gland helps control your body’s systems, including energy levels and heart health. If this small gland produces insufficient hormones, it can lead to hypothyroidism, a condition that impacts millions globally.
This condition is more common in women than in men and typically affects people over the age of 60. The symptoms build up slowly over months or years, making them easy to be mistaken for regular fatigue or stress.
As a result, many people live with an underactive thyroid without realizing it. Early detection of hypothyroidism is essential to manage it effectively and avoid high-risk complications.
Common Symptoms
You may not recognize that specific changes in your body are related to your thyroid until more signs appear. When your thyroid gland doesn’t produce enough hormones, it affects multiple systems in your body.
Fatigue and Weakness
If you have an underactive thyroid, extreme tiredness may be one of the first signs you notice. Lack of hormonal signals can lead to persistent exhaustion throughout the day, even after a full night’s sleep.
Muscle weakness is another related symptom, often felt as heaviness in the limbs or reduced strength linked to your energy levels. Due to decreased endurance, everyday activities like ironing clothes or grocery shopping may feel stressful and challenging.
Unexplained Weight Gain
When you have hypothyroidism, your body’s metabolic rate decreases, which means you burn fewer calories throughout the day. You may gain weight even without changes to your diet or exercise routine, and losing weight becomes noticeably more difficult.
Weight gain from this condition often occurs gradually, sometimes due to fluid retention, which can make the body feel heavier. You may first notice an increasing difficulty in choosing and fitting your clothes.
Intolerance to Cold
A slowed metabolism caused by hypothyroidism reduces body heat production, making it harder to regulate and maintain a stable body temperature.
Slowed blood circulation can make your extremities feel unusually cold, even when the environment is comfortable for others. Simple tasks like typing or holding a pen can make your fingertips feel cold, and your hands and feet may often feel unusually cool.
You might also wear extra layers indoors, like sweaters or thick socks, especially at night, to stay warm. This discomfort can persist throughout the day, affecting your focus at work or your enjoyment of outdoor activities.
Slow Heart Rate
A slow heart rate is typical for athletes, but in hypothyroidism, bradycardia related to metabolism usually comes with other noticeable symptoms.
Because your heart isn’t pumping blood as strongly, you may feel dizzy, lightheaded, or experience a “head rush” when standing up quickly.
You may notice that it’s hard to detect your pulse on the wrist, and when checking your heart rate at the neck, you may feel that your pulse is weaker than usual.
As hypothyroidism slows your overall metabolism, some people have elevated cholesterol levels or other lipid imbalances found during routine blood tests.
Constipation
Low thyroid hormone levels slow down your digestive system, resulting in less frequent bowel movements. This is due to reduced gut motility, which makes waste move more slowly through the intestines.
Even when maintaining a nutritious diet, it’s possible to experience several days without a bowel movement, resulting in bloating and abdominal discomfort.
While increasing fiber and fluid intake can help relieve constipation, it may not be as effective if thyroid function is impaired.
Dry, Coarse Skin
A deficiency in thyroid hormone production can lead to unusual roughness or flakiness of the skin. This dryness is particularly evident in regions such as the elbows, knees, and the backs of the hands.
Low thyroid levels also affect cell regeneration, causing minor cuts or bruises to take longer to heal. Your skin may lose its natural glow, appearing dull and giving you a tired or washed-out look.
Over time, a yellowish tint can appear as a result of your body’s inability to efficiently break down certain pigments. Alongside these skin changes, you may observe that your nails become dry and brittle, making them more susceptible to splitting or breaking.
Brittle and Thinning Hair
Hypothyroidism slows body processes, affecting hair growth and quality. It reduces oil production, leading to drier, rougher hair that tangles easily, increasing the risk of breakage and hair loss.
Hair thinning can make your hair look uneven, and breakage indicates poor health and hygiene, which may leave you feeling concerned about your overall look.
You might begin to notice more strands of hair appearing more frequently in your hairbrush, on your pillow when you wake up, or even collecting in the drain after a shower.
These changes in hair loss might not be limited to your scalp and affect other parts of your body. They can also affect your eyebrows, making the outer edges sparser compared to the denser parts.
Voice Changes
Your thyroid hormones help keep tissues throughout your body functioning normally, including those around your vocal cords. When hormone levels drop, these tissues can become slightly swollen or less flexible, leading to a deeper, strained voice.
As you start to speak, your words might become raspy, almost as if you had been talking for hours. You may sometimes need to clear your throat because of discomfort, dryness, or a feeling of tightness.
Speaking may require more effort, making it challenging to keep a steady volume or tone. Vocal fatigue often becomes apparent during phone calls or video meetings, causing your voice to fade during important conversations.
Numbness and Tingling of the Hands
Low thyroid levels can cause numbness or tingling in your fingers or hands, often described as a mild pins-and-needles sensation. This is usually due to nerve compression from fluid retention or reduced circulation.
You may notice it during daily activities that demand precise hand movements, such as typing or fastening a button. The numbness and reduced dexterity can make gripping objects more difficult, sometimes leading to accidents.
Drooping Eyelids
You might notice that your eyelids appear heavier or sit lower than usual, giving your face a tired or sleepy look. This change may start subtly in one eye but can become more pronounced over time and affect both eyelids.
This is often more noticeable as you wake up and may improve throughout the day, but it doesn’t always disappear. If these changes impair your vision, you might raise your eyebrows or tilt your head back to see better.
Muscle Aches and Stiffness
An underactive thyroid reduces the energy available to your muscles, leading to pain, slower recovery from sprains, increased stiffness, and discomfort.
You might wake up feeling like your muscles are stiff, tight, or sore, even if you haven’t exercised or strained them the day before.
Sitting for long periods or bending down may trigger muscle cramps, joint pain, or sudden twinges when standing up. As a result, you may move more slowly or cautiously, as if guarding against an unexpected discomfort.
Neck Swelling
Goiters form when the thyroid gland works harder to produce enough hormones for the body’s requirements. If it can’t keep up with the demands, the gland may enlarge over time, leading to visible swelling at the front of your neck.
As the swelling increases, it may extend to the sides; shirts or necklaces that once fit comfortably may start to feel snug.
While some goiters are painless, a large goiter can sometimes cause discomfort by putting pressure on nearby organs and muscles, making swallowing, speaking, or breathing difficult.
Puffy Face
Low thyroid hormone levels slow metabolism, leading to fluid retention and the buildup in body tissues. You might notice that your cheeks appear fuller or rounder than usual, giving your face a slightly puffy look.
This puffiness is often most noticeable in the morning and may persist throughout the day. Swelling may extend beyond the face to areas like the ankles and feet, causing socks or shoes to feel tighter.
While mild puffiness is common, widespread or persistent swelling—especially a “doughy” feeling under the skin—may indicate myxedema, a rare but severe condition requiring urgent medical attention.
Brain Health Symptoms
People with hypothyroidism often face mental health challenges that can affect daily life. Low thyroid hormone levels can impact brain function and cause several distinct symptoms.
Brain Fog
Hypothyroidism can affect memory and cognitive function, making it harder to recall information and stay focused. Many people describe this mental sluggishness as “brain fog,” where thoughts feel cloudy or unclear.
You may find it more difficult to remember where you placed items like your keys or wallet, and may have challenges recalling recent conversations. Learning and retaining new information or keeping up with discussions in meetings may require more effort than before.
You may appear distracted or slower to respond when people ask questions. When concentration is affected, you may find yourself repeatedly reading a sentence to fully understand the context, or pausing in a conversation, forgetting what you wanted to say.
Depression and Mood Changes
Low thyroid hormone levels can disrupt brain chemicals that control mood, resulting in low energy or a lack of motivation. Activities you once loved may start to feel like chores instead of enjoyable pastimes.
Your body language and expressions might also change. Loved ones might notice and ask if you’re okay, even if you haven’t said anything. Small frustrations—like work stress or household chores—may trigger stronger feelings of sadness, irritability, or frustration than usual.
Sleep patterns can change; you might sleep more, but have difficulty falling or staying asleep due to worries and thoughts influenced by the effects of hypothyroidism to your brain.
The combination of fatigue, weight gain, changes in the skin and hair quality, voice changes, and other physical symptoms can add to the burden and further intensify emotional exhaustion.
Slow Thinking or Speech
With hypothyroidism, mental processing speed may slow down, affecting both thinking and verbal expression. You may experience slowed reactions to stimuli, and it may seem as if words are just within grasp but difficult to recall during spontaneous discussions.
This is especially noticeable in group discussions or fast-paced conversations, where you might feel a step behind. You may need to reread a paragraph multiple times before it sinks in, or take detailed notes to keep up in a lecture or work meeting.
Decision-making may also feel more difficult to process, and mental tasks that require focus, especially planning or multitasking, can be overwhelming.
Symptoms Affecting the Reproductive System
Reproductive health relies on a delicate equilibrium of hormones, including those produced by the thyroid. Various signs may emerge when this balance is disrupted, potentially influencing your sexual health and ability to conceive.
Irregular or Heavy Periods
A decrease in thyroid levels disrupts hormonal balance, leading to changes in the menstrual cycle. You may notice your cycles becoming farther apart, sometimes skipping months between periods.
Even when a period is missed, PMS symptoms like bloating, mood swings, or breast tenderness may still occur. When menstruation finally occurs, the flow may be heavier than usual, requiring more frequent pad or tampon changes.
Some experience dark, thick bleeding with clots, while others have a bright red flow that lasts longer than usual. Cramping can be more excruciating, causing a deep ache in the lower stomach that may spread to the lower back or thighs.
Trouble Getting Pregnant
Hypothyroidism can make conception more difficult by disrupting hormone balance and ovulation. When thyroid levels are low, your ovaries may not release eggs regularly, making it harder to predict fertile days and making pregnancy efforts frustrating.
Low thyroid levels can also affect the uterine lining, making it less receptive to implantation. If left untreated, hypothyroidism can increase the risk of miscarriage, as your body needs thyroid hormones to support early pregnancy.
Low Sex Drive
An underactive thyroid can lower sex drive by disrupting hormone balance and energy levels. You may experience less interest in physical intimacy, have difficulty becoming aroused, or feel no desire for it due to a lack of pleasure.
The fatigue experienced from other symptoms of hypothyroidism can further contribute to low libido, making you feel too exhausted for sexual activity. Additionally, decreased natural lubrication may cause discomfort or pain during intercourse.
