Signs and Symptoms of Hypothyroidism

Hypothyroidism—also known as underactive thyroid— is a health condition where the thyroid gland does not make enough thyroid hormone for what your body needs. Your thyroid is a small, butterfly-shaped organ in the front of your neck that helps your body regulate your metabolism, temperature, heart rate, and other important functions.

This condition affects about 1 in 20 people in the U.S. and is more common in people assigned female at birth and among those over the age of 60. While symptoms can vary from person to person, the hallmark symptoms of hypothyroidism are fatigue, weight gain, feeling cold, and hair loss, among others.

In some people, symptoms of an underactive thyroid may appear very slowly over several years and may be so mild they are not even noticeable. For others, the onset of symptoms can happen suddenly and be life-threatening. That's why it's so important to learn the symptoms of hypothyroidism so you know when to seek medical care.

Metabolic Symptoms

Having an underactive thyroid can slow down your metabolism. As a result, you might experience changes in several bodily functions. These symptoms may include:

• Unintended weight gain
• Difficulty losing weight
• Fatigue or feeling tired all the time, despite getting enough rest
• Sleeping more than usual
• Having low energy levels
• Feeling cold
  

Dermatologic Symptoms

When your thyroid isn't making enough hormone, it's common for many people to notice changes in their dermatologic health—which includes your skin, hair, and nails. You might experience symptoms such as:

• Thin or fine hair that breaks easily
• Hair loss
• Cool and pale skin
• Dryness and itchiness
• Brittle nails
• Puffiness or swelling in your face, hands, and feet

It's important to note that you might still experience many of these symptoms even if you try natural remedies like moisturizing your skin or deep conditioning your hair. If you're trying at-home lifestyle changes to help manage these symptoms and your symptoms still aren't improving, this is a sign that you may need to visit a provider to get your thyroid checked for any hormonal conditions.

Gastrointestinal Symptoms

Hypothyroidism can also affect your gastrointestinal tract—or, the passageway in your digestive system that runs from your mouth to your anus. As a result, you might experience symptoms that affect your digestive system. Symptoms may include:

• Constipation
• Bacterial growth in your intestines
• Slowed digestion or indigestion that can cause bloating and heartburn
• Stomach or chest pain
• Nausea and vomiting

Neurological Symptoms

Not producing enough thyroid hormone can have an effect on your neurological health, such as your thinking, behaviors, emotions, and overall mental health. Hypothyroidism may cause the following symptoms:

• Difficulty sleeping
• Irritability
• Depressive moods
• Slow movement or speech
• Trouble concentrating or thinking clearly
  
• Forgetting things or having problems with your memory

Symptoms in Your Neck

The thyroid gland is located in the front of the neck above the breastbone (sternum). An underactive thyroid can locally affect your neck area. Symptoms may include:

• Goiter or the enlargement of your thyroid that can cause the front of the neck to look swollen
• Enlargement of the tongue
• Hoarse voice
• Trouble swallowing or difficulty breathing if your goiter is too large

Cardiovascular Symptoms

For some people, hypothyroidism can cause changes to their cardiovascular system, which includes the heart and its blood vessels. Hypothyroidism-related cardiovascular symptoms may include:

• A slowed heart rate
  
• Higher than normal blood pressure
• Fluid retention or edema that can raise cholesterol levels
  

Symptoms in Children 

While most people who receive a diagnosis for hypothyroidism are older adults that are assigned female at birth, children can have a condition called congenital hypothyroidism, which is an underactive thyroid that a baby can be both with.

Most children who have this condition can experience symptoms similar to the ones listed above. However, being born with hypothyroidism can also cause additional symptoms such as:

• Slowed growth that can stunt a child's height, despite getting older or going through puberty
• Delayed onset of puberty
• Muscle weakness or poor muscle tone

Symptoms in Women

While those assigned male at birth can also have hypothyroidism, people assigned female at birth can experience additional concerns related to their reproductive health. People with a uterus may experience the following symptoms if they have an underactive thyroid:

• Heavy bleeding during period
• Irregular menstrual cycle
• Infertility, or difficulty getting pregnant
• Pregnancy complications such as having high blood pressure, giving birth prematurely, or experiencing a miscarriage

When to See a Healthcare Provider 

If you are concerned about your thyroid health or are experiencing symptoms, it's a good idea to see your healthcare provider. Your provider can get you properly tested for a thyroid or hormonal condition and inform you about next steps and treatment options that can help improve your symptoms.

A rare but very serious symptom of an underactive thyroid is called a myxedema coma (or myxedema crisis). This can occur when you have very low levels of thyroid hormone and is a medical emergency. Possible symptoms include:

• Below normal body temperature
• Trouble breathing
• Low blood pressure and blood sugar
• Losing consciousness or being unresponsive