13 signs of underactive thyroid or hypothyroidism

The clinical signs and symptoms of underactive thyroid (hypothyroidism, or low thyroid) vary from person to person, depending on the severity of the hormone deficiency. Initially, you may observe some mild symptoms of hypothyroidism, such as lethargy, fatigue or weight gain. But as your problem continues and metabolism continues to slow, you may develop more specific and obvious signs and symptoms... 1. Fatigue. Fatigue is a very popular and common symptom of hypothyroidism. Fatigue can present itself in numerous ways, from sheer exhaustion to just a lack of enthusiasm. But fear not, when the treatment for hypothyroidism is optimized, many patients report that their fatigue is lessened or even fully resolved. Improvements can be made simply by correct amounts of sleep, healthy diet, keeping your blood sugar level balanced, getting fit by doing non-stress related sports such as yoga, qigong or tai chi, taking vitamin B12 & Vitamin D, or increasing iron levels. However you should seek professional advice before changing your lifestyle drastically if you suspect hypothyroidism. 2. Increased sensitivity to cold. The thyroid gland is also known as a thermostat for our body, as it helps to regulate our heat and metabolism. Patients with hypothyroidism are prone to having cold intolerance and low body temperatures. It’s usually among one of those symptoms that we either ignore, don’t notice and don’t take seriously, but can be very dangerous when we do not take the proper measures and precautions. People suffering from hypothyroidism are also at greater risk of getting hypothermia, a serious life-threatening state when exposed to low and cold temperatures. More symptoms on next page... 3. Dry skin. When thyroid hormones are low, blood circulation is decreased. In advanced cases of underactive thyroid, the skin may receive as little as one-third to one-fourth the normal blood supply. Hypothyroidism can also lead to dry itchy skin, dry fizzy hair, itchy flaky scalp, brittle nails, dry cracked heels, loss of the outer third of eyebrows, falling of eyelashes and chronic eczema. 4. Weight gain. Hypothyroidism also leads to obesity and weight gain. Patients with an underactive thyroid tend to have a very low basal metabolic rate (BMR) . One of the most common and noticeable symptoms of hypothyroidism is obesity, being overweight, and difficulty in losing extra weight. Sometimes hyperthyroidism can also mimic an underactive thyroid by causing weight gain, although this is very rare. Some people especially women with hypothyroidism don’t gain much weight due to biochemistry of their body, the quality and quantity of the calories they consume, and how they consume those calories. 5. Swelling and puffiness of face. Swelling and puffiness of face is also a major and common symptom of underactive thyroid and is also referred to as "myxedema”. Swelling caused by underactive thyroid is a typical and specific swelling caused by hypothyroidism and does not look watery. Patients with underactive thyroid also feel stiffness and swelling in their hands or face when they wake up in the morning. Very Severe swelling of the face can also results in swelling of the eyes and eyelids, thickened lips and enlargement of tongue. Mucous membranes can also become swollen and if your larynx becomes swollen your voice will become hoarse. 6. Constipation. Constipation is also one of the important and classical signs of hypothyroidism. Without adequate thyroid hormones, many of the body’s functions become slow. Hypothyroidism also slows the action and motility of the digestive system causing constipation. Hypothyroidism also weakens the contraction of abdominal and intestinal muscles causing the stool to move too slowly and thus causing constipation. 7. Muscle weakness. Muscles of our body need thyroid hormones to function properly, and deficiency of the thyroid hormones can cause severe muscle weakness and pain. Patients with underactive thyroid often complain of muscle strains and weakness, but this weakness is due to lack of thyroid energy, not due to breakdown of muscles. Patients with hypothyroid also complain of paresthesia (tingling sensations, like pins and needles) and peripheral neuropathy (numbness, weakness, or pain, usually in the feet or hand). According to a study, 70% of the patients with underactive thyroid had abnormal electromyograms, which measure the electrical activity of different muscles of body (at rest and during contraction). 8. Hoarseness of Voice. Hoarseness of voice is also a common symptom of underactive thyroid. Hypothyroidism leads to swelling and thickness of mucous membranes of larynx and vocal cords and this swelling leads to hoarseness of the voice. 9. Elevated blood cholesterol level. Millions of people with high cholesterol levels in body are unaware of the fact that their cholesterol is elevated due to underlying thyroid pathology. Undiagnosed and untreated underactive thyroid can also cause elevated cholesterol levels and heart problems, and of the estimated 20+ million Americans with underactive thyroid, at least half are undiagnosed and millions more are not properly treated, making them prone to many other diseases. 10. Irregular menstrual periods. Many menstrual irregularities may be symptoms of undiagnosed underlying thyroid pathology. Girls who have either very early menarche or very late menstruation should be evaluated and investigated for potential thyroid problems, as thyroid abnormalities can frequently be a cause of early or delayed menstruation and puberty. In addition, any alteration in the menstrual patterns - such as more or less frequent menstrual periods, the onset of substantially lighter or heavier periods, or the lack of periods entirely, should suggest an underlying thyroid disease. Underactive thyroid can cause missing of periods, abnormal menstrual bleeding and other menstrual problems. 11. Infertility. Low levels of thyroid hormone can also interfere with the normal ovulation, which impairs egg formation and fertility and can lead to infertility. Moreover, some of the causes of hypothyroidism — such as some auto-immune disorders like Hashimito disease — can also impair fertility. 12. Slowed heart rate. The most common cardiovascular clinical features of underactive thyroid are slow heart rate (bradycardia), mild hypertension, narrowed pulse pressure, fatigue and cold intolerance. Hypothyroidism can also lead to an enlarged heart and heart failure in extreme circumstances. 13. Anxiety and Depression. Although both hypothyroidism and depression are separate diseases, depression is sometimes a typical symptom of underactive thyroid and hypothyroidism. That’s when your thyroid gland doesn’t produce required thyroid hormone. Medication to boost levels of thyroid hormones can help in getting rid of symptoms of underactive thyroid, including depression. If you are suffering from hypothyroidism, you may have decreased memory, lethargy, fatigue, sluggishness, and problems in concentrating, and you may sleep more than 12 hours. All of these may cause you to feel more depressed and anxious. Getting help. If you're having any of the above mentioned symptom of underactive thyroid, see your doctor as soon as possible. Hypothyroidism and its symptoms can be treated and a proper diagnosis is a first major step towards the treatment. Feature photo by Kues

7. Muscle weakness

8. Hoarseness of Voice

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