10 Signs & Symptoms Of Thyroid Issues To Know, From MDs

Hypothyroidism is the most common endocrine disorder affecting about 4.6% of the U.S. population, according to the U.S. Department of Health and Human Services. The symptoms can range from mild to severe, making it difficult for many people to identify their thyroid problems. 

While lab tests are the best way to verify a thyroid condition, mbg spoke with integrative medicine doctors and endocrinologists to better understand the signs. Here are the most common symptoms, along with tips for managing hypothyroidism. 

“Hypothyroidism is basically another word for underactive thyroid,” integrative medicine doctor and mbg Collective member, Amy Shah, M.D., explains. “It’s a condition where the thyroid gland just doesn't produce enough thyroid hormone.” 

There are many different causes of hypothyroidism, one of the most common being an autoimmune condition, like Hashimoto's disease. “In this scenario the body makes antibodies to its own thyroid cells. The antibodies target the thyroid gland and destroy the cells, causing decreased production,” reproductive endocrinologist Sheeva Talebian, M.D., tells mbg. 

The hypothalamic-pituitary-thyroid (HPT) axis1 helps regulate physiological energy demands, a study in the Frontiers of Physiology states. In other words, the thyroid regulates energy levels. 

“When it's running low, so are you,” internal medicine and board-certified family physician, Aviva Romm, M.D., previously told mbg. When suffering from hypothyroidism, “you might be anywhere from a little more tired than usual, to excruciatingly fatigued,” she wrote. 

Weight gain is one of the most common symptoms of hypothyroidism, but the exact reason is not well understood. One possible explanation is that the thyroid hormone helps regulate metabolism2. When the hormone is underactive, metabolism slows down, making it more difficult to burn calories. 

Along with gaining weight, Talebian says hypothyroidism can also lead to an inability to lose weight. 

A study published in the Indian Journal of Endocrinology and Metabolism says “hypothyroidism is associated with altered gastrointestinal (GI) motility3.” Namely reduced motility, meaning food takes longer to travel through the digestive tract.

“As a result, constipation is a common symptom of low thyroid function, along with gas and bloating,” Romm says. 

Along with fatigue, Talebian says hair loss is one of the most commonly reported symptoms of hypothyroidism. “It is well-known that thyroid hormone is essential for the development and maintenance of the hair follicle,” a study in the International Journal of Trichology states. In severe cases, these thyroid issues may even be linked with alopecia4. 

“The thyroid controls the regularity of menstrual cycles, as well as fertility and women’s hormones in general,” Romm says. Menstrual issues associated with hypothyroidism may include a period that’s very heavy or irregular. 

“Thyroid disease also can cause your periods to stop for several months or longer, a condition called amenorrhea,” the Office of Women’s Health says. 

“The association between thyroid function and psychiatric disorders5 particularly mood disorders has long been recognized,” says one study in the Journal of Thyroid Research. Depressive symptoms are among the most common in people with hypothyroidism, but patients might also experience anxiety, the researchers report. 

The thyroid hormone helps regulate epidermal (skin) homeostasis. People with hypothyroidism tend to have dry, scaly skin6—particularly on the palms of the hands and soles of the feet, research shows. 

One of the more surprising signs of hypothyroidism? "Your body temperature might be a whole degree lower, or your hands and feet are always cold,” board-certified OB/GYN and functional medicine specialist Kyrin Dunston, M.D., said during a mbg podcast episode. 

Sure, this symptom may seem random, but research has shown that 40% of participants with low-thyroid hormones feel more sensitive to cold7. This is because hypothyroidism often leads to poor circulation. 

Hypothyroidism can impact cardiovascular health in many different ways. One is by slowing the heart rate. A presence of thyroid hormones can lead to an increased heart rate, and a lack of thyroid hormones leads to a decreased heart rate8, one study says. When unmanaged, people with hypothyroidism may be at a greater risk of heart disease or heart failure, the researchers add. 

According to research, 79% of people with hypothyroidism are affected by hypothyroid myopathy9, a condition that leads to muscle cramps, muscle weakness, and fatigue. “Proximal weakness especially in the shoulder and pelvic girdle is commonly seen, causing difficulty in climbing stairs, getting up from squatting position, and combing hair,” the study states. 

The symptoms of hypothyroidism can be gradual or rapid, Talebian says. The best way to diagnose it is with a blood test. “TSH (thyroid stimulating hormone) is elevated in the setting of hypothyroidism,” she explains. 

If you think you may have hypothyroidism or it’s been confirmed with a blood test, consult with a doctor about which treatments will work best for you. 

While medications are the most commonly prescribed course of action, some integrative medicine doctors, like Taz Bhatia, M.D., recommend pairing that Western approach with a holistic Eastern approach. This may include taking prescribed medication, while also eating an anti-inflammatory diet full of iodine-rich and other thyroid-supporting foods.