Symptoms of Thyroid Disease

Frequent Symptoms

Your thyroid affects many different body systems. The symptoms you have can be an important clue to whether your thyroid is overactive or underactive.

Weight Changes

Unexplained weight changes can be a sign of a thyroid problem.

• In hypothyroidism, you may gain weight or not be able to lose weight even if you ramp up exercise and cut calories.
• In hyperthyroidism, you may lose weight even if you eat normally. You may also lose weight or stay underweight if you eat more.

Temperature

Both forms of thyroid disease can make you sensitive to temperature.

• In hypothyroidism you may feel cold.
• In hyperthyroidism you may feel hot and sweaty despite a normal temperature around you.

Fatigue and Sleep

Sleep issues and fatigue are common with thyroid issues. Fatigue can get worse without a good night's rest. At times, it can be so profound that it affects your daily life.

Mental Health

Depression, anxiety, and other mood disorders are common with thyroid problems.

• In hypothyroidism, you may have depression that doesn't respond to antidepressants.
• In hyperthyroidism, you may have anxiety, panic disorder, or panic attacks.

Neck or Throat

Thyroid conditions can cause problems in your neck or throat. These disorders may cause changes you can see or feel:

• Autoimmune thyroid disease
• Nodules
• Goiter or enlarged thyroid
• Thyroid cancer

Watch for:

• Swelling of the neck
• A "full" feeling in the neck
• Visibly enlarged neck
• Ear and jaw pain
• Discomfort with turtlenecks or neckties
• Trouble swallowing or breathing
• Tenderness in the neck
• A hoarse, raspy voice

Neck swelling is often a symptom of thyroid disease. It can also indicate serious conditions such as:

• Cancer
• Infection
• Neurological disease

Hair, Skin, and Nails

Thyroid conditions affect your hormones. When they are out of balance, you may see changes in your hair, skin, and nails.

Bowel Habits

Thyroid conditions can cause digestion problems.

• In hypothyroidism, you may have severe or persistent constipation. It might not respond to treatments.
• In hyperthyroidism, you may have diarrhea, loose stools, or irritable bowel syndrome.

Menstruation and Fertility

Thyroid conditions can increase your risk of infertility, This is especially true of hypothyroidism.

It may make fertility treatments less effective. It can also raise your risk of having miscarriages.

Thyroid issues may make your periods irregular, too.

• In hypothyroidism, you may have heavier periods, more period pain, or less time between periods.
• In hyperthyroidism, you may have shorter periods, lighter flow, and fewer or no periods.

Eye Problems and Vision Changes

Thyroid conditions can affect your eyes. You could have symptoms like these:

• Dryness
• Gritty feeling in the eye
• Blurred vision
• Redness
• Swollen, puffy, or watery eyes
• Sensitivity to light
• Double vision
• Proptosis or eye-bulging, a symptom of Graves' disease
• "Lid lag"—when your upper eyelid doesn't smoothly follow eye movement when you look down

Cognitive Problems

"Brain fog" is a slowdown in your thinking abilities. It is common with hypothyroidism. Brain fog involves:

• Trouble concentrating
• Short-term and long-term memory problems
• Forgetfulness
• Lack of focus
• Feeling "spaced out"
• Confusion
• Trouble thinking clearly

Musculoskeletal System

If your thyroid is overactive, you may have muscle aches and joint pain. Arms and legs often have the most trouble. For example, you may have pain or weakness in your upper arms or calves.

Fibromyalgia-like pain is common for people with an underactive thyroid. This includes widespread, achy pain all over the body.

You may also have a greater risk of carpal tunnel syndrome in your hands. This condition can cause weakness and pain in your forearms, wrists, hands, and fingers.

Tarsal tunnel is also a risk. It causes weakness and pain in the shins, ankles, feet, and toes.

Rare Symptoms

The signs and symptoms listed below are rare, but they could be some of the first tip-offs that your thyroid isn't working as it should.

Hypothyroidism

• High cholesterol: Your cholesterol level may stay high even after you change your diet, exercise, or take medications such as statins.
• Myxedema: A substance called hyaluronic acid can build up in the lower layer of the skin. The result is coarse hair and skin, puffiness, tongue enlargement, and hoarseness.

Hyperthyroidism

• Low cholesterol: Your cholesterol may stay too low despite your diet, weight, and exercise.
• Graves’ ophthalmopathy: The most notable symptom is bulging eyes. Your eyes may not be completely covered when your eyelids close.
• Rashes: Hyperthyroidism and Graves' disease can cause pretibial myxedema. It's also known as thyroid dermopathy. The skin on your shins may swell and turn red. In some cases, a bumpy rash known as miliaria can also appear on the face.

Complications

Some thyroid symptoms may seem more annoying than harmful. But your thyroid gland produces hormones that affect your heart, digestion, brain, bones, and more.

Hypothyroidism

• Neuropathy: Low levels of thyroid hormones can lead to nerve damage. You might feel tingling and numbness in your hands and feet. A painful condition known as plantar fasciitis may also develop in your feet. It's brought on by fluid buildup around the nerves.
• Trouble conceiving a baby: Even a mildly underactive thyroid can affect ovulation, the release of an egg each month. It can also keep an embryo from implanting in the uterus.
• Pregnancy complications: Hypothyroidism raises the risk of miscarriage, placental abruption, preterm delivery, and neonatal death. 

Hyperthyroidism

• Osteoporosis: Weak bones raise your risk of fractures or breaks even with minor bumps or falls.
• Atrial fibrillation: This heart arrhythmia can lead to serious problems like stroke or heart failure. It is more common in older people.
• Pregnancy complications: Moderate-to-severe hyperthyroidism can lead to preterm birth, stillbirth, and birth disorders.

When to See Your Healthcare Provider

If you have thyroid symptoms, visit your healthcare provider. To find out what's going on, they may:

• Give you a physical exam
• Ask questions about your medical history
• Ask for details about your symptoms
• Give you a blood test to check your thyroid levels

In most cases, thyroid conditions can be effectively treated.

Thyroid Disease Doctor Discussion Guide

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Certain thyroid symptoms call for emergency medical care.

Thyroid storm is a rare but very serious condition. It occurs when hyperthyroidism isn't treated. Stressful events like surgery, trauma, or infection can trigger it.

In a thyroid storm, symptoms ramp up to dangerous, even deadly, levels. You may have:

• A very fast heart rate
• High fever
• Diarrhea
• Agitation
• Delirium
• Loss of consciousness

Hypothyroidism can lead to another medical emergency. It's called myxedema coma.

Myxedema coma is rare. It's triggered by trauma, infection, cold, and some medications. It causes body temperatures and blood pressure to drop. You may lose consciousness. This condition can cause death.

Summary

Your thyroid produces hormones that affect many different organs and functions in your body. The symptoms you have will differ depending on whether your thyroid is over- or underactive.