Thyroid Disease Symptoms

Symptoms differ between hypothyroidism and hyperthyroidism

Thyroid disease includes several conditions with overlapping symptoms. Hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid) often have opposite effects on the same body systems.

Some thyroid concerns such as goiter, thyroid cancer, and Graves' disease have unique symptoms.

This article takes a look at the symptoms of various thyroid problems. It also describes some serious conditions that can arise if symptoms are left untreated.

Frequent Symptoms

Common symptoms of hypothroidism: depression, brain fog, fatigue, muscle cramps, cold intolerance, weight gain, dry skin
 Verywell

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.

Not everyone with thyroid disease will have these changes. You can have an underactive thyroid and still lose weight or be underweight. You can have an overactive thyroid and find that you can't lose weight, even with a healthy diet and exercise.

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.

Hypothyroidism or Underactive Thyroid
  • You wake up exhausted, even after eight or more hours of sleep.

  • You take long naps.

  • You have "marathon" sleep sessions on your days off.

Hyperthyroidism or Overactive Thyroid
  • You have a hard time falling asleep.

  • You wake up several times during the night.

  • You heart races or you feel anxious at bedtime.

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:

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

If part of your neck is enlarged, talk to your healthcare provider about it right away.

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.

Hypothyroidism or Underactive Thyroid
  • Brittle, coarse, and dry hair

  • Hair that breaks easily

  • Loss of hair, especially on the outer edge of the eyebrows

  • Thick, dry, and scaly skin, especially on the heels, knees, and elbows

  • Brittle, thin, or dull nails

Hyperthyroidism or Overactive Thyroid
  • Severe hair loss

  • Fine, thinning hair

  • Increased skin sensitivity and smoothness

  • Unusual skin rashes

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.

Pain is often overlooked as a symptom of thyroid issues.

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.

You need a sound diagnosis sooner rather than later. Early treatment can lower the risk of complications.

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

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Doctor Discussion Guide Woman

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.

Frequently Asked Questions

  • Can I check my thyroid at home?

    You can perform a thyroid "neck check" at home. Look for lumps on the thyroid gland. A swollen thyroid gland could indicate various thyroid conditions, including nodules, goiters, or thyroid cancer.

    Thyroid problems are usually discovered based on the symptoms they cause. Speak to your healthcare provider about unusual symptoms you have.

  • Should you avoid certain foods with hyperthyroidism?

    There is no specific diet for hyperthyroidism. Still, some foods can affect your thyroid medications. Limit your iodine intake. Be mindful of soy, selenium, and cruciferous vegetables. These can all interact with thyroid medication.

  • How are thyroid issues diagnosed?

    Healthcare providers will ask you about your symptoms and medical history. They will examine your thyroid gland. You may need blood tests or imaging tests, including a thyroid scan or ultrasound.

10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Additional Reading