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Symptoms
By Mayo Clinic staff
The signs and symptoms of hypothyroidism vary widely, depending on the severity of the hormone deficiency. But in general, any problems you do have tend to develop slowly, often over a number of years.
At first, you may barely notice the symptoms of hypothyroidism, such as fatigue and sluggishness, or you may simply attribute them to getting older. But as your metabolism continues to slow, you may develop more obvious signs and symptoms. Hypothyroidism signs and symptoms may include:
- Fatigue
- Sluggishness
- Increased sensitivity to cold
- Constipation
- Pale, dry skin
- A puffy face
- Hoarse voice
- An elevated blood cholesterol level
- Unexplained weight gain
- Muscle aches, tenderness and stiffness
- Pain, stiffness or swelling in your joints
- Muscle weakness
- Heavier than normal menstrual periods
- Brittle fingernails and hair
- Depression
When hypothyroidism isn't treated, signs and symptoms can gradually become more severe. Constant stimulation of your thyroid to release more hormones may lead to an enlarged thyroid (goiter). In addition, you may become more forgetful, your thought processes may slow, or you may feel depressed.
Advanced hypothyroidism, known as myxedema, is rare, but when it occurs it can be life-threatening. Signs and symptoms include low blood pressure, decreased breathing, decreased body temperature, unresponsiveness and even coma. In extreme cases, myxedema can be fatal.
Hypothyroidism in children and teens
Although hypothyroidism most often affects middle-aged and older women, anyone can develop the condition, including infants and teenagers. Initially, babies born without a thyroid gland or with a gland that doesn't work properly may have few signs and symptoms. When newborns do have problems with hypothyroidism, they may include:
- Yellowing of the skin and whites of the eyes (jaundice). In most cases, this occurs when a baby's liver can't metabolize a substance called bilirubin, which normally forms when the body recycles old or damaged red blood cells.
- Frequent choking.
- A large, protruding tongue.
- A puffy appearance to the face.
As the disease progresses, infants are likely to have trouble feeding and may fail to grow and develop normally. They may also have:
- Constipation
- Poor muscle tone
- Excessive sleepiness
When hypothyroidism in infants isn't treated, even mild cases can lead to severe physical and mental retardation.
In general, children and teens who develop hypothyroidism have the same signs and symptoms as adults do, but they may also experience:
- Poor growth, resulting in short stature
- Delayed development of permanent teeth
- Delayed puberty
- Poor mental development
When to see a doctor
See your doctor if you're feeling tired for no reason or have any of the other signs or symptoms of hypothyroidism, such as dry skin, a pale, puffy face, constipation or a hoarse voice.
You'll also need to see your doctor for periodic testing of your thyroid function if you've had previous thyroid surgery, treatment with radioactive iodine or anti-thyroid medications, or radiation therapy to your head, neck or upper chest. However, it may take years or even decades before any of these therapies or procedures result in hypothyroidism.
If you have high blood cholesterol, talk to your doctor about whether hypothyroidism may be a cause. And if you're receiving hormone therapy for hypothyroidism, schedule follow-up visits as often as your doctor recommends. Initially, it's important to make sure you're receiving the correct dose of medicine. And over time, the dose you need may change.
- Hypothyroidism. The American Thyroid Association. www.thyroid.org/patients/brochures/Hypo_brochure.pdf. Accessed April 16, 2010.
- Hershman JM, et al. Thyroid diseases. In: Halter JB, et al. Hazzard's Geriatric Medicine and Gerontology. 6th ed. New York, N.Y.: McGraw-Hill; 2009. http://www.accessmedicine.com/content.aspx?aID=5133014&searchStr=hyperthyroidism. Accessed April 14, 2010.
- Lal G, et al. Thyroid, parathyroid, and adrenal. In: Brunicardi FC, et al. Schwartz's Principles of Surgery. 9th ed. New York, N.Y.: McGraw-Hill; 2010. http://www.accessmedicine.com/content.aspx?aID=5027159&searchStr=hyperthyroidism#5027159. Accessed April 14, 2010.
- Cooper DS, et al. The thyroid gland. In: Gardner DG, et al. Greenspan's Basic & Clinical Endocrinology. 8th ed. New York, N.Y.: McGraw-Hill; 2007. http://www.accessmedicine.com/content.aspx?aID=2629453&searchStr=hypothyroidism. Accessed April 14, 2010.
- Hypothyroidism and myxedema. In: Wolff K, et al. Fitzpatrick's Color Atlas and Synopsis of Clinical Dermatology. 6th ed. New York, N.Y.: McGraw-Hill; 2009. http://www.accessmedicine.com/content.aspx?aID=5189255&searchStr=hypothyroidism. Accessed April 14, 2010.
- Bauer DC, et al. Thyroid disease. In: McPhee SJ, et al. Pathophysiology of Disease: An Introduction to Clinical Medicine. 6th ed. New York, N.Y.: McGraw-Hill; 2010. http://www.accessmedicine.com/content.aspx?aID=5371611&searchStr=hypothyroidism. Accessed April 14, 2010.
- Diseases of the peripheral nerves. In: Ropper AH, et al. Adams & Victor's Principles of Neurology. 9th ed. New York, N.Y.: McGraw-Hill; 2009. http://www.accessmedicine.com/content.aspx?aID=3641633. Accessed April 24, 2010.
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