What Hypothyroidism Looks Like

When your thyroid first starts to produce less thyroid hormone, you won't know it. It's rare to have any symptoms initially, and you may feel perfectly fine. Over time, however, as your metabolism begins to slow, you may start to notice that you are sluggish and fatigued.

Gradually, the condition begins to take its toll on your entire body, slowing everything from your heart rate to your digestion. Below are some of the most notable symptoms of hypothyroidism. Keep in mind that you may not have all these symptoms.

Weight Gain

For many people, the most disturbing symptom of hypothyroidism is unexplained weight gain, which occurs — ironically — even as your appetite shrinks. If you've been trying to lose weight, you might find it has become impossible, no matter how little you eat or how much exercise you do. In fact, even your best efforts to eat less may be met with weight gain.


Your thyroid gland is only one factor influencing your basal metabolic rate (BMR). BMR is also affected by genetics, the amount of exercise you do, and your body's fat and muscle composition. Those who exercise more have a faster BMR, as do people who have more muscle. BMR can also be affected by illnesses such as diabetes.

The weight you're gaining, however, is initially the result of swelling and not the accumulation of fat. As the kidneys retain more water and sodium, more water is left to circulate in the body, causing tissues to swell and weight to climb. Eventually, the body will also accumulate fat. Most of the time, it will top off at no more than ten to twenty pounds — just enough to set off alarm bells and make it hard to squeeze into your jeans. Occasionally, people with hypothyroidism will gain even more weight.

Foggy Mind

Forgetfulness is often a by-product of our busy and stress-filled lives. But in people who have hypothyroidism, the mind may feel similarly strained. Efforts to concentrate and focus may feel overwhelming, and your memory may become shaky and unreliable. Some people call this brain fog. As a result, it can be difficult to follow simple directions or perform your job. This problem can also slow your reaction time, which can affect your driving ability.


It's normal for everyone to experience an occasional bout of the blues, especially if you're going through a difficult time. But in people who have depression, feelings of emptiness, helplessness, and hopelessness may linger for no real apparent reason. As a result, you may lose interest in activities that normally brought you great joy. Such feelings are a normal symptom of hypothyroidism and generally go away once the hypothyroidism is treated.

Dry Skin, Hair, and Nails

It's bad enough that low thyroid function is making you tired, swollen, and depressed. Unfortunately, a sluggish thyroid can take a toll on your appearance, too. Skin may become pale and dry, and even crack. Hair may become dry and brittle. Some people may notice that they are losing more hair than normal, and that hair loss is occurring elsewhere on their body, too. A common place to lose hair is at the outer part of your eyebrows. At the same time, fingernails may become dry and brittle and develop grooves that cause the surface to become uneven.

Sluggish Gastrointestinal Tract

Thyroid hormones play a role in the way your body breaks down food and moves it through the gastrointestinal tract. That's because your digestive tract is lined with muscles that contract in order to propel the digested food. When you become deficient in thyroid hormone, this digestive process slows down. As the propulsion of food into the bowel slows, you may notice that you are frequently constipated.

Irregular Menstruation and Difficulty with Pregnancy

Women who have hypothyroidism may notice that their periods have become heavier and more frequent. Some women may stop ovulating, making it difficult to get pregnant. It may also be difficult to retain a pregnancy: Six of every 100 miscarriages are the result of hypothyroidism.


It's easy to mistake hypothyroidism for premenstrual syndrome (PMS). The two conditions have similar symptoms — fatigue, depression, bloating, and weight gain, among them. Having an underactive thyroid can make your PMS symptoms worse. If you suffer from bothersome PMS, ask to have your thyroid checked. Treating your thyroid problems usually lessens your PMS, too.

Swollen Thyroid Gland

In some people with hypothyroidism, the gland may actually become enlarged, creating a condition called a goiter. Some people can see this enlargement by performing the neck check. You may also notice that your voice is hoarse as the swollen gland presses against your vocal cords. In some cases, you may experience coughing, difficulty breathing, and trouble swallowing.

Impaired Heart Function

Hypothyroidism causes your pulse to slow as your heart rate decreases. In addition, your heart may weaken, and fluid can seep into the heart muscle, causing it to swell. You may also experience an increase in your blood pressure. As a result of this slowdown in activity, your heart is forced to work harder to get oxygen and nutrients throughout your body. This can put you at risk for heart failure, a potentially life-threatening condition.

Other Changes

Hypothyroidism causes myriad other bodily functions to change, too. For instance, you may notice that you are extra sensitive to cold temperatures, and that your hands feel cold. You may notice that you are less interested in sex or that your allergies seem worse. You may also experience frequent headaches and notice that your muscles are achy, tender, and stiff. Any cuts, bruises, and infections you suffer may take longer than normal to heal.

Blood tests may reveal other health problems associated with your underactive thyroid. For instance, you may develop high cholesterol, a problem that can lead to heart disease if left untreated. You may also develop anemia or low red blood cell counts. In hypothyroidism, the anemia is typically the result of a deficiency of iron in the blood.


Women who have hypothyroidism have another reason to quit smoking. Studies show that women who smoke have higher levels of LDL, the bad cholesterol, as well as higher total cholesterol levels, both risks for heart disease. The smokers also had more muscle problems. Cigarette smoking apparently impairs the secretion and action of thyroid hormone.

Hypothyroidism also impacts how your body responds to its environment. Medications you take, for example, may produce more pronounced side effects. Some people, for instance, become more sensitive to stimulants like pseudoephedrine, which is often in cold remedies.

In some cases, it may take years for any symptoms of hypothyroidism to emerge. When they do, it's easy to mistake them for other health problems or life situations. It isn't until a thyroid test is done that a deficiency in thyroid hormone can be properly identified as the root of the problem.

Without treatment, all these symptoms may worsen over time. And if it goes untreated long enough, hypothyroidism can be deadly. The good news is, treatment is readily available and can quickly restore the thyroid to its proper function.

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