Hypothyroidism Symptoms (100+) Checklist: How Many Do You Have?

If you look at the trend of hypothyroidism over time, you will find that it’s a disease that is increasing.

And women, especially, are more prone to developing it compared to men.

But how do you know if you have thyroid disease? Do you have to get you have to go see a doctor?

Not necessarily.

While the most accurate way to assess whether or not a thyroid disease is present is with the use of lab tests, there’s a whole lot you can learn from your symptoms.

If you just haven’t quite felt like yourself recently, or if you have a sneaking suspicion that something is off with your hormones, this article is for you.

Use this thyroid symptoms checklist to help you determine if further testing is necessary and how likely you are to suffer from a thyroid problem:

How To Use This List

Almost every cell in your body has a thyroid hormone receptor so the symptoms of thyroid dysfunction are… astonishingly broad.

Don’t let this overwhelm you, just realize that your thyroid can impact many systems and each person may present with a different set of symptoms even though the problem is primarily related to the thyroid.

Here’s how I would recommend using this checklist:

• Glance at the symptoms presented here and take note of how many you have. As you do, pay attention to the severity of your symptoms. There’s a difference between a weight gain of 5 pounds and a weight gain of 25 pounds (one indicates your situation is more severe).
• If you have 5 or more symptoms then there’s a chance that your thyroid is compromised but can probably be fixed with minor treatments like supplements and lifestyle changes.
• If you have 10 or more symptoms then the chance of you having gross thyroid dysfunction is even higher but you are probably still within the range that lifestyle changes can fix the problem.
• If you have 15 or more symptoms then you are very likely to have gross hypothyroidism that needs treatment with thyroid hormone.

Always remember that your suspicions should be confirmed with a complete set of thyroid lab tests which are outlined here.

Hypothyroid Symptoms By System

Thyroid-Gland Related Symptoms

• Enlarged thyroid
• Swollen thyroid
• Painful thyroid
• Difficult swallowing
• Presence of goiter
• Choking sensation

The most common cause of hypothyroidism is the autoimmune disease Hashimoto’s which results in the destruction of the thyroid gland over time.

But some of the most common thyroid gland disorders, like thyroid nodules, typically do not impact the production of thyroid hormone from the thyroid gland.

Energy-Related Symptoms

• Fatigue
• Decreased tolerance to stress
• Reduced stamina
• Low endurance
• Lethargy
• Long recovery after activity
• Difficult with exertion
• Increased need for sleep

Thyroid hormone regulates the production of cellular energy (ATP) in many cells.

When thyroid function is low, you will experience a global slowdown of cellular energy production which can lead to fatigue in almost any tissue.

Mood-Related Symptoms

• Low-grade depression up to major depression
• Sadness
• A feeling of being “off”
• The need for antidepressants
• Moody
• More emotional than normal (i.e. crying more frequently)
• Anxiety
• Irritability
• Obsessive thinking
• Easy emotional upset
• Emotional instability
• Obsessive thinking
• Nervousness
• Bipolar disorder symptoms

Thyroid hormone impacts hormones and brain-based energy production which can cause changes to your mood.

Metabolism-Related Symptoms

• Weight gain (even in the presence of diet and exercise)
• Lower than normal body temperature (less than 98.6 degrees)
• Decreased sweating (hypohidrosis)
• Slower than normal metabolism
• High cholesterol
• Lower than normal resting heart rate

Thyroid hormone helps to regulate heat production and global metabolism so one of the first symptoms patients notice is weight gain.

Eventually, these symptoms will spread to a global decrease in metabolic function including the breakdown and elimination of cholesterol.

Gut-Related Symptoms

• Constipation
• Diarrhea (more common in hypothyroidism)
• Hard stools
• Pebble stools
• Small intestinal bacterial overgrowth
• Small intestinal fungal overgrowth
• Acid reflux
• Low stomach acid (hypochlorhydria)
• Colitis
• Painful urination
• Bladder urgency
• Reduced urine production
• Malabsorption of vitamins, minerals, and macronutrients
• Presence of vitamin B12 deficiency
• Presence of iron deficiency
• Presence of vitamin D deficiency
• Presence of other B vitamin deficiencies
• Decreased peristalsis
• Decreased bowel sounds

There is a very strong connection between thyroid function and gut health.

When thyroid hormone is low, symptoms arise from decreased stomach acid and decreased peristalsis leading to a host of gut-specific problems.

Heart-Related Symptoms

• Higher risk of cardiovascular disease (heart attack)
• High cholesterol
• Heart palpitations
• Atrial fibrillation
• Congestive heart failure (only if severe and prolonged)
• The atherogenic build-up of plaque in the carotid arteries (an often silent but very concerning side effect)
• High blood pressure
• Orthostatic hypotension (low blood pressure while standing)
• Heart enlargement on X-ray
• Long-normal intervals on ECG
• Dizziness

Of all of the symptoms caused by thyroid dysfunction, those to the heart may be the most concerning.

Not only does thyroid hormone impact the function of your heart cells themselves, it also increases the risk of heart cell damage through its influence on cholesterol and blood pressure.

Hair, Skin & Nails Related Symptoms

• Dry skin
• Eyebrow hair loss
• Hair loss
• Telogen effluvium
• Alopecia areata
• Androgenetic alopecia
• Hives
• Acne and pimples
• Edema
• Coarse hair
• Dry hair
• Brittle nails
• Cracked nails
• Vitiligo
• Cold skin
• Dry, thick, or scaling skin
• Facial swelling (over the entire face or around the eyes)
• Paleness of skin
• Fragile nails
• Slow growth of nails
• Nail separation at the base
• Depression of nails with flaring in the center
• Softening of the nail
• Decreased sweating
• Decline in collagen
• Accelerated aging and wrinkling

As the largest organ in the body, your skin is especially sensitive to changes in thyroid function simply due to its large size.

And because the skin houses hair follicles and other glands that support the structure of the skin, thyroid dysfunction also impacts hair and nails.

Unfortunately, the skin is one of the last tissues to receive thyroid hormone when ingested by mouth but topical thyroid hormone creams may help solve this problem.

Bone, Muscle & Joint Related Symptoms

• Muscle aches (hypothyroid myopathy)
• Joint pain (difficult to treat but receptive to T3 thyroid hormone)
• Osteoporosis (major bone loss)
• Osteopenia (minor bone loss)
• Muscular weakness
• Carpal tunnel syndrome
• Inflammation in the joints
• Stiffness and reduced mobility
• Frozen shoulder
• Numbness in the hands or feet
• Sensitivity to cold, especially in the hands/feet

Joint and muscle-related problems are not as common as some of the other symptoms listed here but, when they are present, they are often very difficult to treat and require higher doses of specific thyroid medications like SR T3 and liothyronine.

Brained-Related Symptoms

• Depression
• Anxiety
• Bipolar disorder
• Inability to concentrate
• Inability to focus
• Forgetfulness
• Brain fog
• Fuzzy thinking (global slowdown of cognitive function)
• Memory problems
• Hyporeflexia (delayed reflexes)
• Irritability
• Slow speech
• Increased risk of seizures
• Poor motor coordination
• Brain-based fatigue

Thyroid hormone impacts neurotransmitter levels like serotonin which have a downstream effect on behavior.

These imbalances can be so strong that they may even lead to a change in personality (hypothyroid patients are more likely to have type D personality disorders) and may even cause psychiatric conditions like bipolar disorder.

Seep-Related Symptoms

• Insomnia
• Difficulty falling asleep or staying asleep
• The need to sleep more than necessary (hypersomnia)
• Restless leg syndrome
• Sleep apnea
• Daytime sleepiness
• Altered circadian rhythm (disordered cortisol regulation leading to high and low energy at the wrong time of day)
• Night sweats
• Cold sensitivity

Sleep disorders are particularly common among hypothyroid patients and present a big problem given the connection between healthy thyroid function and quality sleep.

You can find tips and tricks on how to sleep your way to better thyroid health here.

The Most Common Symptoms of Hypothyroidism

We just went over 100+ different symptoms associated with hypothyroidism, but, believe it or not, we just barely scratched the surface.

In order to keep perspective, I think it’s important to remember that just because your thyroid may cause a specific symptom doesn’t mean that it will.

Which is why I think it’s important to know the top 10 most common low thyroid symptoms:

When you look at all patients with hypothyroidism, you will see that these set of symptoms are more common than all of the rest.

This means that the presence of these symptoms is more important than some of the esoteric symptoms we just went over:

#1. Fatigue (seen in ~70-80% of patients)

#2. Weight gain (seen in ~60-70% of patients)

#3. Mood disorders (seen in ~50-60% of patients)

#4. Hormone imbalances & Menstrual irregularities (Seen in ~30-50% of patients)

#5. Muscle pain & joint pain (seen in ~40-50% of patients)

#6. Cold hands and feet (seen in ~50-60% of patients)

#7. Dry skin (seen in 50-70% of patients)

#8. Constipation (seen in ~30-50% of patients)

#9. Brain fog (seen in ~40-60% of patients)

#10. Neck swelling (~seen in 15-20% of patients)

So while other symptoms are important, the presence of any of the 10 symptoms listed above should carry more weight when you are considering whether or not your symptoms are truly caused by your thyroid and not something else.

Your Next Steps

You might think that your next step is easy; confirm your suspicion with a set of thyroid lab tests.

Unfortunately, it’s not quite that simple owing to how most doctors evaluate thyroid lab tests.

So when we talk about thyroid hormone symptoms, the discussion always needs to extend to the idea of “optimal” vs “normal” thyroid lab tests.

Because what you will likely find, if you are like thousands of other patients and women out there, is that when you go and get your labs tested, you will be told that you are perfectly “normal” even though you are walking around with many of the symptoms we just discussed.

It’s for this reason that you need to have a basic understanding of which thyroid lab tests are necessary and how to actually evaluate your results.

Don’t worry, though, because this isn’t difficult and I’ve outlined exactly how to do it here so be sure to check out that article next.

For those of you who want information on how to actually fix your thyroid naturally, I have you covered as well.

You can learn how to improve your thyroid with a few simple changes here.

If these natural treatments fail, you can always lean on thyroid hormones which are available both in prescription form (T4 and T3) and over-the-counter form (T2).