Symptoms usually come on gradually, over weeks or months. Therefore, you may have hypothyroidism for a long time, even years, before you realize you are ill. If you are an older adult, it may be even harder to recognize you are ill because instead of getting the typical symptoms of hypothyroidism, you may just gain weight or feel tired. Symptoms vary with the severity of the hypothyroidism and the length of time your body has lacked the proper amount of thyroid hormone.
You may have only one of these symptoms, but usually patients have a combination. Occasionally, patients with hypothyroidism have no symptoms at all, or the symptoms are so subtle they go unnoticed for a long period of time.
- Enlargement of the thyroid gland, called goiter (not always present)
- Fullness in the neck
- Difficulty swallowing or trouble breathing (can happen if the goiter is very large)
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Later symptoms or signs include:
- Coarse, brittle hair and hair loss
- Dry, scaly skin
- Intolerance to cold temperatures
- Weight gain (may happen despite having a poor appetite)
- Achy feeling all over
- Depression and irritability
- Memory loss and personality change
- Irregular or heavy menstrual periods
- Orange palms and soles (hypercarotenemia)
- Facial puffiness
- Swollen feet or hands
- Numbness and tingling of extremities
- Reduced sweating
- Sleep apnea
Symptoms of severe or prolonged cases include:
- Diffuse swelling of the skin and tissue around the eyes
- Slow heart rate
- Hypothermia (low body temperature)
- Shortness of breath during exertion or when lying flat
- Lethargy and mental decline
American Association of Clinical Endocrinologists website. Available at:
American Thyroid Association website. Available at:
Harrison’s Principles of Internal Medicine.14th ed. McGraw-Hill; 2002.
Singer P, Cooper D, Levy E, et al. Treatment guidelines for patients with hyperthyroidism and hypothyroidism.
Wartofsky L. Myxedema coma.
Endocrinol Metab Clin North Am.2006;35:687-98.
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