By Amy Harris, MS, RN, CNM

Hyperthyroidism Symptoms to Watch and When to Test

What Is Hypothyroidism?

Hypothyroidism is the name for what happens when your thyroid gland can’t make enough thyroid hormone to keep your body running normally. People are hypothyroid when they have too little thyroid hormone in the blood.

A healthy thyroid gland produces enough thyroid hormone to help your body:

• Use energy
• Stay warm
• Keep other vital organs such as your brain, heart, and muscles working

Hypothyroid Symptoms to Watch For

The signs of thyroid dysfunction can be tricky to spot. Early on, you may miss the common symptoms of an underactive thyroid. The most common signs of hypothyroidism are:

• Tiredness
• Feeling cold all the time
• Having a hard time going poop, called constipation
• Dry skin
• Weight gain
• Hoarse voice
• Having low energy or not feeling motivated

Because it is easy to ignore these symptoms, many people do not seek treatment for hypothyroidism until the condition becomes more severe. Symptoms may worsen slowly, over many years. Later symptoms of hypothyroidism can be:

• Coarse hair and skin
• Muscle weakness
• Muscle aches, tenderness, and stiffness
• Puffy face
• Heavier or irregular periods
• Thinning hair
• Slowed heart rate
• Depression
• Memory problems

Many of these symptoms happen normally as people age, such as dry skin, weight gain, and muscle aches and weakness. So people just chalk up the symptoms to old age and delay asking for a thyroid test. These symptoms of hypothyroidism can also be symptoms of other conditions or diseases, making diagnosis even more confusing.

Don’t Ignore Your Hypothyroid Symptoms

The risks of hypothyroidism are real and can be life-threatening. That is why it is important to watch for symptoms of hypothyroidism. In rare cases, severe hypothyroidism can cause heart problems, breathing problems, and an emergency medical condition called myxedema coma. These medical emergencies can be prevented by:

1. Watching for hypothyroid symptoms
2. Having your thyroid levels regularly tested if you are diagnosed with hypothyroidism
3. Taking your thyroid replacement medicine as prescribed by your healthcare team

Is There a Cure for Hypothyroidism?

No, there is no cure for hypothyroidism. Your healthcare provider may recommend treating hypothyroidism by taking replacement thyroid hormone in a pill form. This medication is called levothyroxine. Most people start to feel better within one to two weeks of starting levothyroxine.

Because there is no cure, you will most likely take thyroid replacement hormone for the rest of your life. Your dose can change over time. This is why it is important to have your thyroid hormone levels tested regularly.

After starting levothyroxine, your TSH should be monitored every six to eight weeks until it is within the normal range, then every six to 12 months. Test results help your healthcare provider find and maintain the right medication dosage for you. Too much levothyroxine can cause side effects, such as:

• Tiredness
• Feeling hungry all the time
• Sleep problems
• Shakiness
• Pounding of the heart, sometimes called heart palpitations

When you are taking the correct dose of levothyroxine, you should not have any side effects.

Regular TSH testing can also prevent more severe symptoms from developing over time.

How Do You Test For Hypothyroidism?

A simple blood test can test your thyroid levels. Blood tests may measure multiple thyroid hormones, including:

1. Thyroid-stimulating hormone (TSH)
2. T3 or triiodothyronine
3. T4 or thyroxine

T3 is considered the more active form of thyroid hormone in the body, but T4 can be converted into T3.

Your diet can also affect the health of your thyroid. For example, not having enough iodine in your diet can increase your risk for hypothyroidism.

When Should You Test For Hypothyroidism?

It is a good idea to talk with your healthcare provider if you notice any of the symptoms of hypothyroidism, particularly if you feel like your body is slowing down in a way that is unhealthy or not normal for you.

Some people may be at higher risk for hypothyroidism. Let your healthcare provider know if:

• Thyroid problems run in your family.
• You have had thyroid surgery.
• You have had radiation to treat head or neck cancer.
• You are pregnant.
• You are taking any of the medications that can cause hypothyroidism. These include amiodarone, lithium, interferon-alpha, interleukin-2, and possibly thalidomide.

If you have any of these risk factors and start to notice hypothyroid symptoms, it makes sense to test your thyroid hormone levels.

Should You Test For Hypothyroidism Even If You Don’t Have Symptoms?

The U.S. Preventive Services Task Force (USPSTF) and the American Thyroid Association (ATA) maintain that most healthy adults do not require regular thyroid testing.

If you have any of the risk factors for hypothyroidism, you can ask your healthcare team whether it makes sense to screen for hypothyroidism regularly.

I Took a Thyroid Test and Was Told I Have Subclinical Hypothyroidism — What Does That Mean?

Remember how three different hormones could be tested to figure out if your thyroid is working correctly? In some people, the first hormone, thyroid-stimulating hormone (TSH), may be elevated outside the normal range, while the T4 hormone level is within the normal range. This is diagnosed as subclinical hypothyroidism.

Subclinical hypothyroidism means that not all of your test results are within the clinical range to diagnose hypothyroidism. People with subclinical hypothyroidism may or may not have any symptoms. It is sometimes considered an early or milder form of hypothyroidism.

Women and people older than 60 are more likely to have subclinical hypothyroidism. Most often, people with subclinical hypothyroidism don’t take replacement thyroid hormone unless their TSH is significantly high or they have bothersome symptoms. If you are diagnosed with subclinical hypothyroidism, talk with a healthcare provider about whether or not you should take thyroid hormone replacement therapy.

Should You Test if You Are Pregnant or Trying to Get Pregnant?

Women are more likely than men to have thyroid conditions. Testing thyroid hormone levels is very important for women who are already pregnant or planning to become pregnant. Thyroid conditions, such as hypothyroidism, can make it harder for women to get pregnant. Talk to your women’s healthcare provider about thyroid testing if:

• Your periods are irregular.
• You have been trying to get pregnant for longer than one year or for at least 6 months if you are 35 years or older.
• You have a family history of thyroid conditions.

Some people can develop hypothyroidism during or after pregnancy. Untreated hypothyroidism during pregnancy can cause:

• Miscarriage
• Problems with the placenta
• High blood pressure problems in pregnancy
• Babies not growing as big or as strong, called fetal growth restriction

Many women who are already taking thyroid hormone medicine to treat their hypothyroidism need to increase their dose during pregnancy. The AAFP recommends that pregnant women with hypothyroidism have their thyroid function tested monthly.

Learn More About Your Thyroid Health with Help from Everlywell

Although a relatively small organ, your thyroid gland plays a pretty big role in your health. Having hypothyroidism can cause unpleasant symptoms that affect your quality of life. Checking your thyroid hormone levels, especially if you are at risk for hypothyroidism or if you have symptoms, can help you stay on top of your health.

With the Everlywell at-home Thyroid Test, you can test your thyroid hormone levels with a small blood sample. One of the Everlywell healthcare providers can advise you:

• If you should take a thyroid test
• What your thyroid test results mean
• How to best take care of yourself if you do have hypothyroidism

Easy and convenient virtual appointments are just one way Everlywell helps you take better care of your health.