The American Thyroid Association estimates that up to 60 percent of people with thyroid disease are unaware of their condition. That silence is part of what makes the gland so easy to miss. Symptoms creep in gradually and get pinned on stress, aging or a bad night's sleep.
Women are five to eight times more likely than men to develop thyroid problems, and one in eight will face a thyroid disorder at some point in her life, the ATA notes. Below are eight warning signs worth paying attention to, drawn from the ATA and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
Signs that lean toward an underactive thyroid
An underactive thyroid, called hypothyroidism, means the gland does not make enough thyroid hormone. The NIDDK notes that because the condition develops slowly, people often do not notice symptoms for months or even years.
1. Unexplained weight gain. The NIDDK lists weight gain among the classic signs of an underactive thyroid, along with fatigue and joint or muscle pain.
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2. Persistent fatigue and low mood. The ATA links hypothyroidism to extreme fatigue, depression and forgetfulness. A review in Thyroid Research reports that both hyper- and hypothyroidism may cause psychiatric symptoms such as depression, anxiety, memory deficits and, in severe cases, psychosis.
3. Feeling cold when others do not. Trouble tolerating cold is one of the symptoms the NIDDK highlights for an underactive thyroid.
4. Dry skin, thinning hair and a slower heartbeat. The NIDDK also flags dry skin, dry or thinning hair, a slowed heart rate and heavy or irregular menstrual periods as possible signs.
Signs that lean toward an overactive thyroid
An overactive thyroid, called hyperthyroidism, is the opposite problem. The gland makes too much hormone and the body speeds up. The NIDDK lists a distinct cluster of symptoms.
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5. Weight loss despite an increased appetite. Losing weight while eating more is one of the hallmark signs of an overactive thyroid, according to the NIDDK.
6. A rapid or irregular heartbeat. The NIDDK warns that hyperthyroidism can cause a rapid and irregular heartbeat that, left untreated, may lead to blood clots, stroke or heart failure.
7. Nervousness, irritability and trouble sleeping. The NIDDK groups nervousness, irritability, trouble sleeping, shaky hands, muscle weakness and heat intolerance together as common features of an overactive thyroid.
8. Swelling at the base of the neck. An enlargement of the thyroid gland, called a goiter, can appear with either an overactive or an underactive thyroid. In older adults, hyperthyroidism can look nothing like the classic picture and is sometimes mistaken for depression or dementia, the NIDDK cautions.
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When to see a doctor
None of these signs on their own confirm a thyroid problem. Many overlap with stress, perimenopause, sleep loss or other conditions. The point is not to self-diagnose, but to notice patterns.
If several of these symptoms show up together, or one is severe or lasting, it is worth raising with a doctor. A simple blood test can settle the question.
The ATA describes measuring thyroid stimulating hormone, or TSH, as the best way to initially test thyroid function, and calls changes in TSH an early warning system that often shows up before hormone levels themselves drift out of range.
Left undiagnosed, thyroid disease may raise the risk of cardiovascular disease, osteoporosis and infertility, the ATA notes, and untreated hypothyroidism in pregnancy carries higher risks of miscarriage and preterm delivery. That is a strong reason not to shrug off symptoms that stick around.
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