19 Signs Your Thyroid Isn’t Working Right

Located below the Adam's apple, your thyroid produces thyroid hormone (TH), which regulates, among other things, your body's temperature, metabolism, and heartbeat. Things can start to go wrong when your thyroid is under- or over-active. If it's sluggish, it produces too little TH; amped-up and it produces too much. What causes your thyroid to go haywire? It could be genetics, an autoimmune attack, pregnancy, stress, nutritional deficiencies, or toxins in the environment, but experts aren't entirely sure. Because of thyroid hormones far reach in the body—from brain to bowels—diagnosing a disorder can be challenging. Here's how to tell if your thyroid could be on the blink.

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Feeling tired and having no energy are issues associated with lots of conditions, but they're strongly linked with hypothyroidism, the disorder that's the result of too little thyroid hormone. If you're still tired in the morning or all day after a full night's sleep, that's a clue that your thyroid may be underactive. Too little thyroid hormone coursing through your bloodstream and cells means your muscles aren't getting that get-going signal. “Fatigue is the number one symptom I see,” says Dr. Miller. “It’s the kind of fatigue where you’re still tired in the morning after a full night’s sleep—that’s a clue that you’re not simply sleep deprived; your thyroid may be underactive.”

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Feeling unusually depressed or sad can also be a symptom of hypothyroidism. Why? It's thought that the production of too little thyroid hormone can have an impact on levels of "feel good" serotonin in the brain. With an underactive thyroid turning other body systems down to "low," it's not surprising that your mood might sink there, too.

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Anxiety and "feeling wired" are associated with hyperthyroidism, when the thyroid gland is making too much thyroid hormone. Flooded with consistent "all systems go" messages, your metabolism and whole body may spin into overdrive. If you feel like you just can't relax, your thyroid may be "hyper."

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Sure, it could be caused by sleep deprivation or aging, but cognitive functioning can take a hit when your thyroid is out of whack. Too much thyroid hormone (hyperthyroidism) can cause difficulty concentrating and too little (hypothyroidism) may cause forgetfulness and general brain fog. “When we treat patients for hypothyroidism, they are often surprised at how fast their brain fog goes away and how much sharper they feel,” Dr. Miller says. “Many women think it’s just something that comes along with menopause when it really is a sign of a thyroid problem.”

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Having little or no desire in the sack could be a side effect of a thyroid disorder. Too little thyroid hormone could be a contributor to a low libido, but the cumulative impact of other hypothyroidism symptoms—weight gain, low energy, and body aches and pains—could also play a part.

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That fluttery feeling you're having may be heart palpitations. It can feel like your heart is actually fluttering or skipping a beat or two, or beating too hard or too quickly. You may notice these feelings in your chest or at pulse points in your throat or neck. Heart flutters or palpitations can be a sign of too many thyroid hormones flooding your system (hyperthyroidism).

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People with hypothyroidism sometimes complain of constipation. The disruption in hormone production has likely caused a slowdown of digestive processes.

“There’s just no motility in your gut,” Dr. Miller says. “This is one of the top three most common symptoms of hypothyroidism I see.”

On the reverse side of the spectrum, an overactive thyroid gland can cause diarrhea or more frequent bowel movements, which is why they're symptoms of hyperthyroidism.

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Sometimes you stub a toe or work out too hard—that kind of pain can be explained away. But if you have mysterious or sudden tingling or numbness—or actual pain—in your arms, legs, feet, or hands, that could be a sign of hypothyroidism. Over time, producing too little thyroid hormone can damage the nerves that send signals from your brain and spinal cord throughout your body. The result is those "unexplained" tingles and twinges.

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Feeling cold or having chills is associated with hypothyroidism. The system slow-down caused by an underactive thyroid means less energy is being burned by cells. Less energy equals less heat.

On the other hand, an overactive thyroid puts energy-producing cells into overdrive. That's why people with hyperthyroidism sometimes feel too warm or sweat profusely.

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A change in your voice or a lump in your throat could be a sign of a thyroid disorder. One way to check is to take a good look at your neck to see if you can detect any signs of thyroid swelling. You can do a physical check of your own thyroid at home with these directions from The American Association of Clinical Endocrinologists:

Using a hand mirror, watch your throat as you swallow a drink of water. You're looking for any bulges or protrusions in the thyroid area, which is below your Adam's apple but above your collarbones. You may want to try this several times to get a hang of where your thyroid really is. If you see anything that's lumpy or suspicious, see your doctor.

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Going up a few dress sizes can be caused by so many things that it's unlikely your doctor will look at weight gain alone as a potential thyroid disorder symptom. However, weight gain is one of the top reasons women show up in Dr. Miller’s office for a thyroid checkup. “They’ll tell me that they aren’t eating any more than usual, but they’re gaining weight,” she says. “They are exercising, but they are getting nowhere. They can’t lose it.” It’s almost always due to an underactive thyroid, she says.

On the other end of the scale, a sudden weight loss can signal hyperthyroidism.

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If you have one or more of these symptoms and suspect it's your thyroid, see your doctor and ask for a thyroid stimulating hormone (TSH) test, Free T3, and Free T4 tests, says Dr. Miller. Based on test results, your symptoms, and your physical exam, you may be prescribed synthetic hormones. Testing and treating a thyroid disorder takes a bit of trial-and-error so expect to visit the doctor a few times before the dosage is right.

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Expect to have to be your own advocate when it comes to your thyroid. Some doctors may be resistant to a thyroid diagnosis, although the American Associated of Clinical Endocrinologists narrowed the TSH range for acceptable thyroid function from 0.5-5.0 to 0.3-3.04 in 2003. That means more women fall into a range that can be treated. “Find a doctor who treats the person, not just the lab tests,” says Dr. Miller. “If you’re feeling better at a certain dosage—that should carry just as much weight as the lab results.”

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