The functions of thyroid hormones include modulation of carbohydrate, protein and fat metabolism, vitamin utilization, mitochondrial function, digestive process, muscle and nerve activity, blood flow, oxygen utilization, hormone secretion and sexual and reproductive health to mention some. Thus, when the thyroid hormone content gets out of balance, systems covering the whole body are affected, and that's why hypothyroidism can look like other diseases. Conversely, sometimes other conditions can be mistaken for hypothyroidism.
Adults
In adults, hypothyroidism is associated with the following symptoms:Early symptoms
- Fatigue (physical)
- Cold intolerance, increased sensitivity to cold
- Constipation
- Weight gain
- Depression (especially in the elderly)
- Muscle cramps and joint pain
- Thin, Brittle fingernails
- Thin, brittle hair
- Paleness
Late symptoms
- Slowed speech and a hoarse, breaking voice. Deepening of the voice can also be noticed.
- Dry puffy skin, especially on the face
- Thinning of the outer third of the eyebrows
- Abnormal menstrual cycles (Specifically Menorrhagia)
More severe symptoms
- Heat intolerance, increased sensitivity to heat
- Impaired memory
- Impaired cognitive function (brain fog) and inattentiveness
- Urticaria (hives)
- Migraine headaches
- A slow heart rate with ECG changes including low voltage signals. Diminished cardiac output and decreased contractility.
- Reactive(or post-prandial) hypoglycemia[8]
- Pericardial effusions may occur.
- Pleural effusion may occur.
- Sluggish reflexes
- hair loss
- very low blood pressure
- Anemia caused by impaired hemoglobin synthesis (decreased EPO levels), impaired intestinal iron and folate absorption or B12 deficiency from pernicious anemia
- anxiety/panic attacks
- difficulty swallowing
- syncope (passing out)
- dizziness
- Shortness of breath with a shallow and slow respiratory pattern.
- Impaired ventilatory responses to hypercapnia and hypoxia.
- Increased need for sleep
- Osteopenia or Osteoporosis
- Irritability and mood instability
- Yellowing of the skin due to impaired conversion of beta-carotene to vitamin A
- Impaired renal function with decreased GFR.
- Thin, fragile or absent cuticles
- Elevated serum cholesterol
- Acute psychosis (myxedema madness) is a rare presentation of hypothyroidism
- Decreased libido
- Myxedema coma (thyroid comna)
- Decreased sense of taste and smell (late, less common symptoms)
- Puffy face, hands and feet (late, less common symptoms)
Pediatric
Hypothyroidism in pediatric patients can cause the following additional symptoms:- short stature
- mental retardation if present at birth, and untreated.
