On a hypothyroidism symptoms checklist, you may expect to see:

  • Fatigue
  • Weight gain
  • Higher sensitivity to the cold
  • Hair loss
  • Constipation
  • Bloating, especially in the face
  • Weakness
  • Dry skin
  • A sore or hoarse throat
  • Mood changes
  • Brain fog

Hypothyroidism is a condition in which the thyroid gland cannot produce a sufficient volume of thyroid hormone. Thyroid hormones are responsible for metabolic processes in the body.

Metabolic processes refer to the chemical reactions that determine the speed at which cell functions can occur.

Thyroid hormones affect every cell in the body which is why you are likely to experience signs and symptoms that affect your overall health as opposed to one set of localized symptoms.

Let’s take a look at the hypothyroidism symptoms checklist, and what you should do if you are experiencing the symptoms of an underactive thyroid on a regular basis.

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Hypothyroidism Symptoms Checklist

In cases of hypothyroidism, those who are living with the condition are likely to experience fatigue, they will feel cold, and tired all of the time. It is likely that they will have dry skin and hair, as well as constipation.

As the metabolism slows down, the function of the intestines slows down. It is also likely that those living with an underactive thyroid will experience depressive or anxious tendencies.


Fatigue and feeling weak or drained is common in those who have an underactive thyroid as low levels of thyroid hormones such as thyroxine and triiodothyronine lead to a slow down in cell function, also known as the metabolic rate.

It is very common for those with an underactive thyroid to suffer from feelings of fatigue and weakness. There are chemical processes at play when it comes to understanding why hypothyroidism may cause fatigue.

The thyroid gland controls the rate at which thyroid hormones are released into the blood and circulate around the body.

If you have hypothyroidism or an underactive thyroid, chemical reactions in the body will slow down in response to the insufficient volume of thyroid hormones being produced and circulated in the body.

A slow down in these chemical reactions, also known as your metabolism may impact your physical and emotional state.

When it comes to energy levels and fatigue, it’s important to know that your thyroid gland has a significant say in your overall vitality.

When the metabolic processes in your cells slow down, you slow down. Decreased thyroid function commonly results in a lower mood, energy levels and fatigue.

In one study that looks at the connection between Chronic Fatigue Syndrome (CFS), thyroid issues, physical inflammation, gut health and overall nutrition, it was found that the majority of those who suffer from CFS have low levels of T3. T3 is the active thyroid hormone which is circulated throughout the body, whereas T4 is the inactive form called thyroxine.


The function of the thyroid gland is to produce thyroid hormones. These hormones impact every cell, every tissue and every organ in the body, controlling the rate of metabolism, and controlling the rate of hormone production. The thyroid gland is responsible for ensuring that all tissues are bathed in the correct amount of thyroid hormones for optimal function.

Weight gain

Hypothyroidism may lead to weight gain as the metabolism slows down, weight gain via an underactive thyroid may also be caused by water retention due to changes in water salt balance in the body.

Thyroid hormones regulate the basal metabolic rate. The basal metabolic rate refers to the amount of energy per unit of time that a person requires to function while resting.

Calories may also be described as energy. Your energy balance refers to your consumption of calories versus the amount of energy you expend through physical movement and other essential processes.

If you have an underactive thyroid, your required calorie intake may lower as fewer calories are being expended as energy. Your appetite may also decline as your body converts fewer calories into energy, it is more likely that you will not burn off excess calories, and will store excess weight as fat leading to overall weight gain.

To explain this process, it may be useful to explain what it means to gain and lose weight from a calorie in and out perspective.

When you eat and drink, you consume calories. When you move your body, you expend energy, also known as calories.

Each and everyday, we burn a certain number of calories just by being alive, it might surprise you to know that even while you sleep, you burn calories at an average rate of 46 calories per hour.

To simplify the above:

  • Calories In = Energy Out = Weight Maintenance
  • Calories In > Energy Out = Weight Gain
  • Calories in < Energy Out = Weight Loss


If you have an underactive thyroid, it means that your thyroid gland is not producing a sufficient volume of thyroid hormones, your metabolism may slow down, meaning that the chemical reactions that maintain fat burning processes also slow down. This is compounded by the fact that you may also suffer from fatigue, low energy and low mood.

As Dr. Dominic Rowley explains in a previous interview, thyroxine acts on every cell in the body, which is why it is known as the powerhouse of all cell functions, if you have a low mood and low energy, this can also lead to a cycle of comfort eating which may become a cycle in itself in causing weight gain.

It is important to remember that no more than 10-20 pounds of weight-gain may be attributed to thyroid issues. If you are worried about weight-gain associated with your thyroid function, you should ask your doctor for tips on how you can balance your levels.

Dr. Dominic Rowley Explains Some Reasonings Behind Unexplained Weight Gain

Higher Sensitivity To The Cold

An underactive thyroid may increase a person's sensitivity to the cold while an overactive thyroid may cause an individual to feel too hot.

Thyroid hormones affect the amount of heat the body produces. Individuals with hypothyroidism will produce less heat than those with hyperthyroidism.

Thyroid hormones also have the ability to influence how much our blood vessels dilate or constrict.In hypothyroidism, the blood vessels tend to constrict or narrow due to a lack of thyroid hormone, and less oxygen can reach tissues in the body. This can result in cold peripheries like the hands and feet. On a bigger scale, the reduction in thyroid hormone levels and the change in blood flow and blood vessel narrowing can have an effect on the heart and its ability to contract.

If you notice that you feel cold at warm temperature or colder again when you're outside, you should talk to your doctor about this symptom as it is prominent in cases of hypothyroidism.


Hair Loss

Generally, hair passes through three stages of growth known as the hair cycle, and hair follicles grow and are replenished through this. Hair follicles are dependant on thyroid hormones to ensure hair growth takes place at a normal rate.

Hair loss can occur in instances of an under or overactive thyroid. When hair loss does occur, it generally affects the entire scalp as opposed to patches. Hair loss usually becomes apparent following several months of living with the condition. Oftentimes the treatment of hypothyroidism or hyperthyroidism using anti-thyroid drugs is blamed as the culprit for hair becoming thin or falling out. However, the use of anti-thyroid drugs is rarely to blame and the withdrawal of treatment can cause hair loss issues to worsen.

Dr. John Morris explains: "Hair loss can happen with many illnesses, including the flu. Subsequent to thyroid issues, hair follicles may stop growing. The scientific answer for why it occurs is varied. With a hypo or hyper thyroid, the hair can enter a cycle where it falls out and grows back in."

Solutions For Hypothyroidism-Related Hair Loss

  • Don't panic, hair loss associated with thyroid issues is temporary.
  • Be patient, regrowth of hair may take some time but know that the anti-thyroid medication will stimulate your hair to grow.
  • Be wary of certain hair supplements as many of them contain iodine and will tamper with the function of your medication.
  • Know that each case is different, each instance of hypothyroidism is unique, always follow the personalized guidelines set for you by a qualified medical practitioner.
  • Try not to stress, believe that your treatment plan will work and that is half the battle, you are not alone.


Hypothyroidism may cause constipation due to the slow-down in metabolic processes.

Constipation is a common symptom of an underactive thyroid and it is related back to slowed metabolism. In the absence of sufficient thyroid hormones circulating in the blood, a number of physiological functions may slow down.

Constipation may occur when the digestion becomes sluggish. Contractions of the intestine may also be slowed leading to constipation and a change in bowel movements.

Bloating, especially in the face

Hypothyroidism can cause bloating and this is due to water retention. Water retention happens when there is a change in water-salt balance in the body.

Bloating, especially in the face may occur in instances of hypothyroidism related to autoimmune disease. Studies have shown this may be due to the presence of an increased amount of hyaluronic acid in the skin, which can hold a large amount of water and swell. This may present as a bloated face, puffiness under the eyes, and swollen ankles.

Dry Skin

Hypothyroidism may be characterized by dry skin due to the slowdown in skin cell turnover, therefore an underactive thyroid or a slowdown in thyroid hormone production may affect the ability of hair follicles and skin cells to grow.

If you are living with an underactive thyroid, skin may take longer to repair, restore and replenish which will lead to the build up of old skin cells. It may also take longer for these skin cells to shed.

A sore or hoarse throat

Hypothyroidism may cause a sore throat or hoarseness if the thyroid becomes enlarged. This is often referred to as goiter.

An enlarged thyroid may present itself with a sore or hoarse throat, making it painful to speak or swallow.

The thyroid may become enlarged if you are suffering from Grave’s disease which is one of the causes of an overactive thyroid, also known as hyperthyroidism. Graves disease is an autoimmune disease, where the immune system attacks the thyroid.

Mood Changes

Hypothyroidism may lead to mood changes such as depression and/or anxiety. An underactive thyroid is more likely to lead to feeling low in mood.

Mood and emotions: it is critical for the brain to have the correct amount of thyroid hormones to manage mood, as can be seen by the high prevalence of anxiety in those who have hyperthyroidism and the incidence of depression in those who have hypothyroidism.

Feeling down or depressed may arise as a side effect of hypothyroidism, however mood changes related to hypothyroidism are often misunderstood and there is little known about why hypothyroidism may cause mood changes. It is well documented that a large number of those who are living with hypothyroidism may experience mood changes.

Brain Fog

Hypothyroidism may lead to brain fog or mental fogginess which may present as difficulty remembering and concentrating. The reason for brain fog in the instance of hypothyroidism is that the brain requires certain levels of thyroid hormones to function correctly.


If you suspect that you are living with hypothyroidism, you should consider getting screened as soon as possible to avoid thyroid damage, as well as the development of day to day symptoms becoming increasingly unpleasant.

If you are thinking about getting screened, aim to take a test that measures thyroid antibodies. Tests that measure thyroid hormones as well as thyroid antibodies will be able to offer more insight into thyroid damage that has already occurred.

You can get checked from home with LetsGetChecked or make an appointment with your physician. Either way, it’s always good to know your baseline hormones and antibodies, especially if you are experiencing any of the elements that appear on the hypothyroidism symptoms checklist.

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Written by Hannah Kingston | Medically Reviewed by Dr. Susan O’ Sullivan