Symptoms of Hypothyroidism
Hypothyroidism presents with a constellation of symptoms primarily resulting from decreased metabolic rate, including fatigue, weight gain, cold intolerance, constipation, dry skin, and cognitive issues. 1, 2
Common Symptoms
Metabolic and General Symptoms
- Fatigue and lethargy (affecting 68-83% of patients) due to decreased metabolic rate 1, 2
- Weight gain and difficulty losing weight (affecting 24-59% of patients) 1, 2
- Cold intolerance (increased sensitivity to cold) 3, 4
- Somnolence (excessive sleepiness) 1
Dermatologic Symptoms
- Dry skin (xeroderma) 1, 5
- Hair loss 1
- Myxedema (non-pitting edema/swelling) 1
- Coarse skin 6
- Periorbital puffiness 6
Gastrointestinal Symptoms
Cardiovascular Symptoms
- Bradycardia (slow heart rate) 1
- Mild hypertension (often diastolic) 1
- Narrowed pulse pressure 1
- Pericardial effusions (in severe cases) 1
Neurological and Cognitive Symptoms
- Intellectual slowness 1
- Depression 1
- Memory loss and difficulty concentrating (affecting 45-48% of patients) 2
- Delayed ankle reflex 6
- Slow movement 6
Musculoskeletal Symptoms
Reproductive Symptoms
- Menstrual irregularities (affecting approximately 23% of patients) including oligomenorrhea and menorrhagia 2
- Disrupted ovulation 2
- Infertility 2
- Increased risk of miscarriage 2
Voice Changes
Laboratory Findings
Severe Complications
- Heart failure 1, 2
- Myxedema coma - a life-threatening condition characterized by hypothermia, hypotension, and altered mental status (mortality rate up to 30%) 2, 5
- Insulin resistance and hyperglycemia in patients with diabetes 2
- Increased risk for cardiovascular events 2
Special Considerations
- Symptoms may be nonspecific and subtle, especially early in the disease 3
- Clinical presentation can differ with age and sex 4
- Symptoms are often the result of a low metabolic rate in the body 5
- If left untreated in infants, hypothyroidism can lead to mental retardation and delayed developmental milestones 5
It's important to note that the diagnosis of hypothyroidism is based on biochemical testing rather than symptoms alone, as many symptoms are nonspecific and can overlap with other conditions 3, 5.