9 Subtle Symptoms That Could Be Early Signs of Thyroid Problems

Thyroid imbalance is common. But it can be hard to recognize. Many of the signs are subtle, like changes in weight or mood. And you might experience these signs even if your thyroid is healthy. 

Here, we discuss the most common thyroid issues, factors that increase your risk for thyroid problems, and how to recognize early symptoms.

What are the different types of thyroid issues?

The thyroid is a gland located in the front of the neck. It’s shaped like a butterfly. It releases hormones to regulate digestion, energy, temperature regulation, and other bodily functions, like growth and development. 

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When your thyroid isn’t working properly, it may release too much or too little of a hormone. And this can impact your health in different ways. 

The main types of thyroid issues include:

• Hyperthyroidism: This is when the thyroid gland produces too much thyroid hormone. Grave’s disease is an autoimmune condition that causes hyperthyroidism.

• Hypothyroidism: This is when the thyroid gland doesn’t produce enough thyroid hormone. The number one cause of hypothyroidism in the U.S. is an autoimmune condition known as Hashimoto’s thyroiditis.

• Thyroid nodules: Small lumps may be found on the thyroid gland by feeling it. Or nodules can be found accidentally — when you get other imaging tests done that include your thyroid, for example. Most often, thyroid nodules are harmless (benign). 

• Thyroid cancer: Tumors in the thyroid may be benign or they may be something more serious, like cancer.

• Goiter: Enlargement of the thyroid gland is referred to as a goiter. It can happen for a number of reasons, like iodine deficiency.

Early warning signs of thyroid problems

Early warning signs of thyroid problems can be subtle. But there are certain things that you can look for if you’re wondering about your thyroid health.

1. Weight changes 

The thyroid gland plays a role in metabolism. So, unintended weight gain and weight loss can be a sign that the thyroid isn’t working like it should. 

It’s important to keep in mind that the thyroid gland is only one piece of a complex process that happens in the body when it comes to metabolism and weight. 

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2. Overactive thyroid weight changes

An overactive thyroid often leads to weight loss. That’s because the production of too much thyroid hormone can put your metabolism in overdrive. 

Excess thyroid hormone can also increase your appetite, so you may end up eating more. In this case, you may maintain your weight. Or it’s possible you may even gain weight, even though your metabolism is working faster.

3. Underactive thyroid weight changes

An underactive thyroid often leads to weight gain. Too little thyroid hormone can slow down your metabolism. Your body will conserve energy, and you won’t burn as many calories. And, even if your appetite is decreased, which is common in hypothyroidism, you may still find yourself gaining weight.

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4. Fatigue 

Your thyroid plays an important role in your day-to-day energy levels. 

For example, when your thyroid gland is overactive, it can lead to extra or nervous energy. It also causes you to burn a lot of energy, which can leave you feeling exhausted. 

If your thyroid gland is underactive, you may feel more tired than usual. And, of course, changes in appetite and weight can also contribute to fatigue.

5. Mood changes 

Changes in thyroid hormone levels can cause changes in your mood. It’s not exactly clear why this is, but researchers believe it’s related to how certain thyroid hormones affect other chemicals in the brain, like serotonin.

If your thyroid is producing too much or too little of certain hormones, you may experience increased feelings of:

• Depression

• Anxiety

• Irritability

• Restlessness

• Agitation

In addition to mood changes, thyroid problems may cause you to feel like your head is in the clouds or you have brain fog. And this may interfere with concentration or cause confusion.

6. Hair loss 

The thyroid produces hormones that help hair follicles grow. So, a change in these hormone levels can cause your hair to thin or fall out. 

This symptom can happen anywhere on the body — like the eyebrows, for example — rather than only on your scalp. You may notice:

• Bald patches on your head or body 

• Your hair starting to look dull or feel brittle

• More strands getting caught in the brush when you brush your hair

Studies show that there’s a chance that thyroid problems could lead to changes in hair color, specifically early graying. Taking thyroid hormone may cause gray or white hair to darken.

7. Irregularities in menstrual cycle 

Your thyroid regulates hormones involved in menstruation and ovulation, including estrogen, progesterone, and prolactin.

Too much or too little of these hormones may cause you to experience:

• Increased or decreased bleeding 

• Periods that last fewer or more days than they typically do

• Less frequent or missed periods

• Difficulty getting pregnant

Thyroid problems have also been linked with an increased risk of miscarriage. But researchers aren’t sure exactly why this is. So, if you’re struggling to get pregnant and/or have a history of miscarriage, your obstetrician will likely check your blood work to see if an underlying thyroid issue may be contributing. 

8. Heart problems 

How your heart functions is affected by the thyroid and the hormones that it produces. This includes how often your heart beats, how easily it expands and contracts, and how much blood it pumps.

Thyroid changes may cause you to experience:

• A feeling like your heart is racing

• Dizziness

• High blood pressure (Thyroid changes can affect the top or bottom number.)

• Increased cholesterol

Untreated high cholesterol and blood pressure increase the chances of heart attack and stroke. This risk is higher if your thyroid condition is also untreated and if you already have an existing heart disease.

9. Skin changes and sweating

Too much or too little thyroid hormone can also affect your skin. Things to look for include:

• Deep cracks in your skin

• Skin that feels scaly, like a snake

• Skin that peels off

• Skin that looks darker or discolored

• The palms of your hands and/or soles of your feet look yellow or orange

• Darker skin in your mouth and/or on your gums

You may also notice that you’re sweating more or less than usual.

What are the risk factors for thyroid problems?

Certain factors play a role in the likelihood of developing thyroid problems.

Sex

People with a female reproductive system are more likely to develop thyroid conditions. Scientists think it may be related to having higher levels of two hormones, estrogen and progesterone. It may also have to do with changes in hormones that occur during and after pregnancy. 

Age

While thyroid disease can affect people of all ages, certain kinds of thyroid problems are seen more commonly at specific points in a person’s lifetime. For instance, hyperthyroidism typically happens between the ages of 20 to 40 years old. Hypothyroidism, on the other hand, is generally seen in people aged 50 years or older.

Family history

Your risk of thyroid disease increases if a close family member — like your parent, child, or sibling — has thyroid disease. Studies suggest that genetics affect up to two-thirds of the amount of thyroid hormone found in a person’s body. And scientists have discovered a link between certain genes and thyroid problems. 

Genetic testing is available for a type of thyroid cancer known as medullary thyroid cancer. But, it’s important to keep in mind that most cases (75%) of this cancer aren’t passed down by other family members. So, having a family history of thyroid problems doesn’t guarantee that you will, too.

Autoimmune conditions

Two types of autoimmune conditions — Hashimoto’s thyroiditis and Grave’s disease — affect the thyroid. In both, the immune system attacks the thyroid gland, causing it to produce too little or too much thyroid hormone. 

In other cases, the immune system attacks the thyroid gland and leads to inflammation of the thyroid (thyroiditis). 

There are a few types of thyroiditis:

• Postpartum thyroiditis: This typically causes symptoms of hyperthyroidism about 1 to 4 months after a person gives birth. Postpartum thyroiditis can then lead to hypothyroidism. Most of the time, it will go away on its own. Other times, it causes longer-lasting hypothyroidism.

• Painless thyroiditis: Painless thyroiditis is just like postpartum thyroiditis but can affect anyone at any time. 

• Subacute thyroiditis: This usually causes pain in your thyroid that can last a few weeks to months. Subacute thyroiditis can also cause fever, muscle aches, and tiredness. Like postpartum thyroiditis, it usually causes hyperthyroidism followed by hypothyroidism before going away.

• Riedel thyroiditis: Riedel thyroiditis is a rare inflammatory condition in which scar tissue replaces healthy tissue in your thyroid, interfering with its normal function.

People with other autoimmune conditions — like lupus, rheumatoid arthritis, and Type 2 diabetes — may have a higher chance of developing thyroid problems. In most cases, it’s not exactly clear why that is. 

Radiation exposure

Large doses of radiation have been linked to an increased risk of thyroid cancer. And, when we say “large doses,” we mean like the kind that happened during the nuclear explosion at Chernobyl. The data around exposure from things like routine dental X-rays isn’t as clear. One study found no connection. Others show a risk if X-rays were done before 1970. But the key takeaway is that the dose of radiation needs to be large to increase your risk. 

That means going to the dentist once every 6 months for X-rays or yearly for a mammogram shouldn’t increase your odds — especially with newer technology that decreases the total exposure to radiation. 

Certain medications 

Some medicines may cause an inactive or overactive thyroid. They interfere with minerals or hormones that the thyroid relies on to function properly. Examples include:

• Amiodarone: This is a heart medication that treats irregular heartbeat. Amiodarone contains a large amount of iodine, a mineral that the body uses to produce thyroid hormones. Too much iodine can interfere with this process.

• Interleukin-2: This medication, which treats certain cancers, like leukemia, has been linked to hypothyroidism.

• Interferon-alpha: This is also used to treat cancers and viral infections, like hepatitis C. Taking interferon-alpha increases the risk of thyroiditis. 

When should you see a doctor for thyroid screening?

If you’re otherwise healthy and you aren’t experiencing any of the above symptoms, it’s unlikely that you have any thyroid problems. And routine thyroid screening isn’t recommended.

But, if you develop one or more of the symptoms described in this article, talk to your primary care provider. It’s especially important to seek professional guidance if you have risk factors that increase the chances that you’ll develop thyroid disease. 

If you do need screening, it usually starts with blood work.

Why trust our experts?

Written by:

Cherilyn Davis, MD

Cherilyn Davis, MD, is a board-certified pediatrician in New York City. She has held local and national roles at the American Medical Women’s Association including board member of the physician division and physician chair of social media.

Edited by:

Katie E. Golden, MD

Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

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