Hurtful misconceptions about thyroid disease still perpetuate, as some believe it’s “not that bad,” only affects the thyroid or can always be easily “fixed” with medication. Others may simply be unaware of the different types of thyroid disease and all the symptoms and side effects thyroid conditions can cause. In fact, it’s estimated that up to 60 percent of people with thyroid disease don’t realize they have it. That’s why it’s so important to raise awareness and promote better understanding of the many ways thyroid disease can manifest.
The thyroid is a small, butterfly-shaped gland in the lower neck. As part of the endocrine system, it produces hormones that help regulate metabolism and autonomic bodily functions, affecting every tissue, organ and system in the human body. Any dysfunction of the thyroid gland falls under the umbrella of thyroid disease.
Hypothyroidism (underactive thyroid disease) occurs when the thyroid doesn’t produce enough thyroid hormone. This slows the body’s processes and metabolism, resulting in symptoms such as weight gain, depression and fatigue. Causes of hypothyroidism may include Hashimoto’s thyroiditis (an autoimmune condition), medications, radiation therapy or thyroid surgery.
Hyperthyroidism (overactive thyroid disease) occurs when the thyroid produces too much thyroid hormone. This accelerates the body’s metabolism, causing symptoms such as increased heart rate, weight loss and tremors. Hyperthyroidism has several possible causes, including Graves’ disease (an autoimmune condition), hyperfunctioning thyroid nodules and thyroiditis.
Thyroid nodules are small lumps that form in your thyroid. The majority are not serious and do not cause any symptoms. Some can become large enough to cause symptoms such as difficulty breathing or swallowing, while others may secrete extra hormones, causing symptoms of hyperthyroidism.
Goiter is the abnormal enlargement of your thyroid gland. It can occur for a number of reasons, including hypothyroidism, hyperthyroidism, nodule growth, thyroid cancer, pregnancy or inflammation.
There are several types of thyroid cancer, though it is considered relatively rare. Thyroid cancer can cause changes to your voice, difficulty swallowing, pain in your neck and throat, and a lump that can be felt on your neck. Most cases can be cured with treatment.
Whatever type of thyroid condition you have, know your symptoms are valid, and there is a community here that understands any struggles you may be facing.
To help raise awareness of some lesser-known thyroid symptoms and remind anyone struggling that they’re not alone, The Mighty teamed up with The National Academy of Hypothyroidism (NAH). We asked our Mighty community and the NAH community to share a surprising symptom of thyroid disease and what it’s like to experience it.
Here’s what our communities shared with us:
1. Throat Tightness
Thyroid disease can cause feelings of tightness or discomfort in the throat for several reasons. Different types of thyroiditis (inflammation of the thyroid gland) may cause pain or swelling in the gland, depending on the presentation of the specific condition.
Goiter, or abnormal enlargement of the thyroid gland, is known to cause throat tightness as well as cough, difficulty breathing or swallowing, hoarseness and swelling in the front of the throat or neck. Goiters can be caused by a few different factors, including Hashimoto’s thyroiditis (hypothyroidism) and Graves’ disease (hyperthyroidism).
Tightness and pain around my thyroid when I’m exercising, upset or stressed. It makes it hard to breathe and difficult to swallow. It also makes my voice sound strained when I’m talking to people. Although I now know this is a symptom of thyroid disease caused by inflammation, it didn’t come up at all when I first started doing research on thyroid disease. – Jessica M.
Tightness in throat quite frequently (not sore just tight, like I’m being strangled. It’s an awful feeling)! – Victoria B.
2. Hair Loss
People with prolonged and severe hypothyroidism or hyperthyroidism may experience hair loss that typically occurs evenly across the entire scalp. Much of the hair may grow back with proper treatment of the disease. It’s also possible to experience hair loss as the result of taking medications to treat your thyroid disease, though this is rare.
Little or no eyebrows when hypothyroid. – Theresa H.
Excessive hair loss. – Stephanie L.
3. Anxiety/Panic Attacks
Anxiety can be a symptom of thyroid disease, particularly hyperthyroidism. The thyroid gland is responsible for producing T3 and T4 hormones, which help regulate many of the body’s automatic functions, such as heart rate and digestion. When the thyroid is overactive, it can cause symptoms such as increased heart rate, high blood pressure, heart palpitations, insomnia and reduced appetite – which are also common symptoms of anxiety. If you’re experiencing these symptoms, it’s important to talk to your doctor to determine their root cause.
Anxiety. I have been told it will go away when my levels are right. They haven’t been right in three years. I’ve panicked driving over a bridge so bad, I didn’t know if I was going to be able to drive all the way across. It was terrifying and embarrassing. – Kelly S.
Panic attacks! Before I was diagnosed they would just come from nowhere. I honestly thought I was going to die or that something was really wrong with me. I still suffer with anxiety now, especially around the time of menstruation. I can feel my hormones changing. – Diane B.
Fatigue is one of the most common symptoms associated with hypothyroidism – and it involves a lot more than feeling “a bit tired.” Fatigue is sleep that doesn’t make you feel refreshed when you wake up. You won’t feel better even with 10 or more hours of sleep because you’re not getting deep sleep. This can make it difficult to do everyday activities because you don’t have the energy.
The bone crushing fatigue. I know fatigue is one of the first listed symptoms, but I never knew how severe it could get until I experienced it myself. That it was possible to fall asleep while walking to college. That I could regularly fall asleep mid sentence while talking. How it became impossible to stay awake through lectures. The tiredness scared me, it was so demanding. Still it took another two years after this to get diagnosed, kept being told I was depressed, and that was making me tired. – Heike K.
5. Frozen Shoulder
Frozen shoulder, or adhesive capsulitis, refers to pain and stiffness in the shoulder area. It occurs when the connective tissue that surrounds the bones, ligaments and tendons of the shoulder joint thickens and becomes inflamed, ultimately causing it to contract and create scar tissue. Though the reason is unclear, a link has been found between endocrine conditions such as thyroid disease and musculoskeletal disorders such as frozen shoulder.
Frozen shoulder, so painful… – Kathy S.
Gall stones, joint pain, frozen shoulder, migraines and palpitations. – Sandy L.
6. Brain Fog
People with thyroid disorders may experience cognitive dysfunction, commonly referred to as “brain fog.” This can include difficulties with concentration, lack of focus or mental alertness, and lapses in short-term memory. Brain fog may affect your ability to think, remember and communicate verbally.
Brain fog is a big one for me. I can forget the most basic things some days. – Heather C.
Memory. My short-term memory is awful. I can have a conversation and five minutes later totally forget what we said. – Rebecca D.
7. Persistent Cough
Frequent coughing and feeling like you need to clear your throat can be symptoms of thyroid nodules or lumps in the thyroid gland. Coughing usually occurs if the nodules are on the backside of the gland, where they can irritate the trachea or vocal cord nerve. Thyroid nodules can also cause uncomfortable pressure on your breathing tube, the sensation that you need to swallow something, difficulty swallowing, or a lump in your neck that you can see or feel. Only about 30 percent of thyroid nodules cause symptoms such as coughing.
Some studies have also found a link between respiratory issues, including coughing, and hypothyroidism, but more research is needed.
I had a chronic cough that wouldn’t go away for years. Six doctors couldn’t diagnose it. It finally went away when I started taking thyroid medication for hypothyroidism. I guess my thyroid was slightly swollen and made me cough constantly, like a smokers’ cough, even though I have never smoked a day in my life. – Liberty W.
8. Facial Flushing
Thyroid disease can affect just about any part of the body – including the skin. People with hyperthyroidism may experience increased blood flow and blood vessel widening in their extremities, which can cause the face to flush and the palms to turn red (also called palmar erythema). On the other hand, people with hypothyroidism may experience the opposite and have skin that is dry, cold or pale due to a decrease in blood flow.
Hot flashes at odd times, having to layer all the time to have appropriate clothing no matter what, flushing beet red during any exercise as well as sweating buckets with exertion. – Julbug83
Oh flushing! Always at night. My cheeks and nose turn red and my face gets super hot. Weird. – Stefanie R.G.
9. Heart Problems
Since the T3 and T4 hormones produced by the thyroid gland help regulate automatic bodily function such as heart rate, too much or too little of these hormones can result in heart problems. Hypothyroidism can cause a decreased heart rate, increased blood pressure and elevated cholesterol levels. Hyperthyroidism can cause an increased heart rate (which may trigger abnormal heart rhythms such as atrial fibrillation or palpitations), increased blood pressure, chest pain or angina.
Heart palpitations! Very scary!! I thankfully do not have them anymore… because of my amazing doctor. – Terry B.
With my hypothyroidism, cardiac symptoms like palpitations and tachycardia I had no idea about. Until blood tests revealed it was my thyroid playing up again. – Tasha L.
10. Hoarse Voice
According to The National Academy of Hypothyroidism, “any sort of thyroidal disruption can influence speech, ability to breath, and even swallowing.” Thyroid hormones have a big impact on the voice, and a consistently hoarse voice can be indicative of hypothyroidism. This occurs because the deficiency of thyroid hormones interferes with the development of the larynx, or voice box, which can impair vocal quality.
Thyroid nodules and goiters can also cause hoarseness or loss of your voice if they expand enough to compress the larynx and alter your speech.
Nearly every medical professional I see comments on how hoarse and raspy my voice is. I’ve had multiple doctors try and diagnose me with laryngitis or give me a strep test when I feel absolutely fine, I just sound like a man. It’s hard to explain to friends and family this is just how I’ve always sounded. – ckhill
A raspy voice. I have cysts on my thyroid and my voice constantly cracks and quivers. Sometimes I’ll be in the middle of a sentence and my voice becomes high pitched, hoarse or I’ll have trouble getting the words out. Other times people can’t understand what I’m saying because of my voice quivering or being so hoarse. No amount of water or tea can fix it. – ella66
11. Skin Issues
Thyroid disease can cause a wide range of skin issues, which can serve as visible indicators that your thyroid levels aren’t quite right. People with hypothyroidism tend to have dry, pale and cool skin that may be flaky and itchy. Some may experience myxedema, a severe form of hypothyroidism that typically occurs when the condition is left untreated. Myxedema often causes the skin to become red, swollen and puffy. Hypothyroidism is also one cause of acanthosis nigricans, a skin condition that causes velvety, dark markings in the folds of the skin.
Hyperthyroidism, on the other hand, may cause your skin to feel moist, velvety and warm, and your face and palms might be redder due to flushing. An overactive thyroid can also lead to skin thinning. People with Graves’ disease may develop Graves’ dermopathy, which causes redness and swelling, often on the shins and feet.
Rash on my chest and neck, itchy skin (skin changes), ringing in my ears, vertigo, puffy eyes… – Stefanie R.G.
Dry cracked feet that hurt to walk on after a day of standing on my feet. Thick callous on the balls of my feet. Dry flaking skin on my legs. – Denise B.
Acute, painful skin rash. – Marissa L.
12. Mood Swings
Both hypothyroidism and hyperthyroidism can cause mood changes due to fluctuations in your hormone levels. Those with hypothyroidism may be prone to depression, low mood and anxiety, while those with hyperthyroidism may experience anxiety, restlessness and irritability.
I have Hashimoto’s and bipolar disorder. I have struggled with the fact that my fluctuating TSH levels affect my moods independent of my mood disorder! It is always surprising when doctors aren’t familiar with this symptom. – Laura O.
13. Fertility Issues
Thyroid disease can affect fertility in both men and women. Hyperthyroidism can cause women to experience lighter, irregular periods and may result in a reduced sperm count for men. If your hyperthyroidism is not well managed, this can also increase the risk of miscarriage in the early stages of pregnancy. Women with hypothyroidism may have longer and heavier periods or their periods may stop completely. It is important to tell your doctor if you become pregnant, as your medication dosages may need to be adjusted.
I was shocked to learn that my three miscarriages could very well have been due to my thyroid disease! – Donna-Jean I.
Infertility, took five years and hardcore dieting and exercise in 2018 to get to a weight that my [medication] dosage actually worked enough to get my hormones level enough to get pregnant. – Kellie W.
Peripheral neuropathy refers to symptoms of muscle weakness, numbness, pain or tingling that occur due to nerve damage – often in the hands and feet. A number of conditions can cause nerve damage, including hypothyroidism. An underactive thyroid often lowers your body temperature, which can lead to fluid retention. This results in swollen tissues that put pressure on peripheral nerves, causing an array of symptoms. Carpal tunnel syndrome in the wrist is a common area for people with hypothyroidism to experience peripheral neuropathy.
Leg and arm pain. I get horrible cramp like pain in my forearms especially. That is my first sign I need to go have my levels checked, and likely my thyroid replacement med upped. It’s pain so bad it makes me feel nauseous. Never heard anyone else talk about it. But, it goes away once I get my levels back on track. – Jessi M.
Peripheral neuropathy – my feet kept getting put down to plantar fasciitis, turns out it’s tarsal tunnel syndrome… Kept bringing up my carpal tunnel being worse and now in both arms. That’s been put down to an injury years ago. The injury was on one forearm. Both sides affected. – Rachael D.
Hypothyroidism causes many of your bodily processes to slow down – and this includes digestion. When your thyroid isn’t producing enough hormones, it can’t activate the muscles lining your digestive tract to contract, causing your stool to move too slowly through your system. To alleviate constipation, check out these six tips The National Academy of Hypothyroidism recommends.
Almost died on Mother’s Day 2001 with almost no thyroid hormone in body. I was not eating, hair falling out, constipation but I went to ER after passed out [and] put in hospital because heart was having difficulty pumping blood to head. I think the constipation always reminds me its time for bloodwork!” – chattykathy25
I have bad circulation and constipation, along with the tiredness. – Renee J.
16. Inability to Regulate Temperature
One of the automatic functions the thyroid gland helps regulate is your internal temperature. Your internal temperature can fluctuate when your thyroid is overactive or underactive. Those with hypothyroidism, for instance, may feel cold all the time, even in a warm environment, due to a slower metabolism and lower body temperature. However, it’s important to note that low or high body temperature is not a reliable indicator of thyroid disease. A person can measure at 98.6°F and still be hyperthyroid or hypothyroid.
Difficulty regaining proper body temperature when too cold or overheated. – Victoria H.
My body’s inability to regulate temperature properly. I’m always freezing to the core with temperatures below 50, and feeling like I’m about to pass out (or actually passing out) in the heat. It stops me from doing a lot of activities in the winter and summer because I never know how my body’s going to react to a given temperature. If I travel, I always pack two outfits for each day as a just in case the weather fluctuates 5 degrees. – Lisa W.
I have extreme heat intolerance, even when my extremities might be cold from being hypo. Even at 76°F, if I try to do something like blow dry my hair – I’ll sweat faster than I can dry my hair! Living in a place where there is like four months straight of triple digit heat hasn’t been easy. – Meg B.
17. Muscle Weakness
Muscle weakness can accompany both hypothyroidism and hyperthyroidism, in addition to muscle pain, aching and stiffness (such as with peripheral neuropathy). Some people may experience hypothyroid or hyperthyroid myopathy, a muscle disease involving muscular weakness or wasting. Hyperthyroid myopathy typically affects muscles in the shoulders and hips, but may also involve the face, throat and respiratory muscles. Hypothyroid myopathy also tends to affect shoulder and hip muscles but can additionally cause a slowing of reflexes, muscle stiffness and muscle cramps.
I had a total thyroidectomy in 2010, due to Hashimoto’s causing multiple benign tumors on my thyroid, which caused a goiter. I was surprised to find out it contributed to my muscle weakness. My youngest daughter also has this disease, and in 2017 she was hospitalized for a week when her TSH went up to 390, and I was shocked when they told us this disease had briefly caused her organs to start shutting down during that time. Thankfully she is doing much better now, but there is so much that this disease causes, besides just attacking the thyroid. – Katie D.
Hypothyroidism with severe muscle weakness. Even though I was being treated with T4, I was still incredibly weak. I recently learned about Hoffman’s syndrome. It’s a rare (or so they say) complication of hypothyroidism that causes myopathy (muscular weakness), stiff muscles, etc. Since I started adding T3 to my treatment and my thyroid levels are optimal (rather than just in-range), I have much more strength now. (Read: Now I can brush my hair without needing to rest after). – Liberty W.
18. Eye Pain and Pressure
Thyroid eye disease is an autoimmune condition most commonly associated with hyperthyroidism/Graves’ disease, but it can occur in people with hypothyroidism or normally functioning thyroids as well. Thyroid eye disease can cause “staring” or bulging eyes, dry eyes, watery eyes, red eyes, sensitivity to light, blurred or double vision, pain in or behind the eye, swelling in the upper eyelids, or difficulty moving or closing the eye.
Pressure around eyes and sinuses. – Alan B.
So much pressure behind the eye sockets with Graves’. After a day on my computer at work, I’d drive home feeling like I had ground glass in my eyes. – Susan W.
Terrible acne from hormones not being right starting with thyroid. Eye pain [and] pressure and light sensitivity. – Stephanie L.
People with hypothyroidism and hyperthyroidism have been known to experience symptoms of vertigo, dizziness and lightheadedness. One study found that vertigo affects two-thirds of people with hypothyroidism. Though episodes are usually brief, they can range in severity.
Vertigo! It’s so scary to experience disorienting dizziness out of nowhere and it’s tough never knowing when it will happen or how long it will last. – Jo A.
Depression and low mood are common symptoms of hypothyroidism. You may also experience difficulty enjoying things, tearfulness, loss of appetite and disturbed sleep. Depression may also develop if you are struggling with the emotional challenges of living with thyroid disease.
No one ever mentioned the link between depression and hypothyroidism. I googled it after my psychiatrist asked for my TSH and my T4 Free numbers from my last bloodwork. Even with medication my numbers are in the gutter. – Janet D.
I’m not good at taking my meds regularly and I always spiral into depression when I haven’t taken them for a while. I’m just tired, have a low mood and can’t be arsed to do anything. As soon as I start taking my meds again I feel better. – Malina M.
Studies have shown that thyroid dysfunction and headaches are linked, though it remains unclear whether thyroid disease causes headaches or vice versa. According to the International Headache Society, approximately 30 percent of people with hypothyroidism have headaches.
In addition to the ‘normal’ symptoms – excessive sweating, constant excessive fatigue, uncontrollable increased chronic migraines and tension headaches! – Heather G.
Cluster headaches… directly related to how much medication I’m taking even if my thyroid levels look normal. – Tina S.
22. Poor Wound Healing
Studies have shown that hypothyroidism may be associated with delayed wound healing, while hyperthyroidism may be associated with accelerated wound healing. However, more research is needed to understand the mechanisms involved.
With hypothyroidism, any wounds I get are very slow to heal. – Shonda R.C.
23. Shortness of Breath
Shortness of breath, also known as dyspnea or “air hunger,” can be associated with both hypothyroidism and hyperthyroidism. When the thyroid is underactive, shortness of breath may occur due to dysfunction of the diaphragm, obstruction of the airway, issues with the central nervous system, pleural effusion (fluid build-up) or sleep apnea. People with an overactive thyroid might experience a racing heart, tremors, high blood pressure or palpitations, which can make it difficult to catch your breath.
I have hyperparathyroidism and when my levels go to high or if they affect other levels in my body I get severe shortness of breath. It’s scary at times. I feel like I can’t catch my breath. – Abby B.
To learn more about thyroid disease, check out The National Academy of Hypothyroidism’s website.
If you are struggling with the symptoms or side effects of thyroid disease, know you are not alone. To read more, check out the following stories from our Mighty community:
- 16 Signs You Grew Up With an Underactive Thyroid
- What It’s Like to Live in the Grip of Graves’ Disease
- 10 Tips for Dealing With a Thyroid Cancer Diagnosis
- What My Thyroid Flare-Ups Feel Like
- How I’ve Learned to Balance the Symptoms of Hashimoto’s Thyroiditis