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Signs & Symptoms

The Thyroid Gland

The thyroid gland is a small, butterfly-shaped gland located in the base of the neck just below the Adam's apple. Although relatively small, the thyroid gland plays a huge role in our body, influencing the function of many of the body’s most important organs, including the heart, brain, liver, kidneys, and skin. Ensuring that the thyroid gland is healthy and functioning properly is vitally important to the body's overall well-being.

The thyroid creates two hormones — triiodothyronine (T3) and thyroxine (T4) — that travel throughout your body to regulate blood pressure, body temperature, heart rate, metabolism, and how the body reacts to other hormones.

The level of hormones produced by the thyroid is controlled by the pituitary gland, often called the “master gland” of the body since it regulates many activities of other glands. The pituitary gland creates thyroid-stimulating hormone (TSH) that signals the thyroid to produce and release the right amount of hormone to meet the body’s needs. In turn, the pituitary responds to signals from the thyroid (T3 and T4) as well as from a part of the brain called the hypothalamus (which releases thyrotropin-releasing hormone or TRH), both of which control how the pituitary releases TSH.

Click on the questions below to learn about common signs and symptoms.

Thyroid Disease Signs and Symptoms

What are common thyroid disease symptoms?

If the thyroid does not function correctly, it can affect every possible aspect of a person's life. Some common signs of thyroid disease include:

  • Unexplained changes in weight
  • Depression, anxiety, or feelings of irritability
  • Changes in memory or ability to concentrate
  • Joint or muscle pain or weakness
  • Fatigue or trouble sleeping
  • Fast or irregular heartbeat
  • Irregular menstrual periods

Because symptoms of thyroid disease can mirror those of other conditions, make sure to talk with your healthcare professional or an endocrinologist if you think you have a thyroid condition.

Signs & Symptoms of Specific Thyroid Conditions

What are common symptoms of hypothyroidism and/or Hashimoto's disease?

In its earliest stage, hypothyroidism may cause few symptoms, since the body has the ability to partially compensate for a failing thyroid gland by increasing the stimulation to it, much like pressing down on the accelerator when climbing a hill to keep a car going the same speed. However, as your metabolism continues to slow, you may develop more obvious problems.

Similar to hypothyroidism, Hashimoto's disease may not cause symptoms for many years and may remain undiagnosed until an enlarged thyroid gland or abnormal blood tests are discovered as part of a routine examination. When symptoms do develop, they are either related to local pressure in the neck caused by the goiter itself or to the low levels of thyroid hormone. The antibodies themselves do not cause symptoms. The first sign of this disease may be painless swelling in the lower front of your neck. This enlargement may cause an uncomfortable pressure in the lower neck. This pressure on surrounding structures may cause additional symptoms, including difficulty swallowing.

As thyroid hormone production decreases and the body's metabolism slows, you may experience some of the following symptoms:

  • Pervasive fatigue
  • Drowsiness
  • Forgetfulness
  • Difficulty with learning
  • Dry, brittle hair and nails
  • Dry, itchy skin
  • Puffy face
  • Constipation
  • Sore muscles
  • Weight gain and fluid retention
  • Heavy and/or irregular menstrual flow
  • Increased frequency of miscarriages
  • Increased sensitivity to cold

What are common symptoms of hyperthyroidism and/or Graves' disease?

When hyperthyroidism develops, a goiter (enlargement of the thyroid) is often present. It is also associated with some or many of the following symptoms:

  • Fast heart rate, often more than 100 beats per minute
  • Becoming anxious, irritable, and argumentative
  • Trembling hands
  • Weight loss, despite eating the same amount or even more than usual
  • Intolerance of warm temperatures and increased likelihood to perspire
  • Hair loss
  • Tendency of fingernails to separate from the nail bed
  • Muscle weakness, especially of the upper arms and thighs
  • Loose and frequent bowel movements
  • Smooth skin
  • Trouble sleeping
  • Change in menstrual pattern
  • Increased likelihood for miscarriage
  • Prominent "stare" of the eyes
  • Protrusion of the eyes, with or without double vision (in patients with Graves' disease)
  • Irregular heart rhythm, especially in patients age 60 and older
  • Accelerated loss of calcium from bones, which increases the risk of osteoporosis and fractures

Some people with Graves' disease also experience inflammation, swelling, and bulging of the eyes (Graves' ophthalmopathy or thyroid eye disease). Common signs of Graves' ophthalmopathy include:

  • Bulging eyes
  • Dryness or grittiness of the eyes
  • Puffy or retracted eyelids
  • Pressure or pain in the eyes
  • Reddened or inflamed eyes
  • Light sensitivity
  • Double vision

What are common symptoms of a goiter?

A goiter may cause no symptoms at all, or it may contribute to changes that you or your health care professional notice. Be sure to see your health care professional if you notice any of the following:

  • A feeling of pressure in your neck
  • A lump at the base of your neck, below your Adam's apple
  • Changes in the sound of your voice
  • Trouble breathing or swallowing
  • Unexplained coughing or wheezing

What are common symptoms of thyroid nodules?

A thyroid nodule usually causes no symptoms at all. However, in some cases it may contribute to changes that you or your health care professional notice. Be sure to see your health care professional if you have any of the following:

  • A lump or swelling in your neck
  • Discomfort when swallowing
  • Goiter (an enlargement of your thyroid gland)
  • Hoarseness or unexplained cough
  • Pressure, pain, or other discomfort in your neck
  • Trouble breathing

Even if your thyroid nodule is small and you have no symptoms, your doctor will likely recommend testing to learn more about it. Depending upon the size of the thyroid nodule and other factors, testing for thyroid cancer may be needed

What are common symptoms of thyroid eye disease?

  • Double vision
  • Eye pain
  • Blurry vision
  • Gritty, dry eyes
  • Bulging eyes
  • Red, watery eyes
  • Light sensitivity

 

Listen to AACE Podcast episode 56 as endocrine expert Dr. Cheryl Rosenfeld and her patient, Andree, discuss how the AACE Journey for Patients With Thyroid Disease serves as a valuable and user-friendly resource.

 

Atypical Symptoms of Thyroid Dysfunction

As thyroid dysfunction can potentially affect every system in the body, you can experience heart problems, weakness, muscle aches, bowel disturbances, memory issues, mood disorders, menstrual irregularities, vision changes, and bulging eyes. Severe thyroid dysfunction can lead to changes in body temperature, heart failure, and coma.

Unrelated Treatment

Unrelated treatments and medications given for a variety of conditions can lead to abnormal thyroid levels. For example, iron deficiency can often mimic many of the symptoms of hypothyroidism and is treated with oral or IV iron supplementation. Post-nasal drip and reflux (GERD) can create many of the compression-type symptoms of thyroid nodules and are treated differently. Treatments for heart rhythm problems, depression, and seizures can sometimes cause thyroid problems. Radiation treatments to the chest and neck for unrelated cancers (e.g., lymphoma) can later lead to an increased risk for thyroid cancer.

Unrelated Imaging

Thyroid nodules or growths on the thyroid (and occasionally Hashimoto's disease) are often found incidentally when imaging the neck or chest such as a computerized tomography (CT) scan of your neck or chest, magnetic resonance imaging (MRI) of your spine, an ultrasound of your carotid artery, or a positron emission tomography (PET) scan of your tissues and organs. If a thyroid disorder is caught during evaluation of other symptoms or problems, a thyroid ultrasound should be performed to confirm the presence of nodules and risk stratify them.