Symptoms

In adults, hypothyroidism is associated with the following symptoms:

Poor muscle tone (muscle hypotonia)

Fatigue

Cold intolerance, increased sensitivity to cold

Constipation

Depression

Muscle cramps and joint pain

Thin, brittle fingernails

Coarse hair

Paleness

Decreased sweating

Dry, itchy skin

Weight gain and water retention

Bradycardia (low heart rate – fewer than sixty beats per minute)

Slow speech and a hoarse, breaking voice – deepening of the voice can also be noticed, caused by

Dry puffy skin, especially on the face

Thinning of the outer third of the eyebrows (sign of Hertoghe)

Abnormal menstrual cycles

Low basal body temperature

Poor memory

Impaired cognitive function (brain fog) and inattentiveness.

A slow heart rate with ECG changes including low voltage signals. Diminished cardiac output and decreased contractility.

Reactive (or post-prandial) hypoglycemia

Sluggish reflexes

Hair loss

Anemia caused by impaired haemoglobin synthesis (decreased EPO levels), impaired intestinal iron and folate absorption or B12 deficiency from pernicious anemia

Difficulty swallowing

Shortness of breath with a shallow and slow respiratory pattern.

Increased need for sleep

Irritability and mood instability

Yellowing of the skin due to impaired conversion of beta-carotene to vitamin A

Impaired renal function with decreased glomerular filtration rate

Elevated serum cholesterol

Acute psychosis (myxedema madness) (a rare presentation of hypothyroidism)

Decreased libido due to impairment of testicular testosterone synthesis

Decreased sense of taste and smell (anosmia)

Puffy face, hands and feet (late, less common symptoms)

Gynecomastia

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