Hypothyroidism is a condition that occurs when your thyroid gland doesn't produce enough thyroid hormones.
There are many glands in the body; the thyroid gland is the small butterfly-shaped organ at the base of your neck that makes hormones that regulate your metabolism — which affects how the body uses energy — and other processes.

While your body goes through hormonal changes every day (hello, mood swings!), big dips like those that occur during hypothyroidism can signal danger, as a lack of thyroid hormone production causes the body’s functions to slow down.

Not to mention, an underactive or overactive thyroid (called hyperthyroidism) can affect your waistline. People with hypothyroidism experience a slower metabolic rate, which is generally associated with some amount of weight gain, about 5 to 10 pounds, usually due to accumulation of salt and water in the body.

Signs and Symptoms of Hypothyroidism

The signs and symptoms of hypothyroidism often develop slowly over the years and may be mistaken for the natural changes of aging.

Hypothyroidism Symptoms in Adults

Look out for these potential symptoms of hypothyroidism:

  • Weight gain
  • Fatigue
  • Sensitivity to cold temperatures
  • Depression
  • Dry skin
  • Thinning hair
  • Heavy menstrual periods (in women)
  • Trouble sleeping
  • Difficulty concentrating
  • Pain or swelling of the joints
  • Constipation
  • High cholesterol levels
  • Muscle weakness

Hypothyroidism Symptoms in Infants

Hypothyroidism is most common in middle-aged and older women. But sometimes infants and children can develop the condition, such as infants who were born without a thyroid gland or who have a thyroid gland that doesn’t function properly.Congenital hypothyroidism occurs in about 1 in 2,000 to 4,000 newborns.If undiagnosed, it can lead to increasingly severe symptoms and even physical and mental disabilities.

Hypothyroidism in infants may include these symptoms:

  • Jaundice (yellowing of the skin and whites of the eyes)
  • Frequent choking
  • Puffy face
  • Constipation

Hypothyroidism Symptoms in Children and Teens

Symptoms of hypothyroidism in children and teens are similar to symptoms in adults and can include the following:
  • Poor growth or short stature
  • Delayed puberty
  • Slow reaction time
  • Weight gain
  • Coarse, dry hair or skin
  • Muscle cramps
  • Delayed mental development
  • Increased menstrual flow (in girls)

Learn More About the Signs and Symptoms of Hypothyroidism

How Is Hypothyroidism Diagnosed?

If you have many of the common symptoms of hypothyroidism, such as dry skin, constipation, fatigue, and a hoarse voice, you can make an appointment with your doctor to check for hypothyroidism.Your doctor can perform various screenings:
  • A physical exam
  • A blood test
  • An imaging scan

If these tests show an elevated thyroid-stimulating hormone (TSH) and low levels of thyroid hormones — like free T4, total T3, or free T3 — it may be an indication that you have hypothyroidism, says Mayumi Endo, MD, an endocrinologist in Seattle.

more on Hypothyroidism

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How to Prepare for an Upcoming Doctor’s Appointment for Hypothyroidism

Aside from conducting a physical exam, blood test, and possible thyroid-imaging scan, your doctor will ask you extensive questions about your symptoms and how long you’ve been experiencing them. Here's how to prepare for your upcoming doctor’s appointment:

Keep a journal that details your symptoms and their severity. Bring your notes to your appointment to share with your doctor. This can help the doctor detect patterns in your hypothyroid symptoms and get a better idea which screenings you may need for a proper diagnosis.

Bring a list of the vitamins, herbal supplements, and prescription or over-the-counter medications you currently take. These items may interact with your treatment regimen, so your doctor should know about them.

Make a list that details your personal health history, including major surgeries. Include family members and relatives who have had thyroid or autoimmune diseases.

Ask the office ahead of time if you need to fast for your blood work. This means that you can’t eat or drink after midnight the day of your appointment, with the exception of water.

Make a list of questions you want to ask your doctor. That way, you won’t forget anything during your appointment.

What to Expect Before and After Your Appointment

Before your appointment, you may need to fast or stop taking medications, but that’s only if your doctor directs you to do so.Bring your lists of symptoms, current medications, and family history, and note any updates so your doctor can see. Be prepared to undergo blood work or possible thyroid scans.
After your appointment, follow your doctor’s orders and call the office for any clarifications. You may need to wait for the results of your blood work before making adjustments to your thyroid medication dose (if you're on medication). Schedule all your follow-up appointments and referrals to specialists as necessary.
You may also ask your doctor about websites to follow or thyroid support networks you can check out for additional education and emotional support.

Prognosis of Hypothyroidism

The overall prognosis of hypothyroidism is promising, especially when caught early. This condition is extremely treatable with thyroid hormones. But you will likely need to take medications for the rest of your life to help ensure that you get enough thyroid hormone, according to the American Thyroid Association.
Hypothyroidism can lead to numerous complications if it goes undetected and untreated.
Children with hypothyroidism can still hit normal growth and developmental milestones as long as they take their thyroid medications. Since children are still growing, they may need more frequent blood work than adults with hypothyroidism to help ensure they are getting the correct hormone replacement dosage.

Treatment and Medication Options for Hypothyroidism

There are a number of treatments for hypothyroidism, usually involving medication. Some people also use alternative medicines to help them manage their disease, too.

Common Medication for Hypothyroidism Treatment

Treatment for hypothyroidism generally involves taking the oral medicine levothyroxine, sold under the brand names Levothroid, Synthroid, and others.
Levothyroxine is a man-made thyroid hormone that works by replacing thyroxine, the hormone your body can no longer make in adequate amounts. It's typically taken daily to reverse symptoms of hypothyroidism.

“Studies after studies show levothyroxine is the best treatment of choice,” Dr. Endo explains. She notes that some people are allergic to the generic form of levothyroxine, mostly due to the color dye. In that case, you can use either the levothyroxine 50 microgram pills (these don’t have dye in them) or the brand Tirosint, although this is more expensive.

Levothyroxine may lower your cholesterol levels and help you return to a normal weight. The medicine causes very few side effects and is relatively inexpensive, with an average retail price of around $15.The generic form of the drug is covered by most Medicare and insurance plans.

Treatment with levothyroxine is usually continued for the rest of your life, but your doctor may adjust your dose over time.

Why Figuring Out the Right Dosage of TSH May Take Some Time

TSH is just one marker that can indicate how your thyroid gland is functioning. Thyroid medications increase T4 hormones, which in turn reduce TSH.The process can take time to work, which is why doctors usually retest within six to eight weeks of a new thyroid medication prescription.
Once your TSH levels are consistent with your thyroid medication, your doctor may need to check your blood work only once or twice per year.

Factors That Can Affect the Proper Absorption of Levothyroxine

The absorption of levothyroxine, the most common prescription used to treat hypothyroidism, can be influenced by many foods and medications. It’s important to take levothyroxine in the morning with water, at least 30 minutes before eating.

You should avoid certain supplements and foods for several hours after taking levothyroxine. These supplements and foods include:
  • Multivitamins
  • Calcium and iron supplements
  • Antacids
  • Walnuts

A Quick Warning About Subclinical Hypothyroidism and Ineffective Treatment

Subclinical hypothyroidism occurs when your TSH levels are elevated but the circulating thyroid hormone levels are normal. It is important for your doctor to determine how your TSH fluctuates before you begin your treatment regimen, as various health conditions can temporarily affect your thyroid levels. In most cases of subclinical hypothyroidism, you should have a discussion regarding the risks and benefits of treatment with levothyroxine with your doctor. That’s particularly true if your TSH is less than 10, which means your doctor should assess carefully whether to treat you for hypothyroidism.

Alternative and Complementary Therapies

Some people with hypothyroidism choose to supplement their treatment with alternative medicines, often to help with symptoms like fatigue, weight gain, stress, and mental fog.Treatments can include yoga, meditation, hypnosis, supplements, or special diets.
Research that includes one small study of 20 women with hypothyroidism found that yoga helped patients manage their symptoms.
More on Managing Hypothyroidism

7 Real-Life Tips to Relieve Hypothyroidism Symptoms

While people with thyroid disease are often careful to eat a diet low in iodine (which can worsen hypothyroidism once a patient has it) or to take vitamin D or calcium supplements, no diet or nutrient can cure thyroid disease.
Above all, keep in mind that any natural remedies for hypothyroidism are not regulated. In fact, some alternative treatments may be dangerous.

Hypothyroidism Treatments That Don’t Work

One treatment that medical doctors do not recommend? Natural dessicated thyroid products (either porcine or bovine products). The most common is the pig thyroid extract called Armour. Because the components of the pig’s thyroid hormone are very different from those of a human being, medical professionals recommend against using this agent, Endo says. These are most often prescribed by naturopathic doctors.

Learn More About Treatment for Hypothyroidism: Medication, Alternative and Complementary Therapies, and More

Hypothyroidism Diet

There's no medical evidence that any particular diet will improve the functioning of your thyroid gland, despite anecdotal claims seen online and elsewhere.

If you're taking thyroid hormone replacement for hypothyroidism, you may want to avoid consuming certain foods within a few hours of taking your thyroid medication. Some foods, like calcium, iron, and multivitamins, may block absorption of the thyroid hormone so should be taken four hours apart from levothyroxine, Endo says.

Foods to limit with hypothyroidism:
  • Soybean flour and cottonseed meal
  • Iron and calcium supplements
  • Antacids containing aluminum or magnesium
  • Some ulcer or cholesterol-lowering drugs
  • Walnuts

Overall, it is most important for people with hypothyroidism to eat a well-balanced diet, rather than consuming any particular food group, Endo says.

Learn More About What to Eat and Avoid if You Have Hypothyroidism

Prevention of Hypothyroidism

You can’t prevent hypothyroidism. While some risk factors may contribute to the development of this thyroid condition (including pituitary disorders, iodine deficiencies, congenital disease, and pregnancy), hypothyroidism is most often caused by factors out of your control.Instead, it’s more important to be aware of the signs of hypothyroidism and to see your doctor if you suspect any of your symptoms could be related.

Research and Statistics: How Many People Have Hypothyroidism?

According to the National Institute of Diabetes and Digestive and Kidney Diseases, in the United States, hypothyroidism affects around 4.6 percent of people age 12 and older (about 5 out of every 100 people).
While anyone can develop hypothyroidism, this condition is most common in women and people over 60.
Also, an estimated 1 in 8 women will develop some form of thyroid disease, which can include hypothyroidism, hyperthyroidism, goiter, and thyroid cancer, among others.

Resources We Love

Favorite Orgs for Essential Thyroid Disease Info

American Thyroid Association

Founded nearly a century ago, the American Thyroid Association is one of the most trusted and well-known thyroid organizations; it provides the latest information on diseases that affect the thyroid gland. On its website, you will find a variety of thyroid-related brochures, updated treatment guidelines, and more. If you’re looking for the latest information on hypothyroidism research and treatment, be sure to sign up for the Friends of the ATA newsletter, which is delivered via email.

Hormone Health Network

This is another one of our favorite patient-centered websites for hypothyroidism, thanks to its vast library of in-depth information pertaining to the causes and symptoms of this condition. Because hypothyroidism is a hormone-related condition, you can also learn more about other aspects of endocrinology that could affect your thyroid. Be sure to check out the pages on pregnancy, goiter, stress, and more.

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

A branch of the National Institutes of Health, the NIDDK is a leader in research pertaining to all kinds of endocrine diseases, including hypothyroidism. Be sure to review and bookmark the NIDDK’s webpage on hypothyroidism as you prepare for your first appointment with your endocrinologist. Check out the list of risk factors and causes to have on hand as you discuss diagnosis and treatment options with your doctor.

American Association of Clinical Endocrinologists

This website isn’t for doctors only. Enter the Public Community Portal’s thyroid page for professional knowledge related to hypothyroidism treatment guidelines and other related conditions, such as thyroid nodules, to better prepare yourself for your appointment with an endocrinologist. While you’re there, you can also learn how to check your own thyroid gland in this step-by-step guide.

Favorite Alternative Medicine Resource

National Center for Complementary and Integrative Health (NCCIH)

Depression, stress, and fatigue are some of the many symptoms you might experience with hypothyroidism. Alongside any medical treatment, you may be tempted to research yoga and other complementary practices for support. Before you do, talk to your doctor and come armed with information from this resource. We like the NCCIH because it provides straightforward and up-to-date research on alternative medicine.

Favorite Online Support Network

Thyroid Federation International

Looking for a local or online support group? We like Thyroid Federation International because of its ability to help patients connect with one another across global borders. Wherever you’re located, finding a support group near you is simple via this list of member organizations.

Favorite Resources for Diet Advice

Thyroid Dietitian

While no specific diet can cure hypothyroidism, eating well can help you feel your best. Still, it can be difficult knowing which foods to eat and avoid, as well as how to cook thyroid-healthy meals. If you need help getting started, check out some of the resources offered by registered dietitian Nicole Morgan, including her YouTube channel featuring free cooking and exercise tips, as well as recommendations for thyroid diet books, grocery shopping must-haves, and beauty products. Be sure to discuss these diet and exercise tips with your doctor before getting started.

Favorite App

BOOST Thyroid

If you want an easier way to track your symptoms and lab results, look no further than the BOOST Thyroid app for Apple devices. It helps you track more than 20 symptoms each day to help you discover patterns you can discuss with your endocrinologist. We also like how the app lets you look at your blood work and past treatments for a better understanding of your thyroid hormone changes.

The BOOST Thyroid app is free to download on Apple products, but you will need a membership to access all of the benefits. In the Apple store, you can try out a monthly membership for $3.49 or an annual membership for $14.99. Currently, BOOST Thyroid is under production for Android devices, and you can sign up here to make sure you receive the latest updates.

Additional reporting by Stephanie Bucklin and Lynn Marks.

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