Feeling Off Lately? Doctors Share the Early Signs of Thyroid Trouble Every Woman Should Know

Most of us don’t give our thyroid a second thought. But the small, butterfly-shaped gland at the front of your neck plays a vital role in keeping your body functioning smoothly: It produces hormones that help regulate metabolism, body temperature, mood, energy, heart rate and more. When your thyroid slows down or speeds up, however, it can lead to health issues. So what are the early warning signs of thyroid problems, and when should you be worried? We asked doctors to weigh in on what you need to know. 

What are the early warning signs of thyroid problems?

The two most common types of thyroid issues are hyperthyroidism and hypothyroidism. Here, the early warning signs of each.

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Hypothyroidism (underactive thyroid)

Hypothyroidism occurs when the thyroid doesn’t make enough hormones to support the body’s needs. This is the most common type of thyroid problem. Hashimoto’s disease, an autoimmune condition wherein the immune system attacks the thyroid, can cause it.

Other causes include thyroiditis—inflammation of the thyroid—as well as certain congenital health conditions and medications. There is often a family history of thyroid problems, too. Dr. Aloi says symptoms of hypothyroidism can include:

• Fluid retention
• Weight gain
• Constipation
• Fatigue or feeling tired
• Dry skin
• Joint and muscle pain
• Thinning hair

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Hyperthyroidism (overactive thyroid)

With hyperthyroidism, the thyroid makes more hormones than the body needs. This type of thyroid problem is less common. The most common culprit is often Graves’ disease, an autoimmune disorder that causes the immune system to attack the thyroid. Dr. Aloi says some of the early warning signs of hyperthyroidism include:

• Weight loss
• Tremors
• Difficulty sleeping
• Anxiety
• Fatigue
• Heart palpitations or irregular heartbeat

“Older patients sometimes don’t have a lot of symptoms at all,” Dr. Aloi says. “And a lot of patients come to me saying, ‘I’m just not feeling right.’”

More advanced signs of thyroid problems

While it’s easy to write off the early warning signs of thyroid problems as something else, Dr. Aloi says some symptoms can indicate more serious disease progression.

“If you have hypothyroidism, it can greatly elevate your cholesterol panel in lab tests,” he says. “So if you typically have had no issues with cholesterol and all of a sudden have cholesterol levels in the 200 to 300 range, that can indicate hypothyroidism.”

Other warning signs of thyroid disease may be more obvious.“Looking in the mirror, some people will see a fullness in their neck,” Dr. Aloi says. “The thyroid gland can be enlarged in both hypo- and hyperthyroidism. It can be a goiter or thyroid nodules, which can indicate thyroid cancer.”

Often find yourself waking up with a puffy face? That, too, can be a common sign of thyroid trouble. “A visibly puffy face, especially around the eyes, is a classic sign caused by fluid retention,” says Martina Ambardjieva, MD, urologist at Dr. Telx. It usually occurs in the later stages of the thyroid condition and can also happen if patients have stopped taking their medication. 

Why thyroid issues are more common in women 

“Women experience thyroid disease three to four times as frequently as men,” says Joseph A. Aloi, MD, endocrinology and metabolism professor at Wake Forest University School of Medicine. Experts suspect this is because women are more prone to autoimmune diseases, which can increase the risk of thyroid trouble.

The link between thyroid problems and menopause

Hormonal changes, such as those experienced during pregnancy and menopause, can also play a role in thyroid problems, and there’s considerable overlap between the two. 

Why? Both can cause common symptoms such as fatigue, weight gain, mood swings and menstrual cycle changes. However, “symptoms such as hot flashes, night sweats and vaginal dryness are more specific to menopause, whereas goiters, bradycardia [a slow heart rate] and facial puffiness point more toward thyroid disease,” says Dr. Ambardijeva.

She also notes that the hormonal shifts during perimenopause can unmask or worsen underlying thyroid disorders, making diagnosis more complex. 

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What to do if you notice warning signs of thyroid problems

Dr. Aloi says that if you notice some of the early warning signs of thyroid problems, you should consult your doctor for testing. They will likely recommend a thyroid-stimulating hormone (TSH) test. This screens thyroid hormone levels for both hypo- and hyperthyroidism with one blood test.

“TSH is the hormone your pituitary gland secretes in response to how it thinks your thyroid is doing,” Dr. Aloi says. “So if your thyroid is underactive, the TSH will be very high. But if you have hyperthyroidism, your brain doesn’t think you need more thyroid hormones, so it doesn’t make TSH.”

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Dr. Aloi cautions that some medications and supplements, such as biotin, can interfere with the results of the TSH screen. “High doses of biotin can be measured as a high rate of hormones, which can give the false impression of an overactive thyroid,” he says. “Biotin doesn’t impact your thyroid. But if you’re taking 5 mg or more [daily], remember to stop it at least by the day before your testing.”

Best treatments for hypo- and hyperthyroidism

Dr. Aloi says several treatments can help patients regulate their thyroid hormone levels. For hypothyroidism, doctors may prescribe desiccated thyroid (derived from animal thyroids) or medications such as levothyroxine. Hyperthyroidism treatments can include medications such as methimazole and radioactive iodine. 

This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan.