Symptoms of Hypothyroidism

The symptoms of hypothyroidism are usually very subtle and develop gradually, most often over a period of years. Every individual experiences symptoms differently, and will present with various combinations of symptoms. Developed with TPA-UK medical advisor Dr Barry Peatfield, this comprehensive checklist (in PDF format) can be given to your doctor for a review into your symptoms. To view this checklist, you’ll need Adobe Acrobat Reader.

Signs of Hypothyroidism

Apart from the symptoms provided in the Hypothyroid Symptoms Checklist, you also need to know the most common signs of hypothyroidism and thyroid hormone resistance (THR).

A sign is an abnormality experienced by the patient that others can see and independently confirm. Dry, scaly skin is a sign that you can show to your doctor.

Other disorders can cause signs typical of hypothyroidism and THR. Because of this, it’s important not to rush to judgment and conclude that a thyroid disorder is the cause of your sign. Some signs may be so subtle that only yourself and your doctor may be certain that you had them only in their absence, after you reach an effective dose of thyroid hormone replacement. An example is the dull, listless appearance of some patients’ eyes, replaced after therapy with a bright radiance.


Dry skin
Thick, scaling skin
Coarse skin


Fineness of hair
Dry, course, brittle hair
Sparse eyebrows, especially outer ends
Hair loss

Nails and skin:

Brittle nails
Dry ridges down nails
Cold skin


Swelling of face (oedema)
Swelling around the eyes (oedema)
Swelling of eyelids (oedema)
No pitting oedema of ankles
Fluid accumulation in abdomen (ascitis)
Thick tongue
Swelling of ankles
Paleness of skin
Paleness of lips
Bluish or purplish colour of skin, nail beds, lips or mucous membrane
Unexplained weight gain
Low basal and activity level temperature
Protrusion of one or both eyeballs (exophthalmos)
Slow speech
Slow pulse rate
Slow thinking
Sluggish movement
Slow relaxation phase of the knee and/or ankle reflex
Listless, dull look to eyes
Wasting of tongue
Rapid heart rate with weak force of contraction
Slow heart rate despite low aerobic fitness
Pounding heart beat
Cardiac enlargement on X-ray
Indistinct or faint heart tones
Low QRS voltage on ECG
Long normal intervals on ECG
Fluid around heart (pericardial effusion)
Changes at the back of the eye (at fundus oculi)