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Here's What Thyroid Disease Looks Like, Says Doctor

Problems with your thyroid could affect your whole body.
FACT CHECKED BY Emilia Paluszek

With over 25 years of experience and 3 board certifications in OB/GYN, Functional medicine and Integrative medicine, I've helped thousands of patients struggling with hormone issues including thyroid disorders, PCOS, menopause and more. As a patient myself that struggled with autoimmune thyroiditis myself, I was often searching for the right tests and treatment to get rid of my symptoms. Read on to find out more—and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.


Why You Should Care About Your Thyroid

doctor examines with her fingers, palpates her neck and lymph nodes

One in eight people is affected by thyroid disorders or about 20 million Americans. A woman is anywhere from 5 to 8 times more likely to be affected.

Your thyroid is located in your neck and has to do with energy processes in your body. Problems with your thyroid could affect your whole body. However, since the thyroid is an endocrine gland, it is part of a large hormonal symphony and can be affected by hormones from the adrenal gland or ovary. Keep reading to learn what thyroid disease symptoms look like.


You Are Fatigued

Woman suffering from stomach cramps on the sofa at home.

The most common presenting symptom is fatigue. People with an underactive thyroid, or hypothyroidism, are usually tired all day long. They may even get good quality sleep but not feel rested in the morning. People with stress-related fatigue usually feel tired in the morning and get a second wind at night, but hypothyroid patients never get that second wind. They don't feel more energy after eating either.


If You Are Woman You May Have Irregular Periods

Cropped illness woman in blue dress holding periods calendar for checking menstruation days put hand on abdomen

Another common sign of thyroid disease is irregular periods for women. This can be a symptom of both underactive or overactive thyroid disease. With hyperthyroidism, periods may become irregular, farther apart or even cease all together. Patients with hypothyroidism may experience heavier menses that could also come more frequently. While this is common in women over 40 year of age, it may be more pronounced with thyroid disease in combination with hormonal changes of perimenopause. During perimenopause, fluctuating levels of estrogen that swing to higher levels can raise a protein called Thyroid Binding Globulin. This protein attaches to both T4 (thyroxine) and T3 (triiodothyronine), resulting in lower amounts of free T4 and Free T3. The free fraction of T3 and T3 is the form that is available to interact at the thyroid receptor and promote thyroid hormone functions.


Your Mood Changes

Thoughtful girl sitting on sill embracing knees looking at window, sad depressed teenager spending time alone at home, young upset pensive woman feeling lonely or frustrated thinking about problems

The next sign of thyroid disease is a change in moods. Typically, hyperthyroidism is associated with a fast heart rate which can contribute to anxiety and irritability. New onset panic attacks could stem from hyperthyroidism.

With hypothyroidism patient are more likely to experience low mood or depression. It may be related to the fatigue, but it could also be due to the sluggish thyroid itself.

Excessive stress can also affect the thyroid and change in mood. High cortisol levels can supress the release of TSH from the pituitary, resulting in less production of T4 in the thyroid. All of that can affect moods.


Your Neck is Swelled

Woman suffering from sore throat.

Another sign is swelling in the neck or an enlarged thyroid. Thyroid enlargement may also be painless, but in the case of thyroiditis, which is generally caused by an infection, the entire thyroid may be enlarged, inflamed and painful. Patients may experience pain with swallowing or when turning their head.

Thyroid enlargement may be diffuse or it could also be local in the form of a nodule. This is more common with hyperthyroidism although nodules can also be "cold" and not producing any hormones. A thyroid nodule may be big enough to visually see or be felt.


You Feel Hot All The Time

menopausal woman experiencing hot flash

Another symptom is intolerance to temperature changes. In general, with hyperthyroidism, patients' metabolism is revved up a bit, so they most often feel warm or hot all the time. They could even experience hot flashes and play it off as menopausal symptoms.

With hypothyroidism patients experience cold intolerance. Often they have cold hands and feet, even if it isn't cold weather. They may feel as if they can never get warm.

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Your Eyeballs Bulge

close-up of woman's hazel eyes

One significant sign of hyperthyroidism is exophthalmos, or when the eyeballs bulge out of the eye sockets. It can affect one or both eyes. With thyroid eye disease, patients may experience dryness or corneal irritation. The soft tissues and muscles around the eyes become swollen and inflamed. The eyes may also be red, puffy, and there may be visual problems. Eye involvement can actually occur up to 10 years prior to the diagnosis of thyroid disease and may not be reversed if it has progressed to far.

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What You Should Do if Notice These Signs

doctor and patient having a somber conversation

The diagnosis for thyroid disease is through blood testing. Commonly most health care providers will only order a TSH. TSH will be elevated with hypothyroidism and low with hyperthyroidism. It is supposed to be inversely proportional to thyroid hormone. A full thyroid panel would include a free or total T4, free or total T3, reverse T3, Thyroid peroxidase antibodies (which would help diagnose autoimmune thyroid disease) and possibly thyroglobulin.

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The Last Word From Physician

Woman getting thyroid exam

One common reason thyroid disease goes undetected for so long is because may providers don't order a full thyroid panel, just a TSH. If a patient has a lot of stress or high cortisol levels, the high cortisol will suppress the release of TSH from the pituitary gland resulting in a falsely low TSH. A free T4 level will help solidify the diagnosis depending on whether it is high or low. In addition, many things can prevent the conversion of T4 to T3, which happens outside of the thyroid. Things like a low vitamin D level, low iron levels, or high cortisol can inhibit the conversion from T4 to T3. As a result, TSH could be normal as well as T4, but the patient could have a low free T3 and subclinical hypothyroidism.

The effect of other hormones on the thyroid should also be considered, as mentioned above, like cortisol and estradiol. And to ensure your health don't miss these 101 Health Habits You Didn't Know Were Deadly.

Dr. Tara Scott
Dr. Tara Scott, Hormone Guru, helps people find the cause of their symptoms and get them on a path to optimal health. Read more about Dr. Tara
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