Underactive Thyroid Symptoms, Risk Factors, And Treatment


When the thyroid gland does not produce enough thyroid hormone, hypothyroidism develops. An underactive thyroid is another term for this condition. Hypothyroidism may not initially manifest any symptoms at all. If hypothyroidism is left untreated, it might eventually result in additional health issues including high cholesterol and cardiac issues.

Hypothyroidism is diagnosed by blood testing. Once you and your healthcare practitioner determine the proper dosage for you, treatment with thyroid hormone medication is often easy, secure, and efficient.


At the base of the neck, just below Adam's apple, is the thyroid, a tiny, butterfly-shaped gland. Thyroxine (T-4) and triiodothyronine are the two primary hormones produced by the thyroid gland (T-3). Every cell in the body is influenced by these hormones. They support how quickly the body consumes carbs and lipids. They aid in regulating body temperature. Heart rate is impacted by them. They assist in regulating the body's production of protein.

When the thyroid gland does not produce enough hormones, hypothyroidism develops. The following conditions or issues can result in hypothyroidism:

Autoimmune illness.  An autoimmune condition known as Hashimoto's disease is the most frequent cause of hypothyroidism. When the immune system produces antibodies that target healthy organs, autoimmune disorders result. 

Radiation treatment. The thyroid gland can be harmed by radiation used to treat head and neck malignancies, which can result in hypothyroidism.

Thyroiditis. When the thyroid gland becomes inflamed, thyroiditis results. This can be the result of an infection. It may also be the outcome of a thyroid issue.

An autoimmune disease or another illness. The thyroid may suddenly release all of the thyroid hormones it has accumulated if it develops thyroiditis. This results in hyperthyroidism, a disorder marked by an increase in thyroid activity. The thyroid then becomes underactive.

Medicine. Many medications have the potential to cause hypothyroidism. Lithium is one such medication, which is applied to treat a few mental conditions. Ask your healthcare practitioner about the medication's impact on the thyroid gland if you take one.

Less frequently, hypothyroidism may result from:

Issues that exist from birth. Some newborns are born with an underactive thyroid gland. Others lack a thyroid gland from birth. In most cases, the cause of the thyroid gland's improper development is unknown. However, some children have a thyroid condition that is hereditary. Infants with hypothyroidism frequently exhibit no symptoms at birth. 

Pituitary dysfunction. Making insufficient thyroid-stimulating hormone by the pituitary gland is a very uncommon cause of hypothyroidism (TSH). 

Pregnancy. Some individuals get hypothyroidism during pregnancy. Untreated hypothyroidism during pregnancy increases the risk of miscarriage, early birth, and hypertension. Blood pressure significantly increases in the latter three months of pregnancy as a result of preeclampsia. The growing foetus might suffer significant consequences from hypothyroidism.

Insufficient iodine. Iodine is a mineral that the thyroid gland needs to produce thyroid hormones. Seafood, seaweed, plants growing in iodine-rich soil, and iodized salt are the major sources of iodine. Hypothyroidism can result from inadequate iodine intake. For those who already have hypothyroidism, too much iodine might exacerbate the illness. It is common for people to consume insufficient amounts of iodine. 
How to check if you have Underactive Thyroid?

If you have other hypothyroidism symptoms or if you feel fatigued all the time, consult your doctor.

Follow your healthcare provider's recommendations for how frequently you should schedule checkups if you are taking thyroid hormone medication for hypothyroidism. To ensure you are taking the proper dosage of medication at first, you might need to plan routine appointments. You could eventually require checks so that your doctor can keep track of your condition and medication.

Risk Factors

Although anybody can have hypothyroid, the following factors put you at higher risk:

  • Being female.
  • If you have thyroid problems running in your family.
  • They have an autoimmune disease, such as type 1 diabetes or celiac disease.
  • Have had hyperthyroidism therapy.
  • Absorbed radiation in your neck or upper chest.
  • Having a thyroid operation.


The severity of the illness determines the hypothyroidism symptoms. Problems can take years to develop slowly.

Initially, hypothyroidism symptoms like fatigue and weight gain could go unrecognized. You could also believe that they are a natural aspect of ageing. However, as your metabolism continues to decrease, you might experience more glaring issues.

Symptoms of hypothyroidism include:

  • Tiredness.
  • Greater sensitivity to the cold
  • Constipation
  • Dry skin
  • Gaining weight
  • Swollen face.
  • Squeaky voice
  • Rough skin and hair.
  • Muscle sluggishness
  • Aches, stiffness, and pain in the muscles.
  • Irregular or heavier-than-normal menstrual periods.
  • Hair thinning.
  • Bradycardia is a slowed heartbeat.
  • Depression.
  • Memory issues.

Newborn hypothyroidism

Even babies can develop hypothyroidism. Most newborns are not born with thyroid glands. Symptoms of a malfunctioning gland may not appear straight away. However, if hypothyroidism is left untreated, symptoms start to show up. They may consist of:

  • Feeding issues.
  • Bad growth
  • Terrible weight gain
  • Jaundice is the medical term for a disorder when the skin and eye whites turn yellow.
  • Constipation.
  • Sluggish muscle tone
  • Dry skin
  • Shrill crying
  • Extended tongue
  • Umbilical hernia, a soft swelling or bulging close to the belly button.

Even modest occurrences of baby hypothyroidism can cause serious issues with physical and mental development if left untreated.

Teenagers and children with hypothyroidism

Symptoms of hypothyroidism in children and adolescents typically resemble those in adults. They may also have:

  • The low height is caused by poor development.
  • Delayed emergence of adult teeth.
  • Postponed puberty.
  • Undeveloped mental capacity.


Levothyroxine is a thyroid hormone medication that is often used daily as part of treatment for hypothyroidism. This medication is ingested. The signs and symptoms of hypothyroidism disappear when hormone levels are returned to a healthy range.

One or two weeks into therapy, you should start to feel better. Levothyroxine therapy will probably last a lifetime. Your doctor may check your TSH level annually since the amount you require might fluctuate.

Choosing the proper dose

Your doctor will assess your TSH level around 6 to 8 weeks after you begin taking levothyroxine to determine the optimal dosage for you. Six months later, you might require another blood test to evaluate your TSH levels. Side effects from taking too much levothyroxine include:

  • Tiredness
  • A bigger appetite
  • Issues with sleep.
  • Shakiness.
  • Heart palpitations are often known as heart pounding. 
  • When taken at the proper dosage, levothyroxine frequently has no negative side effects. Inform your doctor if you switch medication brands since the dosage may need to be adjusted.

Your doctor may begin treating you for coronary artery disease or severe hypothyroidism with a lower dosage of medication and gradually raise it over time. This enables your heart to adapt to the increase in metabolism in your body.

Adequate levothyroxine administration

It is preferable to take levothyroxine at the same time every day on an empty stomach. The hormone should be taken in the morning, and you should wait 30 to 60 minutes before eating or drinking.

Use different medications. If you take the medication before night, wait at least four hours after your last meal or snack before taking it.

Do not stop taking the medication or miss doses just because you feel better. If you do, it is probable that the hypothyroidism symptoms may gradually reappear. Take two tablets of levothyroxine the next day if you miss a dose.

Your body's capacity to absorb levothyroxine may be impacted by some medications, dietary supplements, and even meals. If you often consume a high-fibre diet or consume a lot of soy products, speak with your doctor. Additionally, let your doctor know if you use any additional medications, especially:

  • Supplements including iron or multivitamins.
  • Certain antacids contain aluminium hydroxide.
  • Supplements with calcium.
  • Subclinical thyroid dysfunction

If subclinical hypothyroidism is identified in you, discuss treatment options with your doctor. Medicine for thyroid hormones might not be helpful for a little increase in TSH. Thyroid hormones may help with certain symptoms if your TSH level is higher but still in the subclinical range.

Complications of Underactive Thyroid

If hypothyroidism is left untreated, it might result in other health issues, such as:

Goiter. The thyroid gland may enlarge as a result of hypothyroidism. The term "goitre" refers to this ailment. A big goitre may make it difficult to breathe or swallow.

Heart issues. Heart disease and heart failure risk might increase as a result of hypothyroidism. This is mostly because individuals with hypothyroidism frequently experience elevated levels of low-density lipoprotein (LDL) cholesterol, sometimes known as "bad" cholesterol.

Neuralgia of the periphery. Long-term hypothyroidism without therapy has the potential to harm peripheral nerves. These nerves transmit data from the brain and spinal cord to the body's other organs. The arms and legs may experience pain, numbness, and tingling as a result of peripheral neuropathy.

Infertility. Low amounts of Ovulation disruption caused by thyroid hormone can reduce fertility. Infertility can also be harmed by other hypothyroidism causes, such as autoimmune diseases.

Birth flaws. Compared to children born to moms who do not have thyroid illnesses, children born to persons who have untreated thyroid disease may be more likely to experience birth abnormalities.

Untreated hypothyroidism in newborns increases the chance of major issues with a child's physical and mental growth. The odds of a typical development are very good if the issue is discovered in the first few months of life.

The myxedema coma. This uncommon, potentially fatal illness can develop if hypothyroidism is left untreated over a protracted period of time. Sedatives, infections, or other types of bodily stress can cause a myxedema coma.

Its signs include acute tiredness and severe cold sensitivity, which are followed by a severe loss of energy and finally unconsciousness. Emergency medical care is required for myxedema coma.

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Page last reviewed: Mar 20, 2023

Next review due: Mar 20, 2025

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