What are the symptoms of hypothyroidism?

DEAR DOCTOR K:

I’m a woman in my late 50s. Lately I’ve been colder and more tired than usual. My memory has been off and my skin is drier. I figured these were all effects of getting older. Fortunately, my doctor did a blood test that showed hypothyroidism. Could all of these symptoms really result from an underactive thyroid?

DEAR READER:

Midlife can bring subtle changes in skin, hair, energy, weight and even mental outlook. Like you, many women write these changes off as the effects of aging. But, as your doctor did, it’s a good idea to make sure they’re not the result of an underactive thyroid.

The thyroid is a tiny butterfly-shaped gland that perches in the front of your neck. (I’ve put an illustration below) It makes a vital hormone, thyroid hormone, which travels from the thyroid gland through the blood to every cell in your body.

Your thyroid gland perches with its wings wrapped around the front of your windpipe, below your voice box.

Thyroid hormone influences virtually every organ in your body. It controls how quickly and efficiently cells convert nutrients into energy. Your body needs just the right level of thyroid hormone: not too much, not too little, just right — like Goldilocks wanted the temperature of her porridge.

Hypothyroidism can act as a dimmer switch on nearly every bodily function. The symptoms of hypothyroidism can differ from person to person. The symptoms often include:

  • FATIGUE. Low thyroid function can result in less energy.
  • COLD INTOLERANCE. Slowed-down cells burn less energy, so the body produces less heat. The body temperature drops a bit, and that makes you feel cold.
  • APPETITE LOSS, WEIGHT GAIN. The lower your energy needs, the fewer calories you need, so your appetite declines. At the same time, your body converts fewer calories into energy, leaving more to be stored as fat.
  • CONSTIPATION. The intestine moves food very slowly from the stomach out of the body.
  • MUSCLE ACHES AND JOINT PAIN. These are common.
  • SKIN, HAIR AND NAILS. The skin can become dry, rough and slightly yellow. Hair becomes coarse, and may fall out. The nails become brittle.
  • CARDIOVASCULAR EFFECTS. Low levels of thyroid hormone can lead to high blood pressure and elevated cholesterol levels. The heart’s pumping ability may fall, increasing the risk of heart failure, especially in older women.
  • MENTAL EFFECTS. Hypothyroidism and depression share many of the same symptoms. These include difficulty concentrating, memory problems, and loss of interest in things that are normally important to you. They call for different treatments, so proper diagnosis is important. Speech and movement may slow.

As I write about mental and cardiovascular effects, I vividly remember a night I was having dinner at the hospital. I was paged to see a patient who had just been admitted to the hospital. His heart was beating 30 times a minute; normal is 60. And he spoke … very … slowly. He even laughed very slowly: not “Ha, ha, ha,” but “HA … HA … HA.” He had severe hypothyroidism.

Fortunately, hypothyroidism is easily diagnosed and treatment is straightforward. It usually consists of taking synthetic thyroid hormone to bring hormone levels back to normal.