Symptoms
In adults, hypothyroidism is associated with the following symptoms:[5][7][8]
[edit]Early symptoms
Poor muscle tone (muscle hypotonia)
Fatigue
Cold intolerance, increased sensitivity to cold
Depression
Muscle cramps and joint pain
Carpal Tunnel Syndrome
Goitre
Thin, brittle fingernails
Thin, brittle hair
Paleness
Osteoporosis
Decreased sweating
Dry, itchy skin
Weight gain and water retention[9][10][11]
Bradycardia (low heart rate – fewer than sixty beats per minute)
Constipation
[edit]Late symptoms
Slow speech and a hoarse, breaking voice – deepening of the voice can also be noticed
Dry puffy skin, especially on the face
Thinning of the outer third of the eyebrows (sign of Hertoghe)
Abnormal menstrual cycles
Low basal body temperature
[edit]Less common symptoms
Impaired memory[12]
Impaired cognitive function (brain fog) and inattentiveness.[13]
A slow heart rate with ECG changes including low voltage signals. Diminished cardiac output and decreased contractility.
Reactive (or post-prandial) hypoglycemia[14]
Sluggish reflexes
Hair loss
Anemia caused by impaired haemoglobin synthesis (decreased EPO levels), impaired intestinal iron and folate absorption or B12 deficiency[15] from pernicious anemia
Difficulty swallowing
Shortness of breath with a shallow and slow respiratory pattern.
Increased need for sleep
Irritability and mood instability
Yellowing of the skin due to impaired conversion of beta-carotene[16] to vitamin A
Impaired renal function with decreased glomerular filtration rate
Elevated serum cholesterol
Acute psychosis (myxedema madness) (a rare presentation of hypothyroidism)
Decreased libido[17] due to impairment of testicular testosterone synthesis
Decreased sense of taste and smell (anosmia)
Puffy face, hands and feet (late, less common symptoms)
Gynecomastia
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