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Hypothyroidism is not your garden-variety health issue where you pop a pill and call it a day. Far from it. Low thyroid is often billed as a “silent epidemic,” mainly because some of the symptoms get written off as the cost of a hectic lifestyle or simply getting older. You’ve no doubt heard about the usual low thyroid symptoms—fatigue, weight gain, and cold sensitivity. Those get all the attention, but they’re merely the tip of the iceberg.
Why does this matter? Because you might be grappling with symptoms that you’ve never thought to link back to your thyroid. That’s a big deal. Early diagnosis and targeted treatment can mean the difference between feeling like a sloth and living your life in the fast lane. And let’s be real, who wants to be a sloth when you could be a cheetah?
Oh, and just so you know, I’m speaking from experience. I’ve been taking thyroid medication for years now, and I’ve experienced the effects of not taking it when my prescription went unfilled.
While I’m a proponent of doing all you can to improve your health naturally, for many, medication can significantly shift how they feel and function.
In this article, we will dive into some of the lesser-known symptoms associated with low thyroid function that are often overlooked, but shouldn’t be. Understanding these could be your ticket to reclaiming your health.
Constipation or Bowel Irregularity
Recently, a guy I know asked for guidance on how he could improve his regularity. His diet was really good, and he took a lot of the right supplements, but he was only going every other day. My first thought was that it could be a thyroid issue. But that’s rarely what people think of when it comes to thyroid. Instead, the go-to advice is to take more probiotics, enzymes, magnesium, or fiber. But none of those solutions work well if someone’s hypothyroid.
Transparency: I occasionally run out of my Armour Thyroid before picking up my prescription refill. As I’m writing this, I’ve been out of my prescription for six days. It’s had a significant effect on my digestive system, too. Even though I know the impact it’s having, sometimes I prioritize other things over optimal health, too. And yes, I realize I could have it shipped to my house but I haven’t taken the time to set that up. 😀
Thyroid hormones, namely thyroxine (T4) and triiodothyronine (T3), are critical for gastrointestinal motility. These hormones help regulate the pace and timing of peristalsis, the muscle contractions that propel food through your digestive tract.1Saad, R. J., & Chey, W. D. (2006). “Review article: current and emerging therapies for functional gastrointestinal disorders.” Alimentary pharmacology & therapeutics, 24(3), 475-492. [doi:10.1111/j.1365-2036.2006.03020.x]
Low levels of T3 and T4, which is the hallmark of hypothyroidism, result in decreased peristaltic activity. In other words, low thyroid leads to constipation or irregular bowel movements. One study in the journal Clinical Endocrinology found that about 40% of hypothyroid patients reported constipation as a significant symptom. Forty percent!2Kumar, P., Arora, S., & Sharma, S. (2017). “Prevalence of hypothyroidism in patients with chronic constipation.” Clinical Endocrinology, 87(5), 557-563. [doi:10.1111/cen.13442] Another study in Endocrine Reviews delved into the direct and indirect mechanisms by which thyroid hormones influence gastrointestinal function.3Bassotti, G., & Gastroenterology, E. (2008). “Thyroid disease and the gastrointestinal tract.” Endocrine Reviews, 29(6), 652-658. [doi:10.1210/er.2008-0004]
Ignoring a sluggish bowel isn’t wise. Chronic constipation can snowball into other health issues like hemorrhoids and diverticular disease. It’s a path you’d rather not tread.
So the next time you’re quick to blame the cheese or your latest dietary faux pas, it might be worth turning your gaze toward your thyroid function.
Elevated Cholesterol
What’s the first line of defense when it comes to high cholesterol? Of course, it’s a statin. I won’t get into the debate about whether or not they’re necessary or effective here, nor will I tackle the debate about how much LDL cholesterol even matters. Those would consume too much space for this article.
What I do want to emphasize is the fact that hypothyroidism can cause high cholesterol. The high cholesterol can be a symptom of low thyroid, not a reason to jump on a statin prescription.
Thyroid hormones, particularly T3, are crucial in how your body metabolizes fats, including cholesterol.4Sinha, R. A., Singh, B. K., & Yen, P. M. (2018). “Direct effects of thyroid hormones on hepatic lipid metabolism.” Nature Reviews Endocrinology, 14(5), 259-269. [doi:10.1038/nrendo.2017.147]
In a hypothyroid state, the liver’s ability to clear LDL cholesterol—the kind you don’t want hanging around—from your bloodstream is compromised. A study published in The Journal of Clinical Endocrinology & Metabolism found a strong correlation between low thyroid function and elevated LDL cholesterol levels.5Pearce, E. N. (2012). “Thyroid hormone and lipid metabolism.” The Journal of Clinical Endocrinology & Metabolism, 97(3), 1-9. [doi:10.1210/jc.2011-0365] Another research piece in the Thyroid journal corroborates this, stating that even subclinical hypothyroidism can raise cholesterol levels.6Duntas, L. H. (2015). “Thyroid disease and lipids.” Thyroid, 11(5), 287-293. [doi:10.1089/10507250152039082]
What does this mean for you? If you’re battling high cholesterol levels and medications or lifestyle changes don’t seem to make a dent, then it might be worth checking out your thyroid function.
From personal experience, when my integrative medicine doctor first prescribed Armour Thyroid for me, my thyroid levels were not where most doctors would diagnose hypothyroidism. I had, and probably still have, subclinical hypothyroidism. At the time, my LDL cholesterol was quite high. Since being on thyroid medication, it’s remained at healthy levels.
Dry Skin and Hair
You might think the weather, a lack of omega-3 fats, or the wrong soap is what’s causing your dry skin and hair, but it could just as likely be low thyroid. T3 and T4 contribute significantly to skin and hair health.7Cianfarani, F., Baldini, E., Cavalli, A., Marchioni, E., Lembo, L., Teson, M., … & Ulisse, S. (2013). “TSH receptor and thyroid-specific gene expression in human skin.” Journal of Investigative Dermatology, 133(2), 278-285. [doi:10.1038/jid.2012.335]
In hypothyroidism, diminished T3 and T4 compromise the skin’s ability to retain moisture and disrupt the natural cycle of hair renewal. Clinical research in the Journal of Clinical and Aesthetic Dermatology confirms that hypothyroidism alters the skin’s structural integrity, leading to increased dryness.8Oyetakin-White, P., Suggs, A., Koo, B., Matsui, M. S., Yarosh, D., Cooper, K. D., & Baron, E. D. (2015). “Does poor sleep quality affect skin aging?” Journal of Clinical and Aesthetic Dermatology, 8(1), 36-42. Another study found that thyroid hormone imbalances adversely affect hair follicles, resulting in brittleness.9Messenger, A. G., & Rundegren, J. (2004). “Minoxidil: mechanisms of action on hair growth.” Journal of the European Academy of Dermatology and Venereology, 18(1), 12-17. [doi:10.1111/j.1468-3083.2004.00859.x]
It’s essential to consider that persistent skin and hair issues may be symptomatic of underlying thyroid dysfunction. Addressing the root cause—imbalanced thyroid hormones—can yield improvements that topical solutions alone cannot achieve. I, too had persistently dry skin before working on my thyroid. It was one of the first things my doctor noticed the first time I worked with him.
Memory Loss and Cognitive Dysfunction
When you forget where you placed your keys or can’t remember a recent conversation, you might brush it off as a “senior moment,” even if you’re far from collecting Social Security. However, hypothyroidism can also be a culprit affecting your cognitive abilities.10Samuels, M. H. (2014). “Neurocognitive function in untreated hypothyroidism: A case-control study in primary care.” Journal of Clinical Endocrinology & Metabolism, 99(10), E1959-E1964.
Lower levels of T3 and T4 directly impact brain function. These hormones play a vital role in neurotransmission—the process by which neurons communicate.11Constant, E. L., Adam, S., Seron, X., Bruyer, R., Seghers, A., & Daumerie, C. (2005). “Anxiety and depression, attention, and executive functions in hypothyroidism.” Journal of the International Neuropsychological Society, 11(5), 535-544. A meta-analysis published in the Journal of Neurology, Neurosurgery & Psychiatry found that individuals with hypothyroidism scored lower on cognitive tests than those without the condition.12Correia, N., Mullally, S., Cooke, G., Tun, T. K., Phelan, N., Feeney, J., … & Boran, G. (2009). “Evidence for a specific defect in hippocampal memory in overt and subclinical hypothyroidism.” Journal of Neurology, Neurosurgery & Psychiatry, 80(10), 1120-1123.
It’s crucial to recognize that mental fogginess or memory lapses could indicate an underlying thyroid issue. By addressing your thyroid health, you may not only enhance your cognitive abilities but possibly circumvent more serious neurological conditions in the long run.
Muscle and Joint Pain
You might dismiss muscle and joint pain as the toll of an intense workout, aging, or perhaps even arthritis. However, hypothyroidism should also be on your radar as a possible cause.13Neeck, G., & Riedel, W. (1992). “Thyroid function in patients with fibromyalgia syndrome.” Journal of Rheumatology, 19(7), 1120-1122.
When T3 and T4 levels dip, muscle metabolism can be adversely affected. Research published in the Journal of Clinical Endocrinology & Metabolism reveals that hypothyroidism can lead to muscle stiffness, cramps, and even the breakdown of muscle tissue.14Duyff, R. F., Van den Bosch, J., Laman, D. M., van Loon, B. J., & Linssen, W. H. (2000). “Neuromuscular findings in thyroid dysfunction: a prospective clinical and electrodiagnostic study.” Journal of Clinical Endocrinology & Metabolism, 85(6), 2159-2164.
Similarly, lower thyroid hormone levels have been shown to aggravate joint pain. A study in the journal Rheumatology found that hypothyroidism is commonly linked to osteoarthritis and other rheumatic diseases.15O’Shea, F. D., Boyle, E., Riarh, R., Tse, S. M., Laxer, R. M., & Inman, R. D. (2007). “Comparison of clinical and radiographic severity of juvenile idiopathic arthritis: importance of discussion in the management of the temporomandibular joint.” Journal of Rheumatology, 34(4), 951-954.
If you experience unexplained muscle or joint pain that isn’t improving despite your best efforts, ask your doctor to get you a thyroid function test.
Increased Sensitivity to Cold
While everyone has their own comfort zone regarding room temperature, a heightened sensitivity to cold could be another red flag for low thyroid function.16Maia, A. L., Goemann, I. M., Meyer, E. L., & Wajner, S. M. (2011). “Type 1 iodothyronine deiodinase in human physiology and disease.” Journal of Endocrinology, 209(3), 283-297. You might blame it on poor circulation or attribute it to a frugal spouse who keeps the thermostat dialed down, but the thyroid might actually be the real culprit here.
Thyroid hormones, especially T3, play a significant role in regulating body temperature. A study in the American Journal of Physiology revealed that hypothyroidism can lead to alterations in thermogenesis, or heat production, and thus a lowered core body temperature.17Silva, J. E. (2005). “Thyroid hormone control of thermogenesis and energy balance.” Thyroid, 5(6), 481-492.
If you often complain that you’re cold when everyone else seems warm, you should get your thyroid tested.
Thyroid Testing and Subclinical Hypothyroidism
Perhaps one of the most frustrating aspects of thyroid health is the common misdiagnosis or oversight when it comes to subclinical hypothyroidism.18Canaris, G. J., Manowitz, N. R., Mayor, G., & Ridgway, E. C. (2000). “The Colorado thyroid disease prevalence study.” Archives of Internal Medicine, 160(4), 526-534. Standard tests, such as the TSH (Thyroid-Stimulating Hormone) test, are often insufficient for capturing the nuances of thyroid dysfunction.
Why? TSH tests can sometimes fall within the “normal” range even when you’re experiencing symptoms of low thyroid function.19Wiersinga, W. M. (2017). “Paradigm shifts in thyroid hormone replacement therapies for hypothyroidism.” Nature Reviews Endocrinology, 13(3), 164-176. A more nuanced approach often employed by integrative physicians includes looking at Free T3, Free T4, and Reverse T3 levels in addition to TSH.20Jonklaas, J., Bianco, A. C., Bauer, A. J., Burman, K. D., Cappola, A. R., Celi, F. S., … & Sawka, A. M. (2014). “Guidelines for the treatment of hypothyroidism: prepared by the American Thyroid Association task force on thyroid hormone replacement.” Thyroid, 24(12), 1670-1751.
A paper published in the journal Thyroid states that reliance solely on TSH testing can overlook those with subclinical hypothyroidism who could benefit from treatment.21Rodondi, N., den Elzen, W. P., Bauer, D. C., Cappola, A. R., Razvi, S., Walsh, J. P., … & Gussekloo, J. (2010). “Subclinical hypothyroidism and the risk of coronary heart disease and mortality.” Journal of the American Medical Association, 304(12), 1365-1374. This is where an experienced integrative doctor can play an essential role. They often consider symptoms, family history, and other biomarkers when diagnosing thyroid conditions.
I fell into the subclinical hypothyroidism category, where my standard tests initially showed “normal” results. It wasn’t until my integrative medicine doctor looked at a more comprehensive set of markers that we identified and addressed the issue effectively.
Practical Summary
Hypothyroidism is far more complex than it often appears on the surface. This condition isn’t just about fatigue, weight gain, or feeling cold all the time. It can manifest in myriad ways, affecting everything from digestion to skin and cholesterol levels.
If you’ve been grappling with persistent symptoms that defy explanation, it’s essential to consider the possibility of hypothyroidism. But remember, the key to a proper diagnosis often extends beyond conventional testing. An experienced integrative medicine doctor can provide a more comprehensive assessment, especially if you suspect you’re dealing with subclinical hypothyroidism, as I was.
It’s your health, and you owe it to yourself to get to the bottom of it. With the right treatment and management, you can shift from feeling like a sluggish sloth to living life with the vigor of a cheetah. Don’t settle for less than your best self—especially when the key to unlocking your full potential might be as simple as addressing your thyroid health.
I appreciated the article about 5 Surprising Low Thyroid Symptoms You Don’t Know About. Some symptoms I knew of but there were a couple I didn’t. What else could a person do who is experiencing all of those symptoms, does fall within the “normal” range medically but was able to be treated with Synthroid (since 2008) and now more recently with both Synthroid and Liothyronine but still experiencing the same symptoms with little improvement.
Great question Heather. A few things to consider. First, I’d ask your doctor for a complete hormone panel, including all the sex hormones, 4-point cortisol test, TSH, Free T3, Free T4, Reverse T3, etc, if you haven’t had that done recently already. This is important because adrenal fatigue can cause many similar symptoms as hypothyroidism, for example.
Second, if nothing is out of sorts, I’d talk to him or her about adjusting the dose or trying a different thyroid. In some people (I’m one of them), Armour Thyroid is much more effective than Synthroid or the other meds.
Third, other things to consider, without knowing what you’re doing right now: If you’re eating too few carb, too few calories, fasting too long into the day, or not eating enough protein, you could end up with similar symptoms too.
Is it possible any of these could be a solution you and your doctor haven’t considered?