Symptoms:

Early symptoms:

• Being more sensitive to cold
• Constipation
• Depression
• Fatigue or feeling slowed down
• Heavier menstrual periods
• Joint or muscle pain
• Paleness or dry skin
• Thin, brittle hair or fingernails
• Weakness
• Weight gain (unintentional)

Late symptoms, if left untreated:

• Decreased taste and smell
• Hoarseness
• Puffy face, hands, and feet
• Slow speech
• Thickening of the skin
• Thinning of eyebrows

Signs and tests:

A physical examination may reveal a smaller than normal thyroid gland, although sometimes the gland is normal size or even enlarged (goiter). The examination may also reveal:

• Brittle nails
• Coarse facial features
• Pale or dry skin, which may be cool to the touch
• Swelling of the arms and legs
• Thin and brittle hair

A chest x-ray may show an enlarged heart.

Laboratory tests to determine thyroid function include:

• TSH test
• T4 test

Lab tests may also reveal:

• Anemia on a complete blood count (CBC)
• Increased cholesterol levels
• Increased liver enzymes
• Increased prolactin
• Low sodium