Thyroid disease is common and it affects about five times as many women as men. Knowing the signs can help, but many thyroid symptoms are non-specific, which means they can overlap with a long list of other conditions. That is why it helps to know the red flags doctors take most seriously.
We asked endocrinologists to share the number-one sign your thyroid may be out of balance, so you can act early if something feels off.
Two main types of thyroid disease
Thyroid conditions generally fall into two categories:
- Hypothyroidism (underactive thyroid): when thyroid hormone levels are too low, often due to damage to the thyroid from an underlying disease process, thyroid removal during surgery, neck radiation or certain medicines
- Hyperthyroidism (overactive thyroid): when too much thyroid hormone circulates in the bloodstream
Both can affect how the body uses energy and regulates metabolism, which is why symptoms can show up in unexpected ways.
The number-one sign of an underactive thyroid
If you have hypothyroidism, your body is not making enough thyroid hormone. Because the thyroid helps regulate metabolism, this can trigger a wide range of symptoms.
The key sign to watch for, according to endocrinologist Dr Vivian Sobel, is cold intolerance, especially if it feels sudden or persistent. If you feel unusually cold for an extended period or you become noticeably less tolerant of cold temperatures, it is worth speaking with your doctor.
While fatigue and gradual weight gain are common in people with an underactive thyroid, Dr Sobel notes they can be hard to pin on the thyroid alone. They “are usually non-specific symptoms, and unless severe are unlikely to be caused by hypothyroidism,” she says. Cold intolerance, on the other hand, can be a stronger clue that the thyroid may be involved.
The number-one sign of an overactive thyroid
Hyperthyroidism speeds up many processes in the body, including those linked to heart rate and rhythm.
The top symptom that should prompt a medical check, according to endocrinologist Dr Jamie Mullally, is a rapid or irregular heartbeat. “Palpitations or a racing heart are not something to ignore, since hyperthyroidism can affect heart rhythm,” she explains.
What to do if you suspect a thyroid issue
If you notice these symptoms and something does not feel right, ask your doctor about a blood test to check thyroid hormone levels.
“Many women over 50 have mild or early hypothyroidism, sometimes without realizing it,” says Dr Mullally. “Hyperthyroidism is less common overall, but the prevalence is higher in older women.”
Treatment depends on the type of thyroid condition, but it often involves daily medication and monitoring. If you are feeling off, speak with your healthcare provider so they can assess your symptoms, order the right tests and tailor treatment to your needs.
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