Common Symptoms
| System | Symptoms |
|---|---|
| Metabolism | Weight gain, cold intolerance, low body temperature, slow heart rate |
| Energy | Fatigue, lethargy, poor concentration ('brain fog'), depression |
| Skin/Hair/Nails | Dry skin, hair loss, brittle nails, non-pitting oedema (myxoedema) |
| Gut | Constipation, reduced appetite |
| Reproductive | Heavy periods, reduced fertility, elevated prolactin |
| Cardiovascular | Raised cholesterol, raised diastolic BP, pericardial effusion (severe) |
| Neuromuscular | Muscle cramps, carpal tunnel syndrome, peripheral neuropathy |
Check TSH FirstA normal TSH makes hypothyroidism very unlikely. If your symptoms are classic but TSH is normal, explore other causes: anaemia, vitamin D deficiency, sleep disorder, depression.
Myxoedema Coma
A rare, life-threatening complication of severe untreated hypothyroidism — precipitated by illness, surgery, or cold exposure. Presents with profound hypothermia, coma, hypoventilation, and bradycardia. Medical emergency.
How long until levothyroxine works?
Symptoms begin improving within 2–4 weeks, but full normalisation of TSH and symptom resolution takes 6–8 weeks. Some patients feel better within days — others need dose optimisation over months.
Do I have to take levothyroxine forever?
In Hashimoto's hypothyroidism, yes — the thyroid rarely recovers. In transient thyroiditis, T4 may be discontinued after 6–12 months. This is guided by regular TSH monitoring.
Why am I still symptomatic with normal TSH on levothyroxine?
Check: Free T4 (should be in upper half of range), vitamin D, B12, ferritin, depression screen. Some people do better with addition of T3 (liothyronine) — discuss with an endocrinologist.
Can hypothyroidism cause high cholesterol?
Yes. TSH drives lipid metabolism. Hypothyroidism raises LDL and total cholesterol. Cholesterol often normalises with effective thyroid replacement — confirm thyroid is optimally treated before starting statins.
Medical Disclaimer: This page is for general education only and does not replace professional medical advice. Always consult a qualified healthcare provider.