10 Subtle Signs Your Thyroid Hormones Might Be Off (Beyond a Lump in Your Neck)

Changes to your thyroid hormone can cause a host of subtle symptoms, says Amy Myers, MD, a functional medicine doctor and author of The Thyroid Connection. But over time, they can take a toll on your health and your quality of life. So the sooner you can spot them—and get them checked out and treated—the sooner you can start feeling better.

So what signs should you be watching for? Here's a look at some of the most common early signs of thyroid issues. Plus, how you can manage them.

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Types of thyroid problems

A bunch of different issues can cause your thyroid to make too much or too little thyroid hormone. When that happens, you can end up with a thyroid disorder. The most common thyroid problems include the following, per the NLM:

• Hyperthyroidism: an overproduction of thyroid hormone (which can result from certain chronic conditions like Grave's disease)
• Hypothyroidism: an underproduction of thyroid hormone (which can result from an autoimmune condition called Hashimoto's disease, or chronic lymphocytic thyroiditis)
• Goiter: an enlarged thyroid gland
• Thyroiditis: when your thyroid is swollen
• Thyroid nodules: lumps on your thyroid gland
• Thyroid cancer

10 early warning signs of thyroid problems

A thyroid that's working overtime (or not enough time) can cause symptoms throughout your body. In general, too much thyroid hormone tends to speed certain bodily processes up, while too little can slow them down, notes Dr. Myers.

According to Dr. Myers and the Cleveland Clinic, common red flags (i.e., potential symptoms your thyroid is off), include the following:

1. Weight changes

Unexplained weight gain or trouble losing weight can be a warning sign of hypothyroidism or Hashimoto's disease. On the other hand, unexplained weight loss or trouble keeping weight on could signal hyperthyroidism or Grave's disease.

2. Temperature sensitivity

If you have hypothyroidism or Hashimoto's disease, you might have trouble tolerating cold temperatures or often feel chilly (especially in your hands and feet). With hyperthyroidism or Grave's disease, you might feel unusually sensitive to warm temperatures or get facial flushing.

3. Brittle nails or hair loss

Hypothyroidism or Hashimoto's disease can make your hair feel coarser and drier, or even start to thin or fall out. Your nails might appear brittle or cracked, too.

4. Brain fog and mood changes

An underactive thyroid can make it harder to remember things or think clearly. You might feel inexplicably sad or depressed, too. And if your thyroid is overactive, you might feel anxious, nervous, or irritable.

5. Trembling

Hyperthyroidism or Grave's disease can make your hands shaky or jittery. You might have some muscle weakness, too.

6. Sleep changes or fatigue

Many people with hypothyroidism or Hashimoto's disease feel sluggish and tired, even after getting enough sleep. On the other side, hyperthyroidism can leave you feeling "amped up," or even cause you to have a hard time falling asleep at night.

7. Vision problems

Many people with an overactive thyroid notice that their eyes seem to bulge out or feel like they're dry and irritated. Eye issues are also a common symptom of Grave's disease.

8. GI issues

Your thyroid and gut health are closely connected, which means fluctuating thyroid hormones can mess with your stomach. If your thyroid is underactive, you might feel constipated or bloated. If it's overactive, you might get bouts of diarrhea.

9. Heart issues

If your thyroid is overactive, you might feel heart palpitations or like your heart is beating faster than normal. People with an underactive thyroid might notice their heart rate is slower than normal.

10. Sore thyroid gland or neck

Infectious thyroiditis, which is when the thyroid is inflamed due to an infection, can sometimes cause neck pain that radiates up towards your jaw or ears. And while a goiter is typically painless, it can cause some discomfort in your neck if it grows large enough, per the Cleveland Clinic.

Are thyroid symptoms different between men and women?

"Women are five to eight times more likely to develop thyroid disease," Dr. Myers says. So if women do get thyroid problems, they may have more (and more specific) symptoms than men.

Menstrual cycle problems are at the top of that list. Both too much or too little thyroid hormone can cause your periods to be lighter or heavier than normal, or straight-up irregular, per the Office on Women's Health. In some cases, your periods might stop altogether until your thyroid problem is treated.

Untreated thyroid conditions can also cause menopause-like symptoms. Alongside period changes, you could have hot flashes or a decreased sex drive, Dr. Myers notes.

There can be challenges related to pregnancy, too. Because thyroid problems can affect your period, they can make ovulation less predictable and, ultimately, make it harder to conceive. For pregnant people, unmanaged thyroid conditions can also lead to thyroiditis after giving birth, or cause health problems for your baby, Dr. Myers says.

How to get your thyroid levels back into a healthy range

Lifestyle changes and medication can help regulate your thyroid levels that have gone too high or low. Whether you need medication will depend on the type of thyroid problem you have and how severe it is. Some thyroid treatment options include the following:

Lifestyle changes

Mild cases of hypothyroidism can sometimes be fixed with healthy habits alone, according to the Mayo Clinic. Some strategies that may help include:

• Diet changes. A wholesome diet—think fruits and veggies, whole grains, lean proteins, low-fat dairy, and healthy fats—can support healthy thyroid function. In particular, a Mediterranean-style diet has been tied to lower rates of thyroid disease, according to an October 2022 review in Nutrients¹. The review also noted the benefits of eating foods rich in iodine (found in seaweed, fish, dairy, and eggs) and selenium (found in fish, poultry, beef, and Brazil nuts), which might support thyroid health.
• Exercise: Research suggests that regular movement could help give your thyroid a boost. One small October 2018 study in the Archives of Endocrinology and Metabolism² found women with subclinical hypothyroidism—which can develop into hypothyroidism and may or may not be accompanied by classic hypothyroid symptoms—who engaged in 60 minutes of aerobic activity three times a week for 16 weeks had improved thyroid function along with improved mental and emotional health.
• Sleep: Getting the right amount of shut-eye (think: 7 to 8 hours) is tied to healthier thyroid hormone levels, found a September 2023 study in PLoS One³.

Medications

Meds are usually needed to treat an overactive thyroid, but they may be needed for an underactive thyroid if lifestyle changes haven't improved your levels after several months.

Grave's disease, which often causes hyperthyroidism, can be treated with the following medications, which can stop or greatly reduce the production of thyroid hormones, per the Cleveland Clinic:

• Methimazole
• Propylthiouracil
• Radioactive iodine

Beta blockers are another option. They won't change how much thyroid hormone you make, but they can help manage your symptoms, notes the Cleveland Clinic.

Hashimoto's disease, a common cause of hypothyroidism, can be treated with thyroid-replacement medications like levothyroxine—a synthetic hormone that mimics the natural hormone your thyroid doesn't make, to reduce or eliminate your symptoms, per the Cleveland Clinic.

Surgery

In severe cases of hyperthyroidism, your doctor might recommend removing your thyroid gland. In that case, you'll likely need to take synthetic thyroid medication like levothyroxine to make sure you're getting the right amount of thyroid hormone.

How to check your thyroid gland

The only way to tell for sure if you have an under- or overactive thyroid is by having your thyroid hormone levels measured. This means, if you're having symptoms that you think are thyroid-related, let your doctor know. A simple blood test can determine your thyroid function, and help your doctor properly diagnose you.

You can also try an at-home finger prick test like Let'sGetChecked or Paloma Health Complete Thyroid Home Test Kit, says Dr. Myers. You can bring the results to your doctor and discuss the findings together, to decide if you need more testing or treatment.

All that said, bulges or lumps near your thyroid (located in the center of your neck, right above your collarbone) could also be a sign of an enlarged thyroid gland, a thyroid nodule, or in rare cases, thyroid cancer. To do a quick check, look in the mirror while taking a sip of water with your head tilted back slightly, recommends the American Association of Clinical Endocrinology. If you notice a bulge or protrusion when you swallow, that could be a sign of a thyroid growth or enlargement.

When to see a doctor

If you've gone more than a week or two with unexplained symptoms that could be thyroid-related, let your doctor know. "Recognizing the early warning signs of thyroid disease is the first step to getting to the root cause of your symptoms," Dr. Myers says. Most thyroid conditions are easy to manage with the right treatment, but letting them go under the radar could potentially lead to serious health problems (not to mention you feeling pretty lousy).

You should also seek medical attention for severe symptoms like a rapid heartbeat, high fever, confusion or agitation, diarrhea, or loss of consciousness. These could be signs of thyrotoxicosis (i.e., thyroid toxicity), or dangerously high levels of thyroid hormone, per the Cleveland Clinic.

FAQ

What's the main cause of thyroid problems?

Thyroid problems happen when a person's thyroid either makes too much or too little thyroid hormone, per the Cleveland Clinic. This change can be caused by a number of things, including a thyroid infection, autoimmune conditions, iodine deficiency or excessive iodine intake, or hormone changes triggered by pregnancy or menopause.

At what age do thyroid problems start?

While thyroid issues can happen to anyone, both hypo- and hyperthyroidism are more common in women over 60, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). This may be related to hormone changes that happen during menopause, but can also happen as a result of other autoimmune conditions that increase in old age, or a previous surgery or radiation treatment to the thyroid, neck, or chest, per the NIDDK.

How can I boost my thyroid naturally?

Lifestyle changes like a well-balanced diet, regular exercise, and adequate sleep may help support healthy thyroid levels. But in many cases, medication is needed to bring too-high or too-low thyroid levels back into the healthy range.

—reviewed by Jennifer Gilbert, MD, MPH