1) ….This list is based on actual thyroid patient descriptions of symptoms whether still on the inadequate T4-only medication or from being undiagnosed or UNDERtreated . i.e. it’s not culled from all sorts of internet cold lists to build high numbers and empty volume..

2) Symptoms will vary from individual to individual, but these are the most common.

3) Like some lists, it does not contain adrenal-specific symptoms to bulk up the list (unless noted in parenthesis as also related)

3) These are also symptoms which patients have reported greatly improved or totally went away once they moved over to having T3 in their treatment and being optimal to prevent the hypo from coming back. To get optimal without problems, you also have to have the right levels of iron and cortisol.


  • Less stamina than others
  • Less energy than others
  • Easy fatigue
  • Feeling weak
  • The need to nap more than others
  • Long recovery period after any activity
  • Arms feeling like dead weights after activity
  • Legs getting tired
  • Inability to exercise, or withstand certain exercises
  • Paying a price after activity
  • Inability to hold children for very long
  • Nodding off easily
  • Slowing to a snail’s pace when walking up slight grade
  • Difficulty getting through work day
  • The need to lay on the couch after getting home from work
  • Going to bed earlier than normal
  • “Exhaustion in every dimension–physical, mental, spiritual, emotional”


  • Sleep Apnea (which can also be associated with low cortisol due to continued hypothyroid state)
  • Being so exhausted at bedtime that you have insomnia
  • Sleeping hard
  • Sleeping more hours than normal
  • Dark circles under eyes
  • Yawning all the time
  • Heavy eyelids
  • Getting more fatigued as day goes on
  • The need for naps to get through the afternoon
  • Having trouble studying from snoozing
  • Air Hunger (feeling like you can’t get enough air)


  • Chronic Low Grade Depression
  • Major depression
  • Sadness
  • Moody
  • Need for antidepressants
  • Suicidal Thoughts
  • Hyper sensitive towards others
  • Crying easier
  • Ruminating/worrisome
  • Anxiety (can be a cortisol symptom, but also a hypo symptom and common with Hashi’s, as well)
  • Need for anti-anxietal meds
  • Complete lack of motivation
  • Extremely crabby or irritable
  • Worse PMS emotional symptoms
  • Intolerant of others
  • Bi-polar symptoms (often associated with Hashimoto’s)
  • Feeling on-edge


  • Often feeling cold all over
  • Wearing extra clothing compared to others
  • Cold hands and feet
  • Cold knees
  • A cold bum, butt, derriere, gluteus maximus, haunches, hindquarters, posterior, rear, and/or cheeks. Yup, really exists.
  • Cold ears
  • Cold fingers


  • The need for extra clothing from low metabolism
  • Feeling anxietal (caused by excess adrenaline due to hypo, but can also be related to adrenal issues)
  • High or rising cholesterol (slow removal of fatty acids)
  • Feeling too hot (Hashimoto’s disease usually, but can be due to other issues like low iron, low aldosterone)
  • Low body temperature
  • Less perspiration than others
  • Tendency to put on weight because of low metabolism


  • Swollen (especially Hashimoto’s, but can happen to non-Hashi’s patients)
  • Goiter diagnosis
  • Sore
  • Painful
  • Difficulty swallowing (Hashimoto’s)


  • Acid reflux / GERD
  • Low stomach acid (which causes above)
  • Diagnosis of ‘too much acid’ (it’s really about too little)
  • The need for antiacids to quell symptoms
  • Food sitting in stomach a long time
  • Bloating
  • Craving sweets more than normal
  • Burning stomach lining
  • Inability to eat in the mornings
  • Poor appetite
  • No Appetite
  • Reduced motility (slow movement of food)
  • Small Intestinal Bacterial Overgrowth (SIBO, due to reduced motility)
  • Extreme hunger, especially at nighttime (yes, a minority had this)


  • Poor absorption
  • Poor levels of iron
  • Poor levels of B12
  • Poor levels of Vitamin D
  • Poor levels of B-vitamins



  • Hard stools
  • Little round stools
  • Constipation
  • Diarrhea (less common than constipation)
  • Candida
  • Colitis
  • Irritable bowel syndrome (IBS)
  • Painful bladder; painful urination
  • Bladder spasms
  • Bladder urgency (can also be due to low aldosterone)
  • Not urinating much


  • No eyebrows
  • Thinning outer eyebrows
  • Dry Hair
  • Hair feels like straw
  • Excessive frizziness
  • Hair Loss
  • Broken hair
  • White hairs growing in
  • No hair growth, breaks faster than it grows
  • Dandruff
  • Only needing to wash hair once a week or so
  • Dry face
  • Dry cracking heels
  • Dry skin in general
  • Itchy skin
  • Scaly looking skin
  • Easy bruising!
  • Pimples
  • Acne (yes, some reported it went away on NDT!)
  • Swelling/edema/puffiness
  • Breakout on chest and arms
  • Hives (one woman stated hers went away with NDT, thus the connection here)
  • Neuropathy (nerve issues)
  • Vitiligo (especially with Hashimoto’s)


  • Dry Eye Syndrome
  • Worsening vision
  • Headaches and Migraines
  • Slurred Speech
  • Swollen Tongue
  • Scalloped tongue (in spite of other causes, hypo is one)
  • Lowered voice
  • Dry mouth
  • Gum Problems
  • Internal itching of ears
  • Ringing in the ears
  • Hearing problems
  • Dizziness from fluid on the inner ear
  • Puffy face
  • Puffy eyelids
  • Extra fat under chin/on neck


  • Puffy fingers/hands
  • Stiff fingers
  • Breaking/brittle nails
  • Broken/peeling fingernails
  • Ridged nails
  • Inflammation/pain in fingers
  • Inflammation/pain in hand
  • Tendonitis diagnosis
  • Carpel tunnel pain (also with Hashimoto’s)
  • Palm pain
  • Wrist pain


  • Bumps on legs
  • Swollen legs that impeded walking
  • Shin splints
  • Difficulty standing on feet
  • Sore feet
  • painful soles of feet (like walking on glass–very common)


  • Aching bones or muscles
  • Joint pain
  • Clicking in joints
  • Popping joints
  • Stiffness
  • Inflamed joints
  • Diagnosis of Fibromyalgia
  • Osteopenia
  • Osteoporosis
  • Muscular weakness in activities
  • Carpel Tunnel
  • Back pain
  • Shoulder pain
  • Frozen shoulder
  • Tender elbow
  • pain in knees


  • Inability to concentrate
  • Inability to read long periods of time
  • Inability to retain
  • Forgetfulness
  • Foggy thinking aka Brain Fog
  • Memory issues


  • Inability to lose weight in spite of trying hard
  • Losing only a little when trying hard
  • Gaining weight too easily
  • Obesity
  • Weight loss (a small minority experience this)
  • Fat tummy
  • Water retention
  • Edema


  • Inability to function well in a relationship
  • No or poor sex drive
  • Argumentative (from not feeling well, but can also be due to low cortisol)
  • Avoidance
  • Inability to work full time
  • Constantly tired at work
  • Lower quality work performance
  • The need for sit-down jobs


  • Failure to ovulate
  • Constant bleeding (see Rainbow’s story)
  • Heavy bleeding
  • Longer periods
  • Irregular periods
  • Moody periods
  • Excruciating pain during period
  • Worse PMS
  • PCOS
  • Inability to get pregnant
  • Miscarriages
  • Breast leakage
  • Urinary Tract Infections


  • Bad head colds
  • Seem to get more head colds than others
  • Poor resistance to illnesses going around
  • Taking longer to recover
  • Recurring viral or bacterial illnesses
  • Recurring sore throats
  • Chronic sinus infections
  • Persistant Candida
  • Tightness in throat; sore throat
  • Swollen lymph glands
  • Inflammation

CERTAIN MEDICAL CONDITIONS (though not saying YOUR condition is caused by hypothyroid, but for some, it appears so!)

  • Asthma
  • Dysautonomia symptoms (overreaction of one’s autonomic nervous system–Janie had this)
  • Hypoglycemia/Low Blood Sugar  And a study here.
  • Lactose Intolerance (due to low stomach acid from a poor treatment or undiagnosed)
  • Allergies (which can also be a result of low cortisol–see link below)
  • Dysphagia (nerve damage causing inability to swallow fluid, food, saliva; can also be caused by a goiter or anxiety)
  • Neurogenic bladder
  • Chronic Fatigue Syndrome (which for the vast majority of thyroid patients, is a catch-all diagnosis)
  • Fatty Liver


  • Bad motion sickness
  • Sweaty or clammy palms
  • Clumsiness
  • Worsening of other conditions
  • Handwriting nearly illegible
  • Carpal tunnel symptoms
  • Worsening Varicose Veins
  • Tailbone pain
  • Light headed
  • Just feeling sick
  • Breathless
  • Just generally struggling

In other words….

If you have some or many of these symptoms, and have never received a diagnosis of hypothyroidism, it’s time to visit an informed and open-minded doctor.

If you have some or many of these symptoms and are on T4-only, time to talk to your doctor about adding synthetic T3 to your treatment and getting optimal–the latter which is not just how you feel. It’s also about the free T4 and free T3.

If you have some or many of these symptoms and are on Natural Desiccated Thyroid or T3, you are either underdosing yourself (common scenario), or you need to read about the other two main reasons why one may not do as well on NDT. **NOTE that NDT is not the excellent product it used to be.

Check out Chapter 3 in the updated revised STTM book--all to make you more informed with your doctor. YOU are your own best advocate. Get informed with this BIBLE OF PATIENTS EXPERIENCES AND WISDOM. And see if you can teach your doctor!

Have Hashimoto’s disease? Here’s the excellent companion book to the above. It’s to the point, making it an easier book to get through on Hashi’s. Has a NOTES page after each chapter. Friendly. And four patient-to-patient chapters!

Important note: STTM is an information-only site based on what many patients worldwide have reported in their treatment and wisdom over the years. This is not to be taken as personal medical advice, nor to replace a relationship with your doctor. By reading this information-only website, you take full responsibility for what you choose to do with this website's information or outcomes. See the Disclaimer and Terms of Use.