Why Am I So Tired All of the Sudden? The Signs and Symptoms of Hypothyroidism when your Thyroid Hormone Output is Low

What is the Thyroid Gland?

The thyroid is a small gland located in the front of your neck, just below your voice box, or “Adam’s Apple”. It’s a small gland, but its duties in regulating functions of your body and maintaining your health are tremendous. This all works in quite a mechanical way, but the basic idea is that under control of the pituitary gland, the thyroid takes up iodine from the foods we eat and, in combination with the amino acid Tyrosine, converts it into thyroid hormones. These thyroid hormones are known as triiodothyronine, most commonly referred to as T3; and thyroxine, most commonly referred to as T4. From there, T3 and T4 are distributed throughout the body and regulate our metabolism. An excess or insufficiency of thyroid hormones can lead to many overlapping symptoms and completely throw life as we know it totally off balance.


What is Hypothyroidism and How Do You Get it?

When you hear the term hypothyroidism, it sounds pretty scary. All it means is that you have an underactive thyroid. Your thyroid isn’t producing enough of the thyroid hormone thyroxine, to perform the monumental functions it is designed to perform. Your thyroid regulates your metabolish, which in turn regulates many, many bodily functions. When you are experiencing untreated hypothyroid symptoms, you truly feel like your body is giving out. The good news is that it can be easily treated and you can get back to feeling normal again.

Hypothyroidism can be caused by autoimmune disorders like Hashimoto’s thyroiditis, or it can caused by radioactive iodine treatment for hyperthyroidism, where the thyroid is, in essence, killed off. Some people are born without a fully developed, normally function thyroid gland, and some people developed nodules on their thyroid as a result of receiving x-rays when they were younger, before precautions were being taken to guard against radiation damage. Lithium can actually cause temporary hypothyroidism. Whatever the reason, the symptoms are the same. It is a whole body disease, but it comes on quietly and many times over a period of years. Typically, depression is one of the first symptoms of hypothyroidism, but unfortunately, a thyroid test is rarely ordered at this early stage. Many of us who have experienced untreated symptoms feel like we our mind and our body is absolutely falling apart. Your entire body slows down, along with most of its functions, and continues to slow down if left untreated.

Goiter | Source

Common Symptoms

  • Depression
  • Dry, Scaly, Itchy Skin
  • Intolerance to Cold Cold Hands and Feet
  • Loss of Memory
  • Achy joints
  • Dry Hair/Scalp
  • Hoarseness/Raspy Voice
  • Weight Gain with or without a lowered appetite
  • Constipation Extreme fatigue
  • In women, longer and heavier, or absence of, menstruation
  • Dry eyes
  • Cracked, brittle fingernails
  • Lowered, or absence of, libido
  • Lessened ability to pay attention/lowered comprehension
  • Lowered heart rate
  • Goiter (swelling of the thyroid)
  • Muscle weakness/fatigue

It is important to remember that it hypothyroidism symptoms come on slowly--sometimes over a period of years. As your metabolism slow further and further, the symptoms become more plentiful, more bothersome and more pronounced.



Your doctor will feel (palpate) your thyroid to check for any nodules or swelling. He/She will order a simple blood test to check the levels of your thyroid hormones. Many doctors will order a test of your TSH and T4 levels. A TSH test measures your Serum Thyrotropin, which is a thyroid stimulating hormone. TSH is produced by your pituitary gland and is the hormone that prompts your thyroid gland to release T3 and T4. If your TSH level is high and your T4 is low, it is a very good indication that your thyroid is underactive and is not producing enough thyroid hormones to support your metabolism. Most labs consider a TSH of above 6 to be high, however, it is now being recommended that anything above a 3 needs to be taken under consideration--at least for further testing, with anything between a .3 and 3 being considered normal. Many people feel better with a TSH around 1.

There are many other thyroid tests that can be ordered depending on your doctor, but the above are the most common. In addition to a blood test, your doctor may order an ultrasound of your thyroid gland to check for any abnormalities. This is usually done in cases where the doctor feels an abnormality when he palpates the gland at your visit.


Luckily for hypothyroidism victims, it is easily treatable with a daily dose of synthetic thyroid medication like Levothroid or Synthroid. The pill is small, and side effects are EXTREMELY rare. Normally your doctor will start with a low dosage, and then re-test your thyroid levels in 6-8 weeks. If your levels aren't right, he will adjust your dosage and re-test again until your lab results come back normal. The best thing is that as the hormone is re-introduced at the correct levels, your symptoms will begin to correct themselves, even the weight gain! Slowly but surely, you will get back to normal. Remember, though, that current TSH lab values are higher than what the American Association of Endocrinologists has recommended. If you still don't feel right, ask to have your medication adjusted some more, ask to have more tests run. If you can't get your family doctor to listen to what your symptoms are because the lab ranges are what are considered to be normal, ask to be referred to an endocrinologist.

Common Lab Values For Blood Tests


  • Serum thyroxine T4 4.6-12 ug/dl
  • Free thyroxine fraction FT4F 0.03-0.005%
  • Free Thyroxine  FT4 0.7-1.9 ng/dl
  • Thyroid hormone binding ratio THBR 0.9-1.1
  • Free Thyroxine index FT4I 4-11
  • Serum Triiodothyronine T3 80-180 ng/dl
  • Free Triiodothyronine l FT3 230-619 pg/d
  • Free T3 Index FT3I 80-180
  • Radioactive iodine uptake RAIU 10-30%
  • Serum thyrotropin TSH 0.5-6 uU/ml
  • Thyroxine-binding globulin TBG 12-20 ug/dl T4 +1.8 ugm
  • TRH stimulation test Peak TSH 9-30 uIU/ml at 20-30 min
  • Serum thyroglobulin l Tg 0-30 ng/m

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Comments 16 comments

AliciaC profile image

AliciaC 6 years ago from British Columbia, Canada

Thank you for an informative and useful hub. I am very interested in hypothyroidism. The disorder can cause so many problems. My sister has hypothyroidism and experienced many of the symptoms that you listed before her problem was diagnosed and she received treatment.

Virtual Treasures profile image

Virtual Treasures 6 years ago from Michigan Author

There are many, many more symptoms. I swear there were days I truly thought I was going crazy. I couldn't remember things, I couldn't think straight. I would act horribly to my family. It's a horrible disease that people really discount until they are affected by it. You just can't imagine how much it affects you until it hits you.

RandomLife profile image

RandomLife 6 years ago from Nashville TN

I also have hypothyroidism. For me, I didn't get a lot of relief from my meds even after several increases and going on name brand. I bought a book called Encyclopedia of Healing Juices and started juicing for my thyroid. Now, I've cut my meds in half and feel much better but I do have to juice every day. Small price to feel better. I've bought many books on the subject and was very small all of my life till all of a sudden gained a huge amount of weight. Since juicing I've lost 28 lbs so far and it's stayed off. It's worth checking alternative health resources, at least it was for me. =)

toknowinfo profile image

toknowinfo 5 years ago

Great hub. You really detailed a lot and filled this with valuable information. Excellent hub. Rated up and awesome.

ttagpine profile image

ttagpine 5 years ago

Well written! I have most of those symptoms & have recently been diagnosed. I've been blaming the symptoms on the stress from my previous employment, & my ongoing disability. Do you have any articles on Parkinson's?

justmesuzanne profile image

justmesuzanne 5 years ago from Texas

Valuable information! Voted up and useful! :)

tillsontitan profile image

tillsontitan 5 years ago from New York

You did an excellent job on this one! You provided details, lists, charts and excellent illustrations. So many women are unaware of their thyroid issues, this should help some recognize. I know, I have a hypo thyroid. Voted up, interesting, useful. Thanks for SHARING.

AudreyHowitt profile image

AudreyHowitt 5 years ago from California

I wonder about the interplay between menopause and thyroid problems in women--great article!

rlaha profile image

rlaha 5 years ago from Spartanburg, SC

This is a great hub. I had an autoimmune disease (Hashimoto's Thyroiditis) of my thyroid gland which led to hypothyroidism. I was later diagnosed with papillary carcinoma (cancer), a known side effect of this autoimmune disease. Since I had to have my whole thyroid gland removed, I have been on thyroid medication.

Believe me, it is hard to lose the weight with a thyroid condition. Exercising and healthy eating has not done anything at all for me. I have been to the doctor many times for this and he says that I need to do more exercise and eat less fatty foods. I don't think I eat much fat anyways, but let's see what I can do.

Thanks for sharing!

Virtual Treasures profile image

Virtual Treasures 5 years ago from Michigan Author

Audrey--I'm telling you, I feel extremely hypothyroid when I'm ovulating. All of the symptoms are there. I know there has to be some connection. With the way our hormones interplay, there has to be. I just don't know what it is.

rlaha--I agree. I gained it so quickly and it becomes so frustrating when you just about can't eat anything at all to be able to lose it. Working so hard at it and not seeing any results really doesn't give you any motivation to keep trying. I am where you are! If you ever find something that works, please let me know!

rlaha profile image

rlaha 5 years ago from Spartanburg, SC

Hi Virtual Treasures.

It is really hard. I have gained almost 40 pounds over the years and nothing seems to help. The only thing that I did try (which I am ashamed to say actually works), is Alli. I tried it for a couple of months and exercised. The only downside is that you really have to eat non oily foods to avoid having oily BMs. I stopped because I didn't have the money to keep buying it. That's when I blew up. I really don't want to have to use pills to help me lose the weight but if that is the only option I'm actually open to it.

Virtual Treasures profile image

Virtual Treasures 5 years ago from Michigan Author

rlaha--I actually asked my Dr. to give me pills just to get me started and he wouldn't. I did try Nutrisystem and had a lot of success, but couldn't afford to keep buying it, either. There is a lot of protein and fiber in Nutrisystem and soy in just about everything. It was so easy, too.

rlaha profile image

rlaha 5 years ago from Spartanburg, SC

I wonder if the Atkins diet would work for our situations then? I know that they have recipes for more protein and fiber and less carbs in the diet. Maybe we should try that?

Virtual Treasures profile image

Virtual Treasures 5 years ago from Michigan Author

I couldn't lose a pound with Atkins and I'll never figure out why. Everyone I was doing the diet with did fantastic. I was so frustrated because it just wouldn't work.

rlaha profile image

rlaha 5 years ago from Spartanburg, SC

Hmm. Maybe it is just the way we are with our thyroid issues. :(

Hummingbird5356 profile image

Hummingbird5356 4 years ago

I was diagnosed with this 10 years ago and have taken Levothyroxine ever since and it has solved the problem. Good hub and I look forward to reading more of your hubs.

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