Your thyroid, a small gland in your neck, controls your metabolism. When it makes too little or too much hormone, it affects almost every part of your body. Thyroid problems are much more common in women and often develop slowly.
Imagine blaming two years of exhaustion, weight gain and low mood on long shifts, then discovering a single blood test could explain it, and a daily tablet could fix it.
| Underactive (hypothyroidism) | Overactive (hyperthyroidism) |
|---|---|
| Tiredness and sluggishness | Anxiety, irritability, restlessness |
| Weight gain | Weight loss despite eating more |
| Feeling cold | Feeling hot, sweating |
| Dry skin, thinning hair | Thinning hair |
| Constipation | Frequent bowel movements |
| Slow heart rate | Fast or irregular heartbeat |
| Low mood, poor memory | Trouble sleeping, shaky hands |
| Heavy or irregular periods | Lighter periods |
| Hoarse voice, puffy face | Bulging eyes (in Graves’ disease) |
Common causes
- Underactive: autoimmune disease (Hashimoto’s), iodine deficiency in some regions, after thyroid surgery or treatment
- Overactive: Graves’ disease, thyroid nodules, inflammation of the thyroid
The test
A blood test for thyroid-stimulating hormone (TSH), often with free T4, is the usual first step. High TSH suggests an underactive thyroid; low TSH suggests an overactive one.
Treatment
- Underactive: daily levothyroxine replaces the missing hormone, with blood tests to adjust the dose
- Overactive: medicines that reduce hormone production, radioactive iodine or sometimes surgery, plus beta blockers to ease symptoms
Pregnancy
Thyroid conditions in pregnancy need close monitoring because the baby relies on the mother’s thyroid hormone early on. Tell your midwife if you have a thyroid condition.
“But these symptoms are just stress and getting older.”
They might be. But thyroid problems are common, especially in women, and one blood test can rule them in or out. It is worth checking before accepting tiredness as normal.
Your next step: If several of these symptoms sound familiar, ask for a thyroid function blood test (TSH) at your next appointment.
Sources: British Thyroid Foundation; NICE guideline NG145, Thyroid disease: assessment and management; American Thyroid Association.
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