The thyroid is a small, butterfly-shaped gland in your neck that controls how your body uses energy. When it makes too little or too much hormone, the symptoms are often vague and easy to blame on stress or a busy life — which is why thyroid problems are so commonly missed. A simple TSH blood test usually gives the answer.
Signs of an underactive thyroid (hypothyroidism)
Hypothyroidism means the gland is slow and not making enough hormone. It's the most common thyroid problem, especially in women. Watch for:
- Constant tiredness even after enough sleep
- Unexplained weight gain or difficulty losing weight
- Feeling cold when others are comfortable
- Dry skin and hair fall
- Constipation
- Low mood, poor concentration or "brain fog"
- Heavier or irregular periods
- Puffiness of the face
Signs of an overactive thyroid (hyperthyroidism)
Hyperthyroidism means the gland is working too fast. Symptoms tend to be the opposite of an underactive thyroid:
- Weight loss despite a normal or increased appetite
- Palpitations or a racing heartbeat
- Anxiety, irritability or restlessness
- Trembling hands (tremor)
- Feeling too hot and sweating easily
- Lighter or irregular periods
- Difficulty sleeping
Why thyroid problems are missed
Each symptom on its own is common and non-specific — tiredness, weight change or low mood can have many causes. The thyroid is often overlooked because people (and sometimes doctors) attribute the signs to ageing, stress or lifestyle. The reassuring part: a single blood test (TSH, sometimes with T3, T4 and antibodies) reliably picks up most thyroid disease, and treatment is usually straightforward and very effective.
Who should get their thyroid tested?
- Women, especially after pregnancy or around menopause
- Anyone with a family history of thyroid disease
- Those planning pregnancy or facing fertility difficulty
- People with a neck swelling or a lump (goitre or nodule)
- Anyone with several of the symptoms above
When to see a doctor
See an endocrinologist if you have multiple ongoing symptoms, a neck swelling, an abnormal thyroid report, thyroid problems during pregnancy, or if you're already on thyroid medicine but still don't feel well. Getting the diagnosis and dose right makes a genuine difference to how you feel day to day.
- Sources: American Thyroid Association (ATA) — patient guides on hypothyroidism and hyperthyroidism; World Health Organization — thyroid and iodine health information.