All about Hypothyroidism (Part 4): What are the Signs and Symptoms of Hypothyroidism
Updated: Mar 2
What are the commonly seen symptoms of Hypothyroidism?
High TSH –Blood test showing TSH higher than 5.5 IU,
Weight gain/ Unable to lose weight,
Hair loss,
Fatigue,
Body pain & muscle cramps,
Puffy of face,
Irregular menstrual cycles,
Depression and anxiety,
Memory problems,
Loss of appetite and digestion problems,
Dry skin,
Cold intolerance,
Infertility
What is the link between Hypothyroidism and Hypertension (High blood pressure)
Secondary hypertension (High BP) has been linked to hypothyroidism in the past. Previous research into the prevalence of hypertension in hypothyroidism, had found that patients had higher blood pressure levels.
The relationship between hypothyroidism and diastolic hypertension has been postulated to be increased peripheral vascular resistance and decreased cardiac output.
Significant volume changes characterise the hypothyroid population, triggering a volume-dependent, low plasma renin activity mechanism of blood pressure increase. This article reviews prior research on the effects of hypothyroidism on blood pressure and the early stages of atherosclerosis.
Hypothyroidism is the cause of hypertension in 3% of persons with high blood pressure. Low thyroid function is also linked to hypercholesterolemia and an increase in fatty acids, raising the risk of cardiovascular disease. Supplementing with thyroid hormone may not always result in decreased blood pressure.
What is the link between Hypothyroidism and PCOS?
The most recent studies point towards a connection between Hypothyroidism and PCOS.
PCOS is a disorder caused by hormonal imbalance which affects 1 in 10 women in the reproductive age.
Both conditions are endocrine disorders which have overlapping features. But there is no conclusive evidence to prove that hypothyroidism can cause PCOS.
But this thyroid disorder can have an impact on the ovaries.
The high TSH and Prolactin levels in Hypothyroidism may in turn affect FSH, LH and DHEA causing anovulation and other changes in the ovaries and causing the cysts.
A specific kind of Hypothyroidism called Hashimoto’s Thyroiditis, which is an autoimmune condition, has been found to be more common in PCOS patients than others.
This kind is more common in women than men.
A study conducted in 2013 (Sinha U, Sinharay K, Saha S, Longkumer TA, Baul SN, Pal SK. Thyroid disorders in polycystic ovarian syndrome subjects: A tertiary hospital-based cross-sectional study from Eastern India. Indian J Endocrinol Metab. 2013;17(2):304-9. doi:10.4103/2230-8210.109714) found that 22.5% of women with PCOS had hypothyroidism compared to 8.75% in controls and thyroid antibodies have been shown to be present in 27% of patients with PCOS versus 8% in controls.
Though there is lack of conclusive evidence to say that Hypothyroidism causes PCOS, it is established that hypothyroidism can worsen the insulin resistance and other symptoms of PCOS.
Another study (Arduc A, Aycicek Dogan B, Bilmez S, Imga Nasiroglu N, Tuna MM, Isik S, Berker D, Guler S. High prevalence of Hashimoto’s thyroiditis in patients with polycystic ovary syndrome: does the imbalance between estradiol and progesterone play a role? Endocr Res. 2015;40(4):204-10. doi:10.3109/07435800.2015.1015730) reveals that Hypothyroidism (specifically the Hashimoto’s) can elevate the testosterone levels which can again worsen PCOS condition.
What is the link between Hypothyroidism and Infertility?
In women: As stated above, since there is a connection between hypothyroidism and PCOS and PCOS remains to be one of the main causes of infertility, it can easily be concluded that Hypothyroidism can be one of the conditions which affects fertility in women.
Hypothyroidism is seen to affect the ability to get pregnant and also to carry the pregnancy to full term.
A woman suffering from Hypothyroidism has lower levels of the thyroid hormones which interfere with ovulation. Implantation is also impacted, and chances of early miscarriage is also possible because of incomplete implantation.
The patient can also experience irregular menstrual cycles- longer or shorter, frequent cycles or amenorrhea (lack of menstrual cycle), heavy or scanty bleeding.
In men: Hypothyroidism can affect the quality and the quantity of the sperm and hence can affect the couple’s fertility. Low testosterone level has been associated with men suffering from Hypothyroidism which can be another factor causing infertility.
How does Hypothyroidism affect Pregnancy?
Pregnancy causes changes in the thyroid hormone levels. The symptoms could get worse in a pregnant woman who already has hypothyroidism.
In some other cases, hypothyroidism can set in during pregnancy or after child-birth. In undiagnosed or uncontrolled cases, there is an increased risk of miscarriage and premature birth.
Treating maternal hypothyroidism is very vital for the development of the baby. Uncontrolled hypothyroidism can lead to hypertension, muscle weakness and pain and anemia.
Women who have a previous or family history of thyroid disorders, autoimmune disorders, diabetes, PCOS, goiter are more vulnerable to hypothyroidism during or after pregnancy.