Hypothyroidism symptoms?

Originally Published: January 27, 1995 - Last Updated / Reviewed On: December 4, 2009
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Dear Alice,

I am an insomniac. I also have very dry skin despite frequent lotioning. I have other skin problems associated with dryness and flaking. I am always tired, but as I said before, I cannot sleep, ever! I never have energy. I read somewhere that these may be the symptoms of hypothyroidism, but they don't test for it in women under thirty-five. I am twenty-four. Could it be hypothyroidism? What else could these symptoms be about?

—Overtired and flaky

Dear Overtired and flaky,

Your symptoms do seem to mirror those of hypothyroidism, although only a health care provider can offer a diagnosis. Hypothyroidism is most prevalent in middle-aged and older women, but people of any age can develop the condition and there's no reason you shouldn't be tested.

The thyroid is a large, butterfly-shaped gland that sits just below the Adam's apple in the throat. It produces hormones essential to the normal functioning of metabolism, protein creation, and sensitivity to other regulatory hormones. Hypothyroidism means the thyroid gland is under-active, leading to underproduction of thyroid hormones. The condition is usually caused by the body developing antibodies against its own thyroid gland. One potential indication of the presence of hypothyroidism is an enlargement of the thyroid gland, called a goiter. The most common effects of this condition include:

  • muscle weakness
  • cramps
  • dry and flaky skin
  • hair loss
  • weight gain
  • lethargy

As thyroid hormones are responsible for stimulating energy production, a deficiency of these hormones causes a general tiredness. At this point, however, remember that insomnia also causes lethargy, and that insomnia is not a symptom of hypothyroidism. For tips on creating good sleeping habits, check out Columbia University's sleep information page.

Because of its increased prevalence in women over thirty-five, some health care providers begin routinely screening women of this age and older for the disorder during annual exams. But this certainly doesn't mean that those under thirty-five can't be tested. It might be helpful to make an appointment with your primary health care provider to discuss your symptoms and request a full physical and blood work to see if you have an under-active thyroid gland. It might also be helpful to discuss your dry skin and insomnia with your provider to see if s/he has any suggestions. Columbia students can make an appointment at Primary Care Medical Services (PCMS) by logging into Open Communicator or by calling x4-2284.

Blood tests are used to determine whether an individual has a hypothyroid condition. Standard treatment for hypothyroidism involves daily use of an oral supplement of the synthetic thyroid hormone levothyroxine, which helps to restore hormone levels to normal. Most people begin to feel less fatigued and symptomatic about one to two weeks after starting treatment.

It might also be useful to keep in mind that many conditions could cause dry skin and tiredness. Your health care provider should work with you to diagnose the underlying causes of your symptoms, and to create a treatment plan for them. If your current provider isn't willing to test a woman under thirty-five, perhaps you could go elsewhere for treating this situation. Take care,