Thyroid disease is common, and many people don’t know they have it. That may be in part because some of the symptoms are surprising.

About 30 million people suffer from thyroid dysfunction. And more than half don’t know they have a problem, says the American Association of Clinical Endocrinology.  Because many of the signs are subtle, come on slowly and can seem like other problems, many people are not diagnosed and treated.

Common signs of thyroid disease are unexplained weight gain or loss, fatigue, insomnia, and depression or anxiety. But some symptoms of thyroid problems may not seem like they would have anything to do with a thyroid problem:

• Shaking and nervousness
• Fast heart rate
• Changes in memory or ability to concentrate
• Muscle weakness or aches
• Joint pain or stiffness
• Puffy face
• Dry skin
• Hoarse voice
• Trouble swallowing or breathing
• Changes in menstrual patterns

What Does the Thyroid Do?

While small in size, the thyroid plays a huge role in your total health.

The thyroid is a gland in the front of your neck that makes hormones that impact almost all parts of your body. It affects the work of many of the body’s most vital organs, including the heart, brain, liver, kidneys and skin. Keeping the thyroid gland healthy and working the right way is vital to the whole body.

Along with unexplained weight gain, those with an underactive thyroid may have hair loss, fatigue, dry skin and joint pain. Called hypothyroidism, it’s the most common problem. Many people just feel "off," with no clear signs of being truly sick.

Sometimes, the thyroid makes too much hormone. This is called hyperthyroidism. Some signs involve nervousness, sweating, rapid heartbeat, shaking hands, sleeping problems and weight loss.

Both types are more common in women than in men.

Another type of thyroid problem is thyroid cancer. Signs of thyroid cancer include a lump or pain in the front of the neck, swelling in the neck, hoarseness or voice changes that don’t go away, trouble swallowing or breathing, or a constant cough not due to other illness.

Most thyroid cancer can be diagnosed early and treated successfully.

Think You Might Have Thyroid Troubles?

• Talk to your doctor. A blood test can measure the amount of thyroid hormone you have. Your doctor will use the results to see if you need to be treated for thyroid disease.
• Check your neck.  A lump or enlargement of the small gland in the lower front part of your neck can be a sign that there’s a problem. Thyroid lumps, or nodules, are common. Most are not cancerous. But if you notice one, it’s important to be checked by your doctor.

The American Thyroid Association offers links to patient education materials.  

How Is It Treated?

Most thyroid health problems can be treated with medication. Finding just the right amount of medication to keep levels stable can take time. In some cases, surgery may be needed.

Left untreated, thyroid disease can raise the risk for serious health problems. Getting care prevents long-term harm. If you think you may have signs of a thyroid problem, talk to your doctor.

Sources: Hyperthyroidism,  Hypothyroidism,  American Academy of Family Physicians, 2020; All About Thyroid  , How to check your thyroid,  American Association of Clinical Endocrinologists; About Thyroid Cancer,  American Cancer Society

Originally published 5/1/2015; Revised 2021, 2024