If you’ve lost the pep in your step, more could be at work than an afternoon slump. Your thyroid, a small butterfly-shaped gland on the front of your neck, may not be firing on all cylinders.

Your thyroid releases hormones that control your energy levels and metabolism. If it isn’t functioning at full throttle, neither can you.

In the case of hypothyroidism, your thyroid doesn’t release enough hormones. You could experience fatigue, weight gain, hair loss, and other symptoms.

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Hypothyroidism is sneaky. It’s not like one day you’re happy, motivated, and svelte and the next you’re laid out on the couch packing an extra 20 pounds.

The decrease in thyroid hormone is usually slow, making it hard to recognize the change. Symptoms are also gradual and vary based on your age, medical conditions, and biochemistry. They can be slippery and hard to spot at first.

The list of potential symptoms is long — you may not experience all of them. But being aware of them can help you seek treatment before complications develop.

Symptoms in adults

Hypothyroidism becomes more common after you hit 60 years of age. Many people dismiss the symptoms as typical aches, pains, and fatigue that would normally come along with aging.

It’s yet another reason hypothyroidism can be sneaky. 🕵🏻‍♂️

Common symptoms include:

Symptoms in infants

Infants are far less likely to develop hypothyroidism than older adults. But it can happen, and when it does, they can’t tell you something doesn’t feel right (not all babies are Stewie Griffin).

The symptoms for infants are a little different from those of adults:

Symptoms are often unnoticeable in infants. But as the symptoms progress, an infant may not grow as expected and may have difficulty feeding.

Undiagnosed hypothyroidism in infants can be dangerous, leading to potentially serious physical and mental delays.

Many states require a thyroid screening at birth to catch a problem before it reaches the danger zone. Regular well-child checkups can also help doctors stay on top of thyroid problems.

Symptoms in children/teens

Children and teens experience many of the same hypothyroidism symptoms as adults. However, children and teens are still growing.

Hypothyroidism has developmental symptoms in teens, including:

  • slower mental development
  • slower physical growth, resulting in short stature
  • delayed puberty
  • delayed permanent tooth development

Left to its own devices, an underactive thyroid can do some serious damage. The effects seep into your mental and physical health, which can affect your emotional health too.

Cholesterol changes and heart problems

Hypothyroidism can cause an increase in your level of low-density lipoprotein (LDL) cholesterol (that’s the bad kind). Research suggests this may contribute to a higher risk of heart disease and heart failure further down the line.

Peripheral neuropathy

Decreased production of thyroid hormone can lead to nerve damage. Depending on where the nerves are in your body, this damage may cause central neuropathy (in your central nervous system) or peripheral neuropathy (in your hands, feet, arms, or legs).

Your nerves are responsible for carrying information from your brain to the rest of the body. Nerve damage may result in pain, tingling, or numbness in your fingers, your toes, or other parts of your body.

Congenital anomalies

Babies born to women with hypothyroidism may have a higher risk of developmental delays and congenital anomalies than the children of women with full thyroid function.

However, early detection of hypothyroidism can prevent delays from permanently affecting a baby’s health.

Myxedema

Myxedema is one of the most severe side effects of undiagnosed hypothyroidism. People with this condition can’t tolerate cold and become excessively drowsy to the point that they lose consciousness.

Sedatives, infections, and other physical stress combined with an underactive thyroid can lead to a myxedema coma.

Don’t dismiss symptoms like excessive fatigue with no apparent cause or a combination of symptoms like a puffy face, constipation, hair loss, and weight gain. Talk with a doctor about the potential causes, including hypothyroidism.

If you have an infant, child, or teen who shows symptoms of hypothyroidism, talk with a doctor. They may want to perform tests to make a diagnosis and, if necessary, start treatment as soon as possible.

Take any prescribed medications as directed. Follow your doctor’s recommendations and guidelines for follow-up visits as well as any exercise and diet suggestions. The human body constantly changes, so regular follow-ups are key to making sure your dosage is correct.

Your thyroid can become underactive for a bunch of different reasons.

Common causes

Some of the more common causes of hypothyroidism are:

  • Autoimmune disease. Hashimoto’s disease is the most common cause of hypothyroidism. Autoimmune disorders cause your immune system to attack your tissues and organs, including your thyroid.
  • Treatment of hyperthyroidism. Hyperthyroidism happens when your thyroid makes too much hormone. Treatment includes medications that reduce thyroid hormone production. Sometimes, these medications do their work a little too well, causing the thyroid to produce too little hormone.
  • Thyroid surgery. Thyroid surgeries may decrease the amount of hormones your thyroid makes. Sometimes, surgery can cause your thyroid to stop producing hormones altogether.
  • Thyroiditis. Your thyroid can become inflamed and leak hormones (yikes). For a few months, this will cause too much hormone to circulate in your body. But you’ll usually experience a sharp drop in thyroid hormone levels 1 to 3 months after this spike.
  • Medications. Some medications can cause a drop in thyroid hormone levels. If you take any meds that list hypothyroidism as a potential side effect and you’ve noticed symptoms, contact a healthcare professional.
  • Radiation therapy. Radiation treatments for cancer can change or damage your thyroid. Most doctors keep an eye out for thyroid issues, but it’s super important to let them know about any symptoms at your regular checkups.

Rarer causes

Here are some of the less common causes of hypothyroidism.

Pregnancy

Thyroid function decreases during 3 to 5 percent of pregnancies. Both a pregnant person and their baby need more thyroid hormone during pregnancy. If the pregnant person’s thyroid can’t keep up due to Hashimoto’s thyroiditis, signs of hypothyroidism may start to occur.

The stress of pregnancy can also make the autoimmune condition worse after delivery and lead to postpartum thyroiditis. Without treatment, hypothyroidism can cause miscarriage, preeclampsia, or preterm delivery. It might also affect the developing fetus.

Pituitary gland disorders

The pituitary gland produces hormones that stimulate the thyroid. If the pituitary gland isn’t working at full power, neither is the thyroid. Benign tumors on the pituitary gland usually cause this type of hypothyroidism.

Iodine deficiency

Your body needs iodine to produce thyroid hormones. A low-iodine diet can cause thyroid problems.

Plants that grow in iodine-rich soil, seafood, and seaweed are all good sources of natural iodine. But one of the most accessible sources of iodine, iodized salt, has nearly eliminated iodine deficiency in the United States.

Congenital hypothyroidism

Some babies enter the world with an incorrectly functioning or undeveloped thyroid. Without treatment, this may interfere with their brain and body development.

Risk factors

While anyone can develop hypothyroidism, it tends to show up in certain populations more than others. In the United States, roughly 3 to 7 percent of adults have hypothyroidism.

It’s more common among people who:

The good news? Food fuels your body. Therefore, it also fuels your thyroid. You can certainly eat foods that support thyroid health.

Does diet affect hypothyroidism?

The bad news? You can’t fully cure hypothyroidism with dietary changes. But your diet can certainly help your thyroid function at its best, no matter what its condition.

Try to get enough iodine, selenium, and zinc in your diet. Iodine is a key factor in thyroid health.

The thyroid contains the highest concentration of selenium in the human body. A diet with a regular, balanced amount of selenium keeps the thyroid stocked and happy.

Zinc is another nutrient that plays a role in thyroid activation, which means it’s an integral part of a healthy diet.

Foods to avoid if you have hypothyroidism

Some foods contain nutrients called goitrogens, which can interfere with thyroid function. But many interfere with your thyroid only if you also have iodine deficiency.

These foods include:

  • Soy foods: edamame, tofu, and tempeh
  • Vegetables: kale, cauliflower, and spinach
  • Fruits and starches: sweet potatoes, peaches, and strawberries
  • Nuts and seeds: millet, peanuts, and pine nuts

These are some pretty yummy, nutritious foods. Just because they contain goitrogens doesn’t mean you should cut them out of your diet altogether.

These foods can be part of a healthy, balanced diet. But if you’re struggling to get your thyroid levels under control, you may want to watch your intake.

Foods that support thyroid health

On the other side of the coin are foods that give your thyroid a big ol’ thumbs-up. Iodized salt tops the list as one of the easiest ways to keep your thyroid fueled and functional.

Other foods that support a healthy thyroid:

Most people don’t need a supplement to keep their thyroid healthy. In fact, selenium levels can become toxic (#FreeBritney) if you consume too much. This can happen if you take a selenium supplement that you don’t need.

Talk with your doctor to determine whether you need a supplement. The most important thing you can do is eat a varied, healthy diet full of lean protein, whole grains, vegetables, and fruits.

Hypothyroidism can make it difficult to lose weight, especially if hypothyroidism was the cause of weight gain in the first place.

Of course, regular exercise and a healthy diet are part of any weight management program. Those same principles apply to losing weight with hypothyroidism.

Here are a few other health guidelines to help with weight control.

Get rid of refined sugars

Soda, candy, and other sugary treats provide calories but lack beneficial nutrients. Foods like these can work against your weight management efforts.

Take your thyroid medication as instructed

Most of the time, doctors recommend taking thyroid medication first thing in the morning on an empty stomach and waiting 30 to 60 minutes before eating. This can prevent other food or supplements from interfering with absorption.

A 2013 study found that while many doctors recommend this pre-breakfast pause, taking your meds alongside brekkie may not affect absorption as much as researchers originally thought.

Still, doc knows best. Make sure you follow their advice.

Eat enough calories per day

You may be tempted to drastically cut calories in an attempt to drop weight. However, excessive weight loss in a short amount of time can put your body into stress mode.

Your body might reduce thyroid hormone levels to prevent starvation.

To treat a problem, docs have to spot it first.

How a doctor diagnoses hypothyroidism

Your doc will kick off your appointment by asking about your symptoms and medical history.

If they suspect you have hypothyroidism, they’ll likely order a blood test to measure your levels of thyroid-stimulating hormone. This test also helps a doctor work out the best dosage of meds for your body.

Can you tell if you have hypothyroidism by looking at your hands?

Hands up! Signs and symptoms of hypothyroidism can show up on your meat mitts.

Hypothyroidism can cause deep lines to develop in your palms. It might also darken the skin on your palms.

Other skin symptoms of hypothyroidism:

If you notice these signs along with other symptoms of hypothyroidism, contact a healthcare professional.

Standard treatment includes a daily dose of a synthetic thyroid hormone called levothyroxine.

It’s a pill you’ll probably have to take every day for the rest of your life, but it can reverse the symptoms of hypothyroidism fairly quickly.

Treatment can also lower your LDL cholesterol levels and reverse any hypothyroidism-induced weight gain.

Uncontrolled hypothyroidism can have serious effects on your health.

The fatigue alone can make it hard to do the most basic tasks. But hypothyroidism can also affect the development of young children and lead to severe complications such as myxedema coma.

If you suspect you have hypothyroidism, contact a healthcare professional.

An in-depth conversation with a doctor may reveal underlying causes. They may prescribe a synthetic thyroid hormone to supplement your low levels.

A diagnosis can change your world for the better and get you back on the road to an energy-filled, active life. Take that, hypothyroidism.