Hypothyroidism: Don’t Ignore These Symptoms

The human thyroid is a powerful organ, greatly affecting many of the cells in your body and helping to provide the energy and stamina you need.

But what happens when it’s ailing?

Thyroid dysfunction, particularly hypothyroidism (an underactive thyroid), is a silent health concern that disproportionately affects Black Americans, especially women. Believe it or not, women are up to eight times more likely to develop thyroid issues than men.

And if that’s not concerning enough, many symptoms of thyroid dysfunction aren’t always easy to recognize. Cold sensitivity, scratchy voice, brain fog, constipation, and even carpal tunnel syndrome can all be mistaken for other conditions.

Let’s dive into these five symptoms and uncover how to differentiate them from other conditions that are similar.

1. Cold Sensitivity

If you ever feel unusually cold, especially in your hands and feet, this could be a major indicator of hypothyroidism. This happens because the thyroid gland regulates metabolism, which then generates body heat. No wonder studies find that over 60 percent of hypothyroid patients report cold intolerance.

In Black populations, a lack of vitamin D is also linked to thyroid dysfunction, contributing to this issue.

But here’s how you know it’s not arthritis. In cases of arthritis, joint stiffness and pain are more common than a general cold feeling. So, if you find yourself bundling up while others are comfortable, don’t simply write it off as age or weather effects. See if other signs of thyroid dysfunction are present.

You can look for fatigue and dry skin, and even ask your doctor for a thyroid-stimulating hormone (TSH) test, which is 95 percent accurate in diagnosing hypothyroidism.

2. Scratchy Voice

Do you notice a hoarse or scratchy voice? When this happens, it could be a sign that your thyroid gland is enlarged. When the gland is enlarged or develops nodules, these can sometimes press on your vocal cords, leading to a change in your vocal expression. Roughly 30% of patients with hypothyroidism experience voice changes, so this certainly isn’t rare.

Here’s what you can do. First, differentiate your voice changes from allergies. Unlike allergies, which often include sneezing or itchy eyes, thyroid issues typically do not have these common symptoms. Furthermore, unlike a cold, thyroid voice changes persist and can even worsen without treatment.

If your voice feels strained for over a month, and your neck feels full, look into getting an ultrasound to check for thyroid enlargement. Early detection is key and can prevent complications like vocal cord damage, which is not something you want to mess around with.

3. Brain Fog

We all experience trouble concentrating, remembering, and feeling mentally sharp from time to time – that’s normal. But what happens when forgetfulness and mental sluggishness become severe or persist?

Ample research now shows that hypothyroidism reduces cerebral blood flow, impairing cognitive function in 40 percent of patients. Among Black Americans, who have higher rates of stress-related anxiety disorders, this can be particularly debilitating.

However, this is where it’s critical to distinguish it from anxiety. Unlike anxiety, which often includes racing thoughts or panic, thyroid-related brain fog is quite different. Overall, it feels like a slow, persistent haze, and even comes with weight gain and physical fatigue.

Do you find yourself struggling to focus despite adequate sleep? Then ask for a full thyroid panel (TSH, Free T4, and T3). If you take early action, it’s much easier to restore your mental clarity and get your thyroid back on track.

4. Constipation

Chronic constipation is a classic hypothyroidism symptom, and it happens because gut motility is affected by low thyroid hormone. More than half of hypothyroid patients report constipation compared to roughly 15 percent of healthy controls. The problem is, especially among Black Americans, that the prevalence of irritable bowel syndrome (IBS) is higher. Because of this, many people with constipation due to hypothyroidism might dismiss it as a digestive issue.

So here’s what to look for. IBS-related constipation often alternates with diarrhea and includes abdominal pain, while thyroid-related constipation persists longer and comes with bloating and fatigue.

Fortunately, treating hypothyroidism with levothyroxine can improve bowel movements in 70 percent of patients, and in just three months, too!

If dietary changes or fiber supplements don’t help, you should definitely consider getting thyroid testing. It’s always a good idea to rule out any underlying hormonal causes.

5. Carpal Tunnel Syndrome

We typically think of carpal tunnel syndrome (CTS) as stemming from overuse of the hand or wrist, especially in manual labor jobs or among people who spend a lot of time at a keyboard. Marked by numbness, tingling, and pain, CTS can stem from thyroid troubles as well.

For Black women, who are more likely to work physically demanding jobs, CTS due to thyroid issues is often confused for strains and arthritis. In reality, it could be due to the dysfunction of the thyroid. If you’re not sure how to differentiate, first look for swelling and stiffness. This is common in arthritis, but is absent in thyroid-related CTS.

The good news is that thyroid-related CTS also often improves with hormone replacement therapy in the majority of patients.

If you experience hand numbness that’s worse at night, and have other thyroid signs like dry skin or hair loss, go for a thyroid evaluation. As always, early intervention is key!

For many sufferers of hypothyroidism and thyroid dysfunction, getting properly diagnosed is one of the biggest hurdles out there. In Black communities in particular, patients are less likely to receive timely testing, despite higher rates of symptoms.

This can quickly become a major problem, too. If left untreated, hypothyroidism can increase risks of heart disease (which is already 20 percent higher in Black adults), potentially creating a cascade of health problems down the road.

So take action. Don’t ignore signs, and don’t dismiss unusual symptoms as something normal. If you or your loved ones experience these symptoms, they might be more than just stress, aging, or other conditions.

Have an action plan in order. First, request testing, asking for a full thyroid panel (TSH, Free T4, T3, and thyroid antibodies) to catch issues like Hashimoto’s thyroiditis.

Secondly, advocate for yourself. If a doctor misses or minimizes certain symptoms, go for a second opinion. List all your symptoms and mention any family history, as many thyroid issues are hereditary.

From there, change your lifestyle. A diet rich in iodine, which is found naturally in fish and dairy, is vital for a healthy thyroid. Selenium is also a must-have, and can be found in foods like cashews, Brazil nuts, tuna, salmon, eggs, beef, and lentils.

And finally, don’t neglect regular exercise, as it’s been shown to boost metabolism, counteracting thyroid-related sluggishness. Armed with the knowledge and information in this article, you’ll be well on your way to improving your thyroid and, more importantly, your overall health and wellbeing!

By Evan Bollinger | Published August 23, 2025