You feel tired all the time, your hair is falling more than usual, or your heart races for no reason, and someone at home says, “Get your thyroid checked.” Many people search for “thyroid ke lakshan” at this point, and find long lists that seem to describe almost everyone.
The thyroid is a small gland at the front of your neck, and it can make too little hormone or too much. For what thyroid disorders are, how they are diagnosed and how they are treated, see our thyroid guide on symptoms, tests and treatment.
Underactive or overactive: the signs work in opposite directions
An underactive thyroid (hypothyroidism) slows the body down; an overactive thyroid (hyperthyroidism) speeds it up. That is why the two sets of signs look almost like mirror images: feeling cold against feeling hot, weight gain against weight loss, constipation against loose motions.
- Underactive. National Health Service (NHS) says the signs may be mild, may not be easy to notice, and usually develop slowly and get worse over time. The first things people notice are often tiredness and feeling cold.
- Overactive. NHS says the signs may develop gradually or suddenly, and it is unlikely you will have all of them. A racing heart, nervousness and weight loss are common early clues.
- Either. Hair fall, tiredness, changed periods and a swelling in the neck can happen with both.
An underactive thyroid is common in India. A study in eight Indian cities found it in 10.95% of 5,360 adults, and about a third of them had never been diagnosed. Among 1,500 newly diagnosed Indian adults in a national thyroid registry, the most common findings were tiredness (60.17%), weight gain with poor appetite (36.22%) and hair loss (30.89%). Our guide to the types of thyroid problems explains each condition.
19 signs of thyroid problems: a checklist, not a diagnosis
These are the signs listed by NHS and the American Thyroid Association (ATA). U means usually underactive, O usually overactive.
- Extreme tiredness that sleep does not fix (U, sometimes O)
- Feeling cold when others are comfortable (U)
- Weight gain (U)
- Constipation (U)
- Poor concentration or forgetfulness (U)
- Low mood (U)
- Dry skin or dry hair (U)
- Hair fall or thinning (U or O)
- A croaky, hoarse voice (U)
- Irregular or heavy periods (U)
- Nervousness, anxiety or irritability (O)
- Difficulty sleeping (O)
- Feeling hot and sweating more (O)
- A fast, pounding or irregular heartbeat (O)
- Trembling hands (O)
- Weight loss despite a normal or bigger appetite (O)
- Frequent loose motions (O)
- Gritty, red or bulging eyes, in Graves’ disease (O)
- A swelling at the front of the neck (U or O)
No checklist can diagnose a thyroid problem, and many of these signs are common in people with a normal thyroid. A Danish study compared 140 people newly diagnosed with an underactive thyroid with 560 matched people without thyroid disease. Of those without thyroid disease, 70% had at least one of the 13 thyroid-linked symptoms; people with the condition reported five on average and the others two. Someone with three symptoms was as likely to have a normal thyroid as not, and 5.7% of those with the condition had no symptoms at all. The authors found no single symptom reliable either way.
National Institute for Health and Care Excellence (NICE) advises doctors to consider thyroid tests when they suspect thyroid disease, but to bear in mind that one symptom alone may not point to it. In the Danish study, only people with more than three symptoms were more likely than average to have the condition.
Low thyroid symptoms: signs of an underactive thyroid
These are the signs NHS and the ATA list for an underactive thyroid. The last column matters as much as the first: anaemia, vitamin deficiencies, depression and menopause cause many of the same complaints, and a blood test is what separates them.
| Sign | What you may notice | Also caused by |
|---|---|---|
| Extreme tiredness | Tired even after a full night’s sleep; the commonest complaint in the Indian registry | Iron-deficiency anaemia, vitamin B12 deficiency, depression, diabetes, poor sleep |
| Feeling cold | Needing a shawl or sweater when others do not | On its own it proves little; mention it alongside other signs |
| Weight gain | Usually modest: the ATA says about 2–4.5 kg for most people, mostly salt and water | Menopause (often around the stomach), depression, less activity |
| Constipation | Fewer or harder motions than usual | Depression; iron tablets, as a common side effect |
| Poor concentration or forgetfulness | “Brain fog”, losing your train of thought | Vitamin B12 deficiency, menopause, depression |
| Low mood | Feeling sad or flat most days | Depression, menopause |
| Dry skin or dry hair | Rough, flaky skin; brittle hair | Menopause (dry, itchy skin) |
| Hair fall | More hair on the comb or pillow | Iron-deficiency anaemia, menopause; an overactive thyroid too |
| Hoarse voice | A croaky voice that does not clear | A swollen thyroid (goitre) |
| Irregular or heavy periods | Cycles that change, or heavier bleeding | Menopause, polycystic ovary syndrome (PCOS) |
Weight is where expectations most often go wrong. The ATA says that if your other symptoms improve with treatment but your weight does not, the thyroid was probably not the only cause. It also warns against taking thyroid hormone to lose weight: extra hormone can cause palpitations, anxiety, poor sleep and loss of muscle and bone, and the weight usually returns.
Period changes, pregnancy and the years after childbirth are covered in our guide to thyroid signs in women.
Signs of an overactive thyroid
An overactive thyroid can start suddenly, and the heart and nerves often show it first. NHS lists several signs that people rarely link to the thyroid, such as thirst, passing urine more often and muscle weakness.
| Sign | What you may notice | Also caused by |
|---|---|---|
| Fast, pounding or irregular heartbeat (palpitations) | Your heart racing while you sit still | Iron-deficiency anaemia, vitamin B12 deficiency, menopause, anxiety, too much caffeine |
| Nervousness, anxiety or irritability | Feeling restless and on edge, hard to sit still | Anxiety, depression, menopause |
| Difficulty sleeping | Lying awake, or waking often | Menopause (night sweats), depression |
| Feeling hot and sweating more | Warm, damp skin; fans on when others are cool | Menopause (hot flushes) |
| Weight loss despite eating well | Clothes loosening while your appetite grows | Diabetes, especially with thirst and passing more urine; depression |
| Thirst and passing urine more often | Drinking water all day, getting up at night to pass urine | Diabetes: ask for a sugar test as well |
| Frequent loose motions | Going more often than usual | Vitamin B12 deficiency |
| Muscle weakness | Climbing stairs or getting up from a chair feels hard | Severe vitamin D deficiency, vitamin B12 deficiency |
| Hair thinning, lighter or less frequent periods | Patchy thinning; periods that space out | Menopause, iron-deficiency anaemia |
| Gritty, red or bulging eyes | Watering, light sensitivity, double vision | Specific to Graves’ disease; NHS says about 1 in 4 people with it have eye problems |
Thyroiditis (inflammation of the thyroid, sometimes after a virus or a pregnancy) can cause a short overactive phase followed by an underactive one. The ATA notes most people with it recover normal thyroid function within 12–18 months, so the same person can have both sets of signs in one year.
Neck signs: swelling, lumps and pain
A swollen thyroid, called a goitre (galgand), is usually a painless swelling at the lower front of the neck, sometimes on one side only. It can occur when the thyroid is underactive, overactive or working normally. In the Indian registry, 15.41% of newly diagnosed people had a small goitre and 3.27% a larger one. NHS lists other goitre symptoms: a cough that does not go away, a hoarse voice, a feeling of something stuck in the throat, or difficulty swallowing or breathing.
Thyroid pain is less common than swelling. The ATA calls subacute thyroiditis, often following a viral infection, the major cause of pain in the thyroid; the pain usually lasts about 1–3 months, and around 95% of people recover fully within 12–18 months. In the Danish study, 16% of people with an underactive thyroid reported pain at the front of the neck.
Any new neck swelling needs a doctor to examine it, even if your blood tests are normal. Our guide to an enlarged thyroid and goitre explains the causes and the tests.
High or low thyroid? Only a blood test can tell
Symptoms can suggest which way your thyroid is going, but the ATA says a blood test is the only way to know for sure. People who search “thyroid badhne ke lakshan” often mean one of two different things:
- A high TSH. When the thyroid is slow, the pituitary gland raises TSH to push it harder. So a high TSH usually means an underactive thyroid, and a low TSH usually means an overactive one. “Thyroid badh gaya” on a report is often the reverse of what the body is doing.
- A bigger gland. A swelling in the neck is a goitre, which needs an examination, not just a blood test.
Which test confirms it. NICE suggests starting with TSH alone for most adults, adding free thyroxine (free T4) if TSH is high, and free T4 with free triiodothyronine (free T3) if it is low. A mildly abnormal result is often repeated before any decision. Our guide to the TSH normal range and how to read your report explains the numbers, and our thyroid test price guide covers what each test costs and which package you need.
When to get tested. NICE advises offering thyroid tests to people with type 1 diabetes or another autoimmune disease, and considering them for depression or unexplained anxiety. It adds that in menopausal women, signs of thyroid disease may be mistaken for menopause. NICE does not advise testing during an acute illness such as a fever, because results can be misleading, or testing only because someone has type 2 diabetes. Indian and international guidance on screening are compared on our thyroid hub’s diagnosis section.
Food, sleep and supplements cannot make up for a thyroid that makes too little or too much hormone; that needs a diagnosis and medical treatment.
When to see a doctor
Our hub has the full list of thyroid warning signs.
Emergency: get help now (call 112)
- Difficulty breathing, or a wheezing noise when you breathe, with a neck swelling.
- Palpitations with chest pain, breathlessness or fainting.
- A very fast heartbeat with high fever, confusion or severe agitation.
- Severe drowsiness or confusion in someone with a severe or untreated underactive thyroid.
- Thoughts of harming yourself. Call 112, or contact Tele Mental Health Assistance and Networking Across States (Tele-MANAS), the Government of India’s mental-health helpline.
Prompt review: within days to a few weeks
- A neck lump or swelling that is new or growing, or a painful, tender thyroid.
- Bulging, red or painful eyes, or double or blurred vision.
- Weight loss without trying, especially with thirst and passing urine more often.
- Palpitations that keep coming back.
- Any thyroid signs while pregnant or planning a pregnancy.
Routine review
Book an appointment for tiredness that lasts weeks, unexplained weight change, hair fall, feeling unusually cold or hot, or changed periods, or if you have type 1 diabetes, another autoimmune condition, or a close relative with thyroid disease.
How Disha can help
Disha is an AI health coach that chats and calls in Hindi, English and Hinglish. It does not diagnose thyroid disease, read reports, prescribe or provide emergency care, and it does not replace your doctor. After an onboarding call of about 15–20 minutes with Disha, the AI, it can help with the habits around your care: meals, movement, sleep, and a steady routine for tablets and tests once your doctor has a plan. Read how Disha coaching works.
This is not medical advice. This page is general education for adults (18+), not a diagnosis. Symptoms alone cannot confirm or rule out a thyroid problem. Do not start, stop or change a thyroid medicine, or any other medicine or supplement, because of it. If you are pregnant, planning a pregnancy or breastfeeding, get your symptoms and results reviewed by your own doctor. In an emergency, call 112; Disha does not provide emergency care.
Frequently asked questions
What are the first signs of thyroid problems?
For an underactive thyroid, tiredness and feeling cold are often first, followed by weight gain, constipation, dry skin and low mood; NHS says these usually develop slowly. An overactive thyroid often shows first as a racing heart, nervousness, sweating or weight loss, and can start suddenly. Because these early signs are vague and common, a TSH blood test is the only way to know.
Can thyroid cause weight gain and hair fall?
Yes, but usually less than people expect. The ATA says weight gain from an underactive thyroid is about 2–4.5 kg for most people, mostly salt and water. Hair fall can occur with both an underactive and an overactive thyroid, and also with iron deficiency and menopause. If treatment fixes your other symptoms but not your weight or hair, look for other causes with your doctor.
Can thyroid problems cause anxiety?
Yes. Nervousness, anxiety, irritability and difficulty sleeping are common signs of an overactive thyroid, and an underactive one is linked to low mood. NICE advises doctors to consider thyroid tests in people with depression or unexplained anxiety. Anxiety has many causes besides the thyroid, so if anxiety is affecting your daily life, ask for help whatever the test shows.
Does thyroid cause neck pain?
Sometimes. A goitre is usually painless. The ATA calls subacute thyroiditis, often after a viral infection, the main cause of pain in the thyroid itself; it usually settles within months. In a Danish study, 16% of people with an underactive thyroid reported pain at the front of the neck. Mention it to your doctor, and get a tender swelling, fever or trouble swallowing checked promptly.
How do I know if my thyroid is high or low?
Only a blood test can tell. A high TSH usually means an underactive (low) thyroid, because the pituitary is pushing a slow gland harder; a low TSH usually means an overactive (high) one. Symptoms point in a direction but overlap, and thyroiditis can swing from high to low. Your doctor reads TSH with free T4, and sometimes T3, to decide.
Which test confirms a thyroid problem?
TSH is the first test for most adults. NICE adds free T4 if TSH is high, and free T4 and free T3 if it is low. Antibody tests can show the cause, and an ultrasound is used for a lump, not to check how the thyroid works. A mildly abnormal result is usually repeated before treatment, and results during an acute illness can mislead.
Can you have a thyroid problem with no symptoms?
Yes. In a Danish study, 5.7% of people newly diagnosed with an underactive thyroid had none of the listed symptoms, and the ATA says many people with mild (subclinical) overactivity have no symptoms either. In a study across eight Indian cities, about a third of adults with an underactive thyroid had never been diagnosed. That is why doctors test people at higher risk, not only those with symptoms.
Sources
- NHS. Underactive thyroid (hypothyroidism), Overactive thyroid: symptoms, Overactive thyroid: complications and Goitre. Current patient guidance. Supports: underactive symptoms, mild and slow onset; overactive symptoms and signs including thirst, passing urine more often, muscle weakness and hair thinning, gradual or sudden onset; eye problems in about 1 in 4 people with Graves’ disease; thyroid storm and myxoedema coma; goitre as a usually painless swelling, sometimes on one side, its other symptoms and the emergency of difficulty breathing.
- American Thyroid Association. Adult Hypothyroidism, Hyperthyroidism, Thyroiditis and Thyroid and Weight. Current patient brochures. Supports: symptoms of each condition and that other health problems can cause them; a blood test as the only way to know; TSH rising when the thyroid is slow; subclinical hyperthyroidism often without symptoms; fever or severe sore throat on antithyroid medicine; subacute thyroiditis as the major cause of thyroid pain, its 1–3 month course and recovery in about 95% within 12–18 months; weight gain of about 5–10 pounds, mostly salt and water; the risks of taking thyroid hormone to lose weight.
- National Institute for Health and Care Excellence (NICE). Thyroid disease: assessment and management (NG145). 2019, updated 2023. Supports: considering tests on clinical suspicion while one symptom alone may not indicate thyroid disease; offering tests with type 1 diabetes, other autoimmune disease or new atrial fibrillation; considering tests with depression or unexplained anxiety; signs of thyroid disease mistaken for menopause; no testing during acute illness or solely for type 2 diabetes; TSH first, with free T4 or free T3 added.
- Carlé A, Pedersen IB, Knudsen N, Perrild H, Ovesen L, Laurberg P. Hypothyroid symptoms and the likelihood of overt thyroid failure: a population-based case-control study. European Journal of Endocrinology, 2014. Observational study. Supports: 140 newly diagnosed people and 560 matched controls; 13 of 34 symptoms more common with hypothyroidism; no single symptom reliable for deciding who to test; even minor suspicion should lead to a blood test.
- American Thyroid Association. There is substantial overlap between the symptoms of patients with hypothyroidism and those with normal thyroid function. Clinical Thyroidology for the Public, volume 8, issue 1, 2015 (summary of Carlé et al.). Supports: 70% of people without thyroid disease having at least one linked symptom; an average of five symptoms with hypothyroidism and two without; three symptoms carrying equal probability; 5.7% of patients with no symptoms; anterior neck pain in 16%.
- Sethi B, Barua S, Raghavendra MS, Gotur J, Khandelwal D, Vyas U. The Thyroid Registry: Clinical and Hormonal Characteristics of Adult Indian Patients with Hypothyroidism. Indian Journal of Endocrinology and Metabolism, 2017. Observational registry of 1,500 newly diagnosed adults at 33 centres, funded by a thyroid-medicine maker. Supports: fatigue in 60.17%, weight gain with poor appetite in 36.22% and hair loss in 30.89%; grade 1 goitre in 15.41% and grade 2 in 3.27%; symptoms overlapping with other common diseases.
- Unnikrishnan AG, Kalra S, Sahay RK, Bantwal G, John M, Tewari N. Prevalence of hypothyroidism in adults: An epidemiological study in eight cities of India. Indian Journal of Endocrinology and Metabolism, 2013. Observational study of urban adults, industry-funded. Supports: hypothyroidism in 10.95% of 5,360 adults, 3.47% previously undetected (about a third of those affected).
- NHS. Iron deficiency anaemia, Vitamin B12 or folate deficiency anaemia: symptoms, Diabetes, Depression in adults: symptoms and Menopause and perimenopause symptoms. Current patient guidance. Supports: the “also caused by” columns: tiredness, palpitations and hair loss with iron deficiency, and constipation from iron tablets; tiredness, palpitations, diarrhoea, memory problems and muscle weakness with vitamin B12 deficiency; thirst, passing more urine, tiredness and weight loss with diabetes; low mood, anxiety, constipation, poor sleep and appetite or weight change with depression; period changes, hot flushes, night sweats, poor sleep, low mood, brain fog, weight gain, palpitations, hair thinning and dry skin with menopause.
- MedlinePlus (US National Library of Medicine). Vitamin D Deficiency. Current patient information. Supports: severe vitamin D deficiency in adults causing osteomalacia, with weak bones, bone pain and muscle weakness.
Related reads
- Thyroid disorders in India: symptoms, tests and treatment: the overview this page sits under. It lists the main signs briefly and covers causes, tests, treatment and the full warning-sign list.
- Types of thyroid problems: underactive, overactive, Hashimoto’s, Graves’, thyroiditis and goitre, explained one by one.
- Thyroid signs in women: periods, fertility, pregnancy, after childbirth and menopause.
- Thyroid test price in India: what TSH, T3, T4 and a thyroid profile cost, and which one you need.
- All thyroid articles: every Disha thyroid guide in one place.
- BMI calculator with Indian cut-offs: weight change often prompts a thyroid test; BMI is a screening number, not a thyroid test.
