More than half of all people with thyroid disease are unaware that they have a thyroid problem. Individuals with low levels of thyroid hormones (hypothyroidism) may have several of the following symptoms, but may not be diagnosed for years: 

• PMS, Irregular menstrual periods
• Lack of exercise tolerance
• Weight gain (especially in the stomach)
• Hypoglycemia (low blood sugar)
• Fatigue
• Irritability - low self esteem
• Low sexual desire
• Infertility
• Dry skin, eyes and/or hair
• Yellowed skin
• Loss of eyebrows
• Constipation
• Headaches, migraines
• Depression, apathy and anxiety
• Memory and concentration impairment
• Fluid retention - face, legs, eyelids and abdomen
• Slowed metabolism and slowed heart rate
• Cold and heat intolerance - cold hands and feet
• Enlarged tongue, deep voice and swollen neck 

   Both men and women can have stress, exposure to environmental toxins, or suboptimal nutrition, all of which increase the risk of hypothyroidism. However, women are more vulnerable to thyroid imbalances due to hormonal changes throughout their lifetime (puberty, birth control pills, pregnancy, menopause, HRT).
 
   Hormone replacement therapy often is focused on other hormones such as estrogens, progesterone, DHEA and testosterone, but optimal hormone balance cannot be achieved without correcting thyroid hormone imbalances. Many symptoms of hypothyroidism and menopause overlap. It is especially important for menopausal women who decide to use hormone replacement therapy (HRT) to have their thyroid function tested, because oral estrogens can lower the amount of bioavailable thyroid hormone. This means that if a woman is already on thyroid treatment, and begins oral estrogens, her thyroid dose may need to be increased.
  

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