This website is dedicated to the millions of thyroid patients who are being ignored and left to suffer unnecessarily, and to healthcare practitioners, who want to better serve those patients.

Signs of Hypothyroidism Thyroxine Conversion Block

The most common signs of hypothyroidism and thyroid hormone resistance (THR).

A sign is an abnormality experienced by the patient that others can see and independently confirm. Dry, scaly skin is a sign that you can show to your doctor. Other disorders can cause signs typical of hypothyroidism and THR. Because of this, its important not to rush to judgment and conclude that a thyroid disorder is the cause of your sign. Some signs may be so subtle that only you and your doctor may be certain that you had them only in their absence, after you reach an effective dose of thyroid hormone replacement. An example is the dull, listless appearance of some patients eyes, replaced after therapy with a bright radiance.

Cold skin
Coarse skin on hands, feet, elbows, knees, lower legs (just above the ankles)
Dry skin
Thickened skin between biceps, triceps and in front of tibia, caused by mucin under the skin.
Itchy skin
Puffy skin
Paleness of skin
Paleness of lips
Bluish or purplish colour of skin and lips
Pink flush may be present over cheeks
Absence of, or diminished, perspiration
Excessive perspiration
Bruising of skin
Depigmented white patches on skin
Moles (especially on the trunk)
Subcutaneous tissue infections
Parchment like fine wrinkles (face and hands)
Yellowish or amber tint to skin

Brittle nails
Soft nails (may be due to iron deficiency)
Dry ridges down nails
Bluish or purplish colour of nail beds
Yellowish pale nails
Striated and thickened nails
Peeling nails (easily broken)

Fine/thin/straight hair
Dry, coarse, brittle hair
Alopecia (hair loss)
Premature baldness
Thinning or loss of outer third of eyebrows (Sign of Hertoghe)
Eyebrows raised
Loss of public/lower legs/arms/armpits

Listless, dull look to eyes
Changes at the back of the eye (at fundus oculi)
Protrusion of one or both eyeballs (exophthalmos)
Thickened or swollen eyelids
Glaucoma and cataracts
Sparse eyelashes
Macular degeneration
Spasm of the eyelids (blepharospasm)
Drooping eyelid(s)

Deep depression of the root of the nose
Broadened nostrils

Lips corners may turn down as if pouting
Swollen lips
Pale lips
Bluish or purplish colour of lips or mucous membrane

Thick tongue (often with scalloped edges)
Wasting of tongue
Swollen gums
Spongy gums
bleeding gums
Receding gums
Overdeveloped gums which project downward between the teeth
Slow speech
Hoarse voice (vocal cords infiltrated with mucin)
Slow, monotonous speech
Swelling of the lips.
Swallowing difficulty in the aged

Ears thickened/swollen
Ears may stand out
Dry, scaley, itchy ear canal
Exess formation of earwax

Swelling: Swelling of face
Swelling around eyes
Swelling of eyelids
Swelling of ankles (oedema)
No pitting oedema of ankles
Fluid accumulation in abdomen (ascitis)

Skeletal changes:

Scoliosis and general contraction of the pelvis
Chronic deforming changes in the joints
Unexplained weight gain
Fat pads above the collarbones

Temperature/Blood Pressure/Tendon Reflexes/Heart:
Low basal and activity level temperature
Low BP
Raised BP
Slow relaxation phase of the knee and/or ankle reflex (SPECIFIC to hypothyroidism)
Rapid heart rate with weak force of contraction
Slow pulse rate despite low aerobic fitness
Pounding heart beat
Indistinct or faint heart tones
Cardiac enlargement on X-ray
Low QRS voltage on ECG
Long normal intervals on ECG

Slow thinking
Sluggish movement
Laxity of ligaments
Tremor of hands


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