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6 signs your thyroid is struggling but your blood tests are, ‘normal’

Updated: Nov 30, 2023

Have you been feeling sluggish or cold lately, been to the GP and had some bloods done to check your thyroid function - but the results are 'normal'?

There is growing evidence to suggest that even relatively mild increases in your TSH levels, that would still fall into the 'normal' range, can affect your health and wellbeing.

This is described as 'subclinical hypothyroidism' as its below the level that a healthcare profession would usually treat. However, the presence of which increases the likelihood of moving to clinically significant hypothyroidsim (Taylor, P. et al: 2013).

So, what are the symptoms?

1. Muscle cramps or lack of muscle energy?

Subclinical hypothyroidism has been associated an increase in lactate levels which may make you more prone to muscles cramps or a feeling of a lack of energy in your muscles. Interestingly, this lack of muscle energy levels was related to the duration of time that the person had been classed as suffering from sub-clinical hypothyroidism and not the levels of TSH in blood – a marker that is used in general practice (Monzani et al., 1997).

2. Need an extra jumper?

A common symptom of hypothyroidism, feeling the cold is also noted in sub-clinical hypothyroidism – this is often particularly felt in the morning. However, if you have heat and cold intolerance – you seem to get very hot and/or very cold with temperature fluctuations this could be a sign that your adrenals may need a little TLC – a Registered nutritional therapist is a great place to start if you suspect your adrenals may be getting tired.

3. A bit bunged up?

Less regular bowel movements or constipation can also indicate a less than optimal thyroid function. So, if you're experiencing less visits to the loo, along with any other of these symptoms, maybe consider your thyroid function (Vigário et al., 2009).

4. Eyebrows looking a little thin?

Losing hair from the outer edge of your eyebrows or patchy hair loss on your head can be an indicator that your thyroid needs some support (Bahar, A et al; 2011)

5. Puffy eyes – especially in the morning?

Puffy eyes (not related to late night partying), can also be an indicator of less than optimal thyroid function (Livingston, 2019).

6. Periods all over the place?

Menstrual irregularity can be another symptom of a struggling thyroid and wavering thyroid levels has also been linked to a possible cause for women who have difficulty conceiving or maintaining pregnancy (Khan et al., 2017).

If you are experiencing some 3 or more of these symptoms, it may be that you and your thyroid may need some support.

Whilst these are the outward symptoms, it is important to address the underlying cause and reduce the chance of progression to overt hyothyroidism.

Sometimes it can be as simple as making your meals more nutrient dense or increasing your protein intake, other times sub-optimal thyroid function can be a downward effect of a whole host of issues for example, from stress, a chronic infection, underlying autoimmune disease, food intolerance, poor gut health or poor adrenal function. A Registered Nutritional therapist or Functional Medicine Practitioner can help you to get to the bottom of this.

A Functional Medicine Practitioner will work to much tighter reference ranges that are associated with optimal health, rather than the reference ranges commonly used to detect overt disease. These warning signals give indication that your body systems are beginning to struggle, rather than when active disease is present, allowing you to make informed dietary and lifestyle changes to prevent progression to disease.

Bahar, A., et al (2011) 'Hyperprolactinemia in association with subclinical hypothyroidism' Caspian Journal of Medicine Spring 2(2): 229-233

Khan, M. A. et al. (2017) ‘Subclinical Hypothyroidism: Frequency, clinical presentations and treatment indications’, Pakistan Journal of Medical Sciences, 33(4), p. 818. doi: 10.12669/pjms.334.12921.

Livingston, E. H. (2019) ‘Subclinical Hypothyroidism’, JAMA - Journal of the American Medical Association. American Medical Association, p. 180. doi: 10.1001/jama.2019.9508.

Monzani, F. et al. (1997) Clinical and Biochemical Features of Muscle Dysfunction in Subclinical Hypothyroidism, Journal of Clinical Endocrinology and Metabolism Printed. Available at: (Accessed: 18 November 2020).

Taylor P., et al (2013) 'A Review Of The Clinical Consequences of Variation in Thyroid Function Within the Reference Range; The Journal of Clinical Endocrinology & Metabolism, Volume 98, Issue 9, pp 3562 - 3571.

Vigário, P. et al. (2009) ‘Perceived health status of women with overt and subclinical hypothyroidism’, Medical Principles and Practice, 18(4), pp. 317–322. doi: 10.1159/000215731.

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