Is my thyroid off?

Feeling off doesn’t always mean your thyroid is the problem, but thyroid issues are common enough, especially around menopause, that they’re worth ruling out. 

The classic signs of an underactive thyroid (hypothyroidism) are fatigue that doesn’t improve with rest, unexplained weight gain, feeling cold when others don’t, dry skin, hair thinning, constipation, and brain fog. An overactive thyroid (hyperthyroidism) tends to look almost opposite: unintended weight loss, a racing heart, feeling hot or sweaty, anxiety, tremor, and trouble sleeping.

The tricky part is that a lot of these symptoms overlap heavily with perimenopause and menopause. Fatigue, weight changes, brain fog, and mood shifts show up in both conditions, which is exactly why thyroid problems get missed or misattributed so often in women in their 40s and 50s. 

The only way to actually know is bloodwork. TSH, free T4 and sometimes free T3 and thyroid antibodies to figure out what’s driving it. Thyroid disorders are also far more common in women than men, and autoimmune thyroid disease in particular tends to cluster around major hormonal transitions, which includes perimenopause.

If you’re dealing with a cluster of these symptoms, the answer isn’t to guess whether it’s your thyroid or your hormones. It’s to test both, since one often affects the other, and treatment differs completely depending on which one is actually off.​​​​​​​​​​​​​​​​

This content is for educational purposes only and is not intended as medical advice. It does not replace a consultation with a licensed healthcare provider. Individual results and appropriate treatment vary based on personal health history. Always consult your provider before starting, stopping, or changing any medication or hormone therapy.