Understanding the symptoms of high TSH can ensure you get help as soon as possible.

Symptoms of High TSH: Understanding What Hypothyroidism Looks Like

by Charlotte

The human body in an astoundingly complex network of interconnected parts and processes. Even if you intuitively know this, it is often shocking to consider just how interconnected it is, and how much organs and systems depend on each other to function. 

Take the thyroid: this small gland in the neck is rarely thought about and may seem far removed from the rest of the body, but it is largely responsible for regulating how the body consumes energy. That means that every motion is impacted by the functioning of the thyroid. 

When the thyroid is malfunctioning, the rest of the body is as well. Hypothyroidism—when the body doesn’t produce as much thyroid hormone as it needs—can have debilitating mental and physical symptoms that impact your life. And one of the most important signs of hypothyroidism is an overabundance of thyroid-stimulating hormone, also known as TSH.

Millions of Americans have high TSH, but many aren’t aware that anything is wrong—or don’t realize the symptoms they have are related to their thyroid. Knowing the symptoms of high TSH can put you on the road to receiving the care you need to improve your quality of life and protect your long-term health.

High TSH Means Low Thyroid Activity

To begin, let’s explain a bit of confusing nomenclature. It would seem logical to assume that high TSH means that you might have hyperthyroidism, an overabundance of thyroid hormones. But in fact, the opposite is true. 

TSH is produced by the pituitary gland. When the thyroid is functioning normally, the pituitary produces a normal amount. But when the thyroid is underperforming, it starts to produce more and more, hoping to kick the thyroid into gear. While this could indeed elevate thyroid hormone production in a person with a healthy thyroid, it doesn’t fix a malfunctioning thyroid. It isn’t like trying to jump a stalled car—it’s more like turning the key again and again. 

Thyroid underactivity is common; according to the National Institute of Diabetes and Digestive and Kidney Diseases, nearly 5% of Americans over the age of 12 have hypothyroidism.  And while this can strike anyone, you are at a higher risk for it if you are in one or more of these groups:

  • Women
  • People over 60
  • People who have given birth in the last 6 months
  • People who have a history of thyroid disease in their family
  • People with autoimmune diseases (more on this below)

That’s why when you are experiencing the symptoms of high TSH, it is important to see a medical professional. You can often avoid serious, long-term health complications by getting the right thyroid function tests and starting treatment as soon as possible. 

The Symptoms of High TSH

While experiencing symptoms of high TSH and hypothyroidism is common, many patients—and even clinicians—often fail to attribute those symptoms to a thyroid disorder. This is largely because they are typically also symptoms of other medical conditions as well as non-pathological physical or emotional states. As the American Thyroid Association Task Force on Thyroid Hormone Replacement noted in 2014, “The symptoms often have an insidious onset and overlap significantly between patients with thyroid disease and those without. Many signs and symptoms of thyroid dysfunction are neither sensitive nor specific.” In other words, you can have hypothyroidism and have the exact same symptoms of someone without it. That’s why it is important to look at the cumulative symptoms. 

The most common symptoms of high TSH and hypothyroidism include:

  • Feeling tired/worn out
  • Feeling cold
  • Unusual weight gain
  • Constipation
  • Irregular periods
  • Itchy or dry skin
  • Concentration/memory difficulties
  • Hair loss
  • Depression

Unfortunately, as previously noted, these symptoms are often difficult to identify as thyroid-related. To use the words of the task force, they are not always “sensitive nor specific.”  There are, however, a number of symptoms that may more urgently point to hypothyroidism, including:

  • Slowed heart rate
  • Slowed movement
  • Puffiness in ankles
  • Delayed ankle reflexes

Now, we understand; you probably don’t usually check your ankle reflexes. Unless you are an athlete you probably don’t really have a gauge for how fast your ankle is moving. But this is often accompanied by a general sort of slow-down that becomes noticeable over time. Still, while these might be very specific, they aren’t quite as sensitive—you might not recognize an incremental change. That’s why you have to consider the possibility that you are suffering from hypothyroidism if you begin experiencing any of the symptoms above to any significant degree. And one way to get closer is to look at the possible causes. 

Possible Causes of Hypothyroidism

There is no one cause of hypothyroidism, nor is there always a direct linear path between one of the precipitating events and its onset. However, it is important to know the potential causes so that you can connect the dots with possible symptoms. 

Major causes of hypothyroidism include:

  • Hashimoto’s thyroiditis. This autoimmune disease produces antibodies that attack the tissues of the thyroid, causing it to produce less thyroid hormone. 
  • Medication. Certain medications, including lithium, can lower thyroid hormone production. 
  • Hyperthyroidism treatment. A number of treatments for hyperthyroidism, including radioactive iodine treatment, can impair thyroid function.
  • Radiation therapy. Radiation therapy for conditions unrelated to the thyroid may cause the thyroid to shrink. 

There are a few other possible causes, including iodine disorders and some pregnancy-related risks. We’ll take a look at the dangers of the latter just below. But it is important to know that if you fall into any of these risk categories, the seemingly-mild symptoms might be so much more. 

The Long-Term Dangers of Hypothyroidism

Due to the prevalence of hypothyroidism and relatively mild symptoms experienced by many patients, it is common to underestimate how damaging hypothyroidism can truly be. But hypothyroidism and high TSH levels can cause potentially serious health problems, particularly in pregnant women. These complications include:

  • Possible miscarriage or premature delivery
  • Preeclampsia 
  • Potential birth defects
  • Infertility
  • Goiters
  • Chronic depression
  • Heart problems
  • Long-term damage to nerves in arms and legs

These dangers are why it’s critical to get diagnosed and treated as early as possible—even if your symptoms are mild.

The Benefits of Thyroid Hormone Replacement Therapy

The first thing you can do if you are worried about hypothyroidism is to get a comprehensive panel of thyroid tests. This is a simple matter of bloodwork and will allow your health care practitioner to quickly assess your levels. If high TSH is detected and hypothyroidism is diagnosed, your practitioner can then design a treatment plan to help you restore balance and address your symptoms.

The centerpiece of treatment for hypothyroidism is hormone replacement therapy, which will compensate for your body’s diminished thyroid hormone levels. Because finding the right dosage is critical to ensuring you receive optimal therapeutic benefit, it is important to partner with a practitioner who specializes in hormone health throughout the treatment process. They will have the training and experience necessary to create a tailored treatment plan and provide ongoing monitoring to keep you feeling your best. They can also offer nutrition, fitness, and lifestyle counseling that could help you address symptoms like weight gain and mood disturbances while promoting greater overall wellness.

Low TSH and hypothyroidism can be devastating for your mind and your body. But hormone replacement therapy can harness the connectedness of the body to help you feel like yourself again.

If you want to know more about the benefits of thyroid hormone replacement therapy, BodyLogicMD can help. The BodyLogicMD network is comprised of top medical professionals specializing in hormone health, HRT, and integrative medicine. BodyLogicMD-affiliated practitioners are dedicated to helping people address hormone imbalances like hypothyroidism through personalized treatment plans that enhance quality of life. Contact a local practitioner to schedule your first appointment, or take the BodyLogicMD Hormone Balance Quiz today.

Disclaimer: These statements have not been evaluated by the Food and Drug Administration. All content on this website is for informational purposes only. The content is not intended to diagnose, treat, cure or prevent diseases.


  • Charlotte

    Charlotte is a patient care coordinator specializing in bioidentical hormone replacement therapy. She is committed to helping patients who struggle with the symptoms of hormonal change and imbalance explore their treatment options and develop effective strategies to optimize wellness.