Weight changes, low mood, tiredness, anxiety or itchy skin? When your thyroid gland isn’t working properly, it can have a big effect both physically and emotionally, causing troublesome symptoms.
Whether you have an overactive thyroid (hyperthyroidism) or underactive thyroid (hypothyroidism), the varied symptoms these conditions can cause can be hard to live with, and are often overlooked as part and parcel of the pressures of everyday life.
The good news is that thyroid problems and their side effects can be managed with a combination of medication and lifestyle changes. It can take a few months to find the right dose of medication and see the benefits – but with tailored self-care, you can start to regain your wellbeing and confidence in the meantime.
So read on for the self-care advice that can help you manage a thyroid condition alongside your prescription.
8 ways to help ease your thyroid symptoms
Try these tips to help improve your wellbeing and get the most from your medication:
- time your dose right – both food and caffeine can stop your body absorbing the underactive thyroid medication levothyroxine properly, meaning it won’t work as well. So it’s best to wait at least 30 minutes after taking it before eating or having a drink containing caffeine, such as tea, coffee or an energy drink
- sleep well – even when taking thyroid medication, you may still feel tired, so put steps in place to help you get enough shuteye. You need between 7 and 9 hours of quality sleep a night to feel refreshed and recharged. Good ‘sleep hygiene’ can help, such as going to bed at the same time each night, cutting down on caffeine and technology use before bedtime, and not eating a big meal late in the evening
- keep a diary – making a note of your medication dose, blood test results and work and social schedule can help you learn what things affect your mood and energy levels, so you can manage them
- stop smoking – research shows that smoking affects your thyroid. Not only can it increase your risk of overactive thyroid, but it can also make treatment less effective
- do relaxing exercise – activities such as yoga, meditation and tai chi focus on breathing and slow movements, which can help ease feelings of stress and anxiety and promote relaxation
- practise resilience – as mentioned above, it can take a few months before you feel the benefits of thyroid medication, and some people will have to wait longer than others. Being prepared for this, and for the fact that your medication dose may need to be adjusted over time, requires patience. Focusing on your good relationships and having a positive attitude can help you cope with the challenges of your condition
- build a support network – as well as support from your social circle, you can get expert help from organisations such as the British Thyroid Foundation, which runs local support groups and online events
- talk to a therapist – thyroid conditions can have a big emotional impact, with symptoms including mood swings, anxiety or depression. Your emotions will usually begin to settle as your medication starts to work, but this doesn’t happen overnight and you may still feel ‘off balance’ for a while. If your thyroid problem is affecting mental health, your doctor may be able to refer you for a talking therapy, such as cognitive behavioural therapy (CBT) or counselling
Managing your weight with a thyroid problem
Thyroid problems can cause changes in your weight. But the good news is that once your thyroid medication rebalances your hormone levels, these changes should level out.
Here’s what you need to know:
- if you have an overactive thyroid, you’ll see a reversal of any weight loss and start to gain weight again once your medication takes effect
- with an underactive thyroid, you’ll see some reversal of weight gain. Excess weight caused by an underactive thyroid is due to a build-up of salt and water in your body, so you can expect modest weight loss – usually less than 10% of your body weight – once your medication takes effect
- even with thyroid medication, you may not get to a weight that you and your doctor feel comfortable with. This may be because your weight wasn’t actually healthy in the first place. But once you’re on medication, you can gain or lose weight in the same way as anyone else
- remember that being either overweight or underweight can carry health risks. Thyroid problems can be more common after menopause, and menopause increases your risk of conditions such as osteoporosis (which can be worse if you’re underweight) and heart disease (a risk increased by being overweight) – so getting to a healthy weight will give you extra health protections and benefits
Tips for healthy weight loss
It’s best to lose weight safely by:
- eating a healthy, balanced diet. The Eatwell Guide can help, with advice on getting your 5-a-day and boosting your fibre intake, and the highly processed, sugar-spiking foods to avoid
- losing weight gradually – between 0.5kg and 1kg a week, which means cutting about 500 calories a day from your diet
- introducing exercise you enjoy into your daily routine, to help burn excess calories
- drinking plenty of water to help keep hunger at bay
For a structured, 12-week diet plan, download the free NHS Weight Loss Plan.
Tips for healthy weight gain
Things you can try to gain weight safely include:
- switching from low-fat to full-fat versions of dairy products, such as milk, yoghurt and cheese
- increasing healthy fats in your diet – such as olive oil, oily fish and avocado
- eating 2 to 3 healthy snacks a day – such as peanut butter on wholemeal toast, banana and yoghurt, or a handful of nuts
- asking your doctor if they think referral a dietitian would be helpful – they can suggest a healthy, nutrient-dense diet to suit your needs
Too hot or too cold? Try these tips
Sensitivity to cold and heat are common symptoms of thyroid conditions. Try these tips to adjust your body’s thermostat.
Too cold (underactive thyroid):
- wearing layers of clothing is a good way to trap heat, and you can add or remove layers as your temperature changes
- woolly hats, gloves and socks stop you losing heat from your extremities
- short bursts of energetic exercise can warm you up – try a few minutes of skipping or Zumba, for example
- hot drinks will warm you up and don’t have to be tea or coffee – try a hot apple juice or a mug of soup
- a long, warm bath will help raise your core temperature
- to save on energy costs, deal with draughty areas in your home, snuggle under a rug with a hot water bottle, or grab an early night with a warm duvet and a book
Too hot (overactive thyroid):
- wearing clothes made from natural, breathable fabrics such as cotton and linen will help you stay cool
- drinking chilled (non-alcoholic) drinks will help lower your body temperature
- buy fans and air conditioning units for hot, sunny rooms
- try to avoid spicy foods, which can raise your body temperature
- fill a hot water bottle and keep in the freezer, then wrap it in a towel and use it to cool you down
- stock up on ice and ice lollies to eat or add to drinks when you need them
What to do about thyroid hair loss
Severe or long-lasting overactive or underactive thyroid can lead to hair loss or hair thinning, which can be distressing. Once your medication starts to work, your hair will grow back – but this can take a few months.
In the meantime, be patient and kind to yourself. You can also:
- avoid styling your hair in ways that can lead to more hair loss. Wide-tooth brushes and combs are gentler on hair, as are loose hairstyles. Avoid tight buns, ponytails or braids, or using hair straighteners, all of which can weaken your hair. Read more about how to style your hair to minimise hair loss
- ask your doctor about hair-loss treatments. They may recommend a lotion for your scalp called minoxidil, but it doesn’t work for everyone, and can be expensive
Read more about thyroid problems and hair loss.
How to manage tiredness
Fatigue is an extreme form of tiredness that doesn’t go away after a good night’s sleep, which can leave you feeling constantly drained.
It’s particularly common if you have an underactive thyroid, as your body’s metabolism slows down. Or if you have an overactive thyroid, your metabolism speeds up, which can lead to restlessness and trouble sleeping at night – leaving you feeling tired during the day.
As with other thyroid symptoms, once your medication takes effect, your tiredness should gradually improve. In the meantime, it can help to:
- rest when you can – building periods of rest into your day can help manage your tiredness
- take some exercise to raise your energy levels. It doesn’t have to be strenuous – try a gentle, restorative class such as yoga or tai chi, which can also help you relax
- practise good sleep hygiene and aim for 7 to 9 hours of sleep a night
Find more self-help tips to fight fatigue.
Tips for dealing with low mood
The emotional symptoms of a thyroid problem, such as mood swings and anxiety, can leave you feeling lethargic and low. It may take a while for your medication to help you feel more like yourself.
In the meantime, try these tips to help improve your mood:
- get active – regular exercise can boost your mood as it makes your body release ‘feel-good’ chemicals, such as serotonin and endorphins. You should aim for about 150 minutes a week, but start slowly if you’re new to exercise (such as with 10-minute walks)
- take time out – prioritise ‘me time’ for things you enjoy. This could be meeting a friend, having a phone call with your family, doing your favourite hobby, or going to the cinema. And if you need a reminder to switch off, set an alert on your phone to build in some downtime
- practise gratitude – before going to bed, make a list of 3 things that gave you some kind of positive feeling (writing them down strengthens your memory). In the morning, reread your list (this preps your brain to look for similar things). In the evening, add 3 more things to your list. The theory is that positivity leads to more positivity!
Find more ways to naturally boost low mood.
How to manage itchy skin
Dry, itchy skin is common when you have an underactive thyroid. Apart from making sure you’re on the right medication, it can be helpful to make some changes to your skincare routine to help ease irritation and dryness:
- avoid perfumed soaps – choose mild soap, or a soap substitute body wash. Soap can be drying, and isn’t needed for most of your body. Use gentle, fragrance-free cleansers on your face
- skip long showers or baths – these can dry your skin and increase your risk of developing other skin problems. Shower for no more than 5 to 10 minutes in warm (not hot) water, then gently pat your skin dry with a towel and apply moisturiser right away
- choose a fragrance-free moisturiser – after showering, apply a moisturiser that’s free from perfumes or additives. Apply to slightly damp skin and allow it to sink in to help seal in moisture
- soothe with an emollient cream – emollient creams designed for itchy skin help to lock in moisture and prevent flare-ups
If these steps don’t help, see your doctor, who can examine your skin and may advise other treatments or refer you to a skin specialist (dermatologist).
When to see a doctor
You should always see a doctor if you think you have symptoms of a thyroid problem. If needed, they will order some tests, so they can make a diagnosis and recommend the best treatment for you.
You should see a doctor as soon as possible if you’re:
- losing weight without meaning to
- having heart palpitations
Remember that the symptoms discussed in this article aren’t only related to thyroid problems. For example, hot flushes and fatigue can be caused by the menopause, while dry, itchy skin may be due to eczema or an allergy.
You should see a doctor about your thyroid treatment if:
- medication isn’t helping to control your symptoms after 2 months
- your symptoms are getting worse while taking medication
- you feel you can’t cope with your symptoms and they’re affecting your daily life
Not sure whether you need to see a doctor? Use our Smart Symptom Checker to get a fast assessment that helps you work out if an appointment is your best next step.