I used to think being cold all the time was just how my body worked. No matter how many layers I wore or how high I turned up the heating, I could not warm up. My hands and feet felt like ice blocks, even in the middle of summer. At the same time, I was struggling with chronic fatigue syndrome, constantly exhausted, struggling to focus, and living with crippling anxiety.
I went to the doctor many times as I knew something wasn’t right. But when my thyroid labs came back ‘normal,’ I was told everything was fine.
Deep down, I knew it wasn’t. So I pushed my doctors, and they performed a full thyroid panel, including free T3 and free T4. I learned that I had subclinical hypothyroidism—meaning my thyroid wasn’t functioning optimally, but it wasn’t severe enough to flag on standard tests.
If any of this sounds familiar, you’re not alone. Many people experience early thyroid dysfunction without realising it, and because standard lab ranges often miss the early signs, their symptoms are dismissed. But your body is always giving you signals.
And this can even happen following a diagnosis of hypothyroidism. I work with many clients who were diagnosed with hypothyroidism years earlier, and even though they are taking medications to support their thyroid, they are still having symptoms, this is because, even though their TSH is now in range, their active thyroid hormones that support metabolism are low.
Here are five hidden signs that your thyroid might need support—even if your labs are ‘normal.’
1. You’re always cold (even when others aren’t)
Your thyroid plays a key role in regulating body temperature. When it’s underactive, your metabolism slows down, and your body produces less heat. This is why many people with hypothyroidism struggle with cold intolerance, especially in their hands and feet.
A simple way to check? Try the Basal Body Temperature Test:
- Take your temperature first thing in the morning before getting out of bed.
- Do this for five days and track your average.
- If your temperature is consistently below 97.8°F (36.5°C), your thyroid may need support.
2. Unrelenting fatigue (even after a full night’s sleep)
Feeling tired all the time—despite getting enough sleep—is one of the most common but overlooked signs of thyroid dysfunction. Your thyroid hormones help regulate energy production at the cellular level. When levels are low, your body slows down, making even simple tasks feel exhausting.
If you’re relying on caffeine to get through the day, feeling wiped out after exercise, or experiencing afternoon crashes, it could be a sign your thyroid needs attention.
3. Brain fog and poor concentration
I used to forget words mid-sentence and struggle to focus on simple tasks. I blamed stress, but in reality, my thyroid was affecting my cognitive function.
Thyroid hormones influence brain function and neurotransmitter balance. When levels drop, it can lead to symptoms like:
- Memory problems
- Difficulty concentrating
- Slower processing speed
- Feeling mentally sluggish
If you constantly feel like you’re in a mental fog, your thyroid may be a missing piece of the puzzle.
4. Unexplained weight gain or difficulty losing weight
If you’re eating well, moving your body, and still struggling with stubborn weight gain, your thyroid might be involved.
Your thyroid controls metabolism, and when it slows down, your body burns fewer calories at rest. Even if you’re doing all the ‘right’ things, an underactive thyroid can make weight loss feel impossible.
If this sounds like you, it’s important to look beyond just calories in, calories out and assess your thyroid health, stress levels, and inflammation.
I worked with a client recently, and she had tried everything to lose weight. When we checked her free T3 levels, they were below the reference range, even when her TSH was in range.
Low free T3, despite a normal TSH can occur due to impaired conversion of T4 to T3, which is influenced by factors such as chronic stress, inflammation, nutrient deficiencies (e.g., selenium, zinc, iron), and high cortisol levels. Additionally, conditions like chronic illness, calorie restriction, and certain medications can shift thyroid hormone metabolism towards increased reverse T3 production, reducing the availability of active T3.
Consider your symptoms and health history before ruling out your thyroid as the culprit, even if your TSH is in range.
5. Dry skin, hair thinning, and brittle nails
Your thyroid also plays a role in skin and hair health. When thyroid function is low, your body prioritises essential functions, meaning hair growth and skin hydration become less of a priority. This can lead to dry, flaky skin that persists even with moisturiser, increased hair shedding, and brittle nails that break easily. It can also be a contributing factor to conditions like alopecia areata, where the immune system attacks the hair follicles, leading to sudden hair loss.
I personally experienced significant hair loss due to alopecia areata when my thyroid wasn’t functioning well. I kept finding strands of hair all over my black jacket. Once I started supporting my thyroid properly, my hair began to grow back, my skin felt less dry, and my nails became stronger.
What to do next?
If any of these symptoms sound familiar, don’t ignore them. Even if your standard thyroid tests come back ‘normal,’ that doesn’t necessarily mean your thyroid is working optimally.
Here’s what you can do:
✔️ Track your symptoms—write down what you’re experiencing and when it started.
✔️ Try the Basal Body Temperature Test to get a clue about your metabolism.
✔️ Get a full thyroid panel, including TSH, Free T3, Free T4, Reverse T3, and Thyroid Antibodies (many doctors only test TSH, which doesn’t tell the whole story). You can learn more about the one that is offered at The Autoimmunity Nutritionist Clinic here.
✔️ Support your thyroid naturally with nutrient-rich foods, stress management, and targeted supplementation.
If you’re ready to restore balance and feel like yourself again, Thyroid Revival: Restoring Balance for Hypothyroidism will give you the tools to support your body and improve your energy, mood, and overall well-being.
By joining, you’ll:
- Gain clarity on your thyroid health through 5 self-paced modules covering key nutrients, lab testing, and essential thyroid knowledge
- Nourish your body with a 4-week meal plan designed to support optimal thyroid function, and a supplement protocol based on your individual needs.
- Get personalised guidance in a 2-hour live workshop, helping you tailor the approach to your unique needs.
The first live workshops are on 24th February and 7th March 2025. Spaces are limited to keep the sessions interactive, so if you’re ready to start improving your thyroid health, be sure to sign up soon! You can sign up here.
This programme is designed to help you feel more energised, reduce symptoms, and take back control of your health.
The first modules and meal plan will be available in the next few days! Get early access so you can get started before the live session.
If you’re ready to finally get answers and support your thyroid the right way, please get in contact here, and we can discuss it further.
However, if you are looking for more one-to-one support, you can book a free initial consultation with me here, or learn more about my services here.
VJ Hamilton, BSc, RNT
VJ Hamilton is a Registered Nutritionist (BANT) and an expert in autoimmune disease. VJ combines her knowledge from her medical science degree in Biochemistry & Immunology with Nutritional Therapy to offer a thorough and personalised approach to support her clients based on the most current scientific research. VJ runs a virtual and in-person nutritional therapy and functional medicine practice, The Autoimmunity Nutritionist, specialising in gut skin and immune health.