Thyroid Problems Explained 2026. Every Symptom, Every Cause and How to Find Out If It Is Your Thyroid
Around 1 in 20 people in the UK have a thyroid disorder, women roughly 8 to 10 times more often than men, and a large share go years without a diagnosis because the symptoms are so easily attributed to something else. An underactive thyroid produces fatigue, weight gain, feeling cold when others are comfortable, dry skin, hair thinning, constipation, low mood, poor concentration, heavier periods and muscle aches. An overactive thyroid produces the reverse, with weight loss despite eating normally, palpitations, tremor, anxiety, heat intolerance, sweating, loose stools, poor sleep and lighter periods. Both lists overlap almost completely with stress, perimenopause, iron deficiency, vitamin D deficiency, sleep apnoea and depression, which is why a diagnosis rests on blood work rather than on a symptom checklist.
Hashimoto's thyroiditis causes the majority of hypothyroidism in the UK and Graves' disease causes roughly 70% to 80% of hyperthyroidism, and both are autoimmune, both run in families, and both are found with antibody testing that is frequently omitted from a standard panel. Around 50% of adults also have a thyroid nodule visible on ultrasound, of which roughly 95% are benign. At The Wellness you are assessed, we arrange the thyroid blood work at an accredited laboratory and imaging at a specialist centre where it is indicated, and then a further appointment goes through all of it together. Targeted thyroid panel from £295, complete thyroid assessment from £1,795. Fees appear further down this page.
Reviewed by the medical team at The Wellness. Last updated August 2026.
Ask about thyroid symptoms on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.
What are the symptoms of an underactive thyroid
Hypothyroidism slows everything down, and the symptoms arrive gradually enough that people adjust to them. Persistent tiredness that sleep does not fix. Weight gain of a few kilograms without a change in diet. Feeling cold in rooms other people find warm. Dry skin, brittle nails and hair that thins or falls out more than it used to. Constipation. Low mood, tearfulness and a flatness that is frequently diagnosed as depression. Poor concentration and word-finding difficulty. Muscle aches and cramps. Heavier or more frequent periods. A slower pulse. Puffiness around the eyes and face.
Hashimoto's thyroiditis is the commonest cause in the UK, an autoimmune condition where antibodies gradually damage the gland. It is diagnosed by raised TPO antibodies alongside the hormone picture, and it runs in families, so a mother or sister with thyroid disease raises your likelihood considerably. Other causes include previous thyroid surgery, radioiodine treatment, certain drugs including lithium and amiodarone, and postpartum thyroiditis, which affects around 5% to 10% of women in the year after giving birth and is missed extremely often because the symptoms are indistinguishable from new parenthood.
What are the symptoms of an overactive thyroid
Hyperthyroidism speeds everything up and tends to declare itself faster. Weight loss despite a normal or increased appetite. Palpitations or a racing heart, sometimes with an irregular rhythm. A fine tremor in the hands. Anxiety, restlessness and irritability that feel out of proportion. Heat intolerance and excessive sweating. Frequent or loose stools. Difficulty sleeping. Muscle weakness, particularly in the thighs and upper arms. Lighter or absent periods.
Graves' disease causes roughly 70% to 80% of cases and is autoimmune, driven by TSH receptor antibodies that stimulate the gland continuously. It can also affect the eyes in a minority of people, producing grittiness, bulging, double vision or swelling around the eyes, which needs prompt specialist assessment rather than watching. Toxic nodular goitre is the next commonest cause, where 1 or more nodules produce hormone independently. Thyroiditis, including the subacute painful form after a viral illness, causes a temporary overactive phase followed by an underactive one and usually settles on its own.
Palpitations with an irregular pulse, chest pain, severe agitation, fever or confusion in someone with known thyroid disease need urgent assessment rather than an appointment next week.
Ask which tests you need on WhatsApp or email team@thewellnesslondon.com.
Who is most likely to have a thyroid problem
Women, by a wide margin, at roughly 8 to 10 times the rate of men. Anyone with a first-degree relative affected, since both Hashimoto's and Graves' cluster in families. Anyone with another autoimmune condition, particularly type 1 diabetes, coeliac disease, rheumatoid arthritis, vitiligo or pernicious anaemia, because autoimmune conditions travel together.
Women in the year after childbirth, where postpartum thyroiditis affects around 5% to 10%. Women in the perimenopausal years, where thyroid disease and perimenopause produce almost identical symptoms and are routinely mistaken for one another, which is why both should be assessed rather than assumed. People over 60, in whom hypothyroidism becomes more common and presents more subtly. Anyone taking lithium, amiodarone, interferon or immune checkpoint inhibitors. Anyone who has had neck radiotherapy or previous thyroid surgery. And anyone with a goitre or a nodule already known about.
If you sit in more than 1 of those groups and have symptoms, testing is worth doing now rather than after another 6 months of wondering.
What is the difference between a thyroid problem and something that mimics it
This is where most diagnoses are missed in both directions. Iron deficiency produces fatigue, hair loss, poor concentration and cold intolerance, and ferritin below 30 means depleted stores while the full blood count still reads normal. Vitamin D deficiency, near universal by the end of a British winter, produces fatigue and low mood. B12 deficiency produces fatigue, poor memory and pins and needles. Perimenopause produces fatigue, weight change, brain fog, low mood, poor sleep and hair thinning. Obstructive sleep apnoea produces exhaustion, low mood and cognitive slowing while the person sleeps through the cause. Depression produces most of the hypothyroid list.
The practical answer is to test the thyroid and the mimics together rather than sequentially, because testing 1 at a time turns a 2-week question into a 6-month one. A useful panel therefore covers TSH, free T4 and thyroid antibodies alongside ferritin and iron studies, B12, folate, vitamin D, full blood count, HbA1c and kidney and liver function, with hormonal markers added where the stage of life warrants it.
The other half of the answer is structural. Function and structure are independent, so a nodule or a goitre can sit in someone with entirely normal blood tests, which is why a lump in the neck is imaged regardless of what the hormone levels say.
What does thyroid assessment cost in London
Consultant endocrinology appointments in the Harley Street district run £250 to £450 before any test is ordered, with follow-ups charged separately. Comprehensive imaging programmes at the top of the London market exceed £32,000 and multi-day executive programmes at the Harley Street executive health centres reach £14,000. Private hospital imaging is billed per region, reaching £415 per area before consultation and reporting are added. Below that sits a tier defined by its conditions rather than its price, a TSH sold as a standalone test with no antibodies, no mimics screened and nobody to interpret the number against your symptoms.
At The Wellness the assessment, the coordination and the review appointment are 1 fee. All figures are from prices.
Executive Health Programme, the most comprehensive assessment with full biomarker profiling and coordinated imaging, from £11,995.
Executive Body Scan, consultant-reported imaging including the thyroid with full bloods and consolidated review, from £5,995.
Women's and men's body scan programmes including thyroid imaging, with full bloods and review, from £3,495.
Complete Thyroid Assessment, thyroid and neck ultrasound, full thyroid and metabolic panel including ferritin, B12 and vitamin D, extended review appointment and coordination of any specialist referral, from £1,795.
Combined thyroid assessment, ultrasound with the full thyroid panel and review, from £1,295.
Thyroid and neck ultrasound with assessment, consultant radiologist reporting and review, from £995.
Comprehensive Blood Panel covering thyroid, iron, B12, folate, vitamin D, HbA1c, kidney and liver function, with consultation and interpretation, from £495.
Targeted thyroid panel covering TSH, free T4, free T3 and antibodies, with interpretation, from £295.
Consultations, video from £150, in person from £220, extended 45-minute from £395.
Assessments within the week in Marylebone, 3 minutes from Baker Street.
Why The Wellness is the best place in London for thyroid assessment
Because a thyroid answer needs 3 things done properly and most people are given 1. The blood work has to include antibodies, since Hashimoto's and Graves' are autoimmune and a TSH alone tells you the level without telling you the cause. The mimics have to be tested at the same time, because a ferritin of 12 alongside a borderline TSH changes the whole conclusion. And structure has to be imaged where there is a lump, a goitre or a family history, since function and appearance are independent of each other.
We arrange each part where it is done best. Blood work at an accredited laboratory, imaging at the London centre equipped for head and neck work with consultant radiologist reporting, and where diaries allow both are compressed into a single day. Then a further appointment where the hormone levels, the antibodies, the mimics and any scan report are read together against your symptoms, treatment is started where it is indicated, and referral to a named endocrinologist is written and booked where specialist input is needed.
And where the thyroid turns out to be normal and something else explains the symptoms, that gets treated too, which is the outcome a thyroid-only service cannot offer and a great many people actually need.
Arrange an assessment on WhatsApp or call 020 3951 3429.
Frequently asked questions
What are the first signs of a thyroid problem
Underactive, the commonest, causes fatigue, weight gain, feeling cold, dry skin, hair thinning, constipation, low mood and poor concentration. Overactive causes weight loss, palpitations, tremor, anxiety, heat intolerance, sweating and poor sleep. Both overlap heavily with iron deficiency, perimenopause, sleep apnoea and depression, so blood testing rather than a symptom list settles it.
How do I know if my tiredness is my thyroid
You test the thyroid and the mimics together. A useful panel covers TSH, free T4 and thyroid antibodies alongside ferritin and iron studies, B12, folate, vitamin D, full blood count and HbA1c, because iron deficiency, vitamin D deficiency and perimenopause produce almost the same symptom list and are far commoner than thyroid disease.
Who is most at risk of thyroid disease
Women, at roughly 8 to 10 times the rate of men. Anyone with a first-degree relative affected, anyone with another autoimmune condition such as type 1 diabetes or coeliac disease, women in the year after childbirth where postpartum thyroiditis affects around 5% to 10%, people over 60, and anyone taking lithium, amiodarone or immune checkpoint inhibitors.
What causes an underactive thyroid in the UK
Hashimoto's thyroiditis causes the majority, an autoimmune condition diagnosed by raised TPO antibodies. Other causes include previous thyroid surgery or radioiodine treatment, certain medications, and postpartum thyroiditis. Iodine deficiency, the commonest cause worldwide, is rare in the UK.
Can I have a thyroid problem with normal blood tests
You can have a structural one. Around 50% of adults have a thyroid nodule on ultrasound and most have entirely normal hormone levels, so a lump or a goitre is imaged regardless of the blood results. If both the bloods and the scan are normal, the symptoms have another cause worth pursuing.
When is a thyroid problem an emergency
Palpitations with an irregular pulse, chest pain, severe agitation, fever or confusion in someone with known thyroid disease needs urgent assessment. New eye symptoms in Graves' disease, including double vision, bulging or pain, need prompt specialist review. In an emergency call 999.
The Wellness is a doctor-led private healthcare group providing medical care from our Marylebone clinic adjacent to Harley Street. All doctors are GMC-registered. Blood analysis is performed by accredited laboratories and imaging is arranged at specialist centres and reported by consultant radiologists. In an emergency call 999. This article is general information and not a substitute for medical advice about your own health.
Enquire now on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.
References. NICE guideline NG145, thyroid disease assessment and management. NICE Clinical Knowledge Summaries on hypothyroidism, hyperthyroidism and postpartum thyroiditis. British Thyroid Foundation prevalence data on thyroid disorders in the UK. British Thyroid Association guidance on the management of thyroid disease and on Graves' orbitopathy. Published data on the proportion of hyperthyroidism attributable to Graves' disease and on postpartum thyroiditis incidence. Published prevalence data on thyroid nodules detected by ultrasound. NICE guideline NG23 on menopause and Clinical Knowledge Summaries on anaemia and vitamin B12 deficiency.
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