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The resulting decrease in thyroid hormones impacts cells throughout the body, causing symptoms such as: Fatigue Weight gain Headaches and migraines Thinning or dry hair, nails, and skin Feeling cold all the time Irregular periods Puffiness or fluid retention Fertility problems Slow digestion and constipation Brain fog Depression Aching muscles and joints Loss of muscle strength and tone These symptoms may be vague early on, but the inflammation can result in an enlarged thyroid (goiter) and thyroid nodules over time