Symptoms and signs of hypothyroidism may be subtle and nonspecific, so they may not always clearly signal a thyroid problem. Sometimes, the patient may not notice specific symptoms related to hypothyroidism. Common symptoms of hypothyroidism include fatigue, depression, mild weight gain, cold intolerance, sleepiness, and constipation. Other symptoms can include dry and coarse hair, dry skin, and muscle cramps. Blood cholesterol levels may be elevated. Patients with hypothyroidism may also report aches and pains, swelling in the legs, and difficulty concentrating. Menstrual dysfunction, hair loss, decreased sweating, decreased appetite, mood changes, blurred vision, and hearing impairment are also possible symptoms. Later symptoms (when the condition worsens) can include puffiness around the eyes, slow heart rate, lowered body temperature, and heart failure.