Hypothyroidism creates several vague symptoms that may go unnoticed. While it can occur at any age, hypothyroidism is much more common in women, especially those over the age of 50.

“Your thyroid is the thermostat of your body. It controls energy, metabolism, mood, digestive function and temperature,” said a family medicine physician with TMH Medical Clinic.

If you have extra dry skin, often feel cold, tired or constipated, have trouble remembering things, feel depressed, experience muscle cramps, have heavy or painful periods, weight gain or discharge from your breast, it might be hypothyroidism.

“It can be hard to pinpoint and it’s not something we test for regularly at annual exams, so if you have even one or two symptoms, ask to be tested,” the physician said.

The test is a simple blood test that looks at the level of two hormones – TS3 and TS4.

“We look at the opposite of what you’d think, meaning a high TSH means you have low thyroid, and a low TSH means you have too much thyroid. We confirm with a test that measures free T4 levels and sometimes consider testing free T3 hormone levels as well,” she said.

Some people have full-blown hypothyroidism caused by an autoimmune disorder called Hashimoto’s Disease. Much more common is hypothyroidism due to a thyroid glad that stops producing enough hormones.

“We don’t really know why the thyroid sometimes stops producing enough hormone, but it is 5 to 8 times more common in older women. From my perspective, it can occur at any age. I see women in there 20s with hypothyroidism. Men can have it, too,” the physician said.

If you have hypothyroidism, it’s important to get tested because left unchecked it can have serious consequences. According to the Mayo Clinic, untreated hypothyroidism can increase the risk of heart disease, mental health issues, nerve damage in your limbs, infertility and more.

The treatment for hypothyroidism is a daily dose of synthetic hormone. It can take some time to get the right medication and right dose, but generally people feel better within a few weeks of starting treatment.

“It’s important to come back six weeks after starting treatment or switching brands to make sure it’s working properly. The wrong dose can contribute to falls in the elderly and too much thyroid medicine can cause heart palpitations or heart failure, so it is important to be precise,” the physician said.

She also recommends taking the medicine on an empty stomach—30 minutes before eating or two hours after a meal. Otherwise it might not be absorbed well and become ineffective.

As a final note, avoid self-treatment as it can do more harm than good. Hormones are tricky to get right, so it’s best to leave it to the expert—your doctor. If you’ve been feeling especially tired of late or seem to be extra bothered by the cold, it could be your thyroid. See your doctor and get it checked.