Hypothyroidism can cause puffy eyelids. Hypothyroidism is a condition in which the thyroid gland produces low levels of thyroid hormone due to various reasons. Common symptoms include easy fatigue, fear of cold, weight gain, unresponsiveness, constipation, drowsiness memory loss. Typical facial features can be seen in people who have an apathetic expression, thinning eyebrows, swelling of the face and eyelids, and the skin of the hands and feet can take on a ginger color. Hypothyroidism can also lead to pericardial effusion, causing a decrease in the contractility of the heart muscle, leading to hypothyroid heart disease, anemia, abdominal distension, and often increased menstruation or amenorrhea in female patients. In severe cases, it can also lead to mucous edema coma and even life-threatening. The main treatment for hypothyroidism is lifelong thyroxine replacement therapy.