When hypothyroidism can have a special facial appearance, which is very important for the diagnosis of hypothyroidism, specifically: facial puffiness, eyelid laxity, significantly smaller eyes, difficulty in opening the eyes, dull expression, indifference, larger tongue, thickened lips. Some people may also have a tongue sticking out of the mouth, salivation, few words, low voice when speaking, unclear spitting, men may show thinning hair, beard significantly reduced, dry, waxy facial skin, combined with anemia may also appear facial skin pale. These symptoms are mainly related to the significant decrease in the basal metabolic rate of the hypothyroid gland.