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Both an underactive thyroid or an overactive thyroid can impact normal testosterone levels in men
Men need to understand that while less common than in women, thyroid disease can be an issue in males. Learning to recognize the symptoms of thyroid disorders in men can lead to early diagnosis and effective treatment, leading to a return to hormonal harmony and optimal health.
Thyroid disease is much more common in women than men. This leads many men to think that thyroid disease is not something to be concerned about. But just because women are at greater risk than men for thyroid issues, that does not mean men cannot develop thyroid hormone issues. In fact, thyroid disease is more common in men than you might think, and its symptoms often go overlooked because they overlap with other common conditions experienced by males.
Like in women, problems related to the thyroid can occur if the male body is making too much or not enough thyroid hormone. Many of the symptoms of too much thyroid hormone (hyperthyroidism) or too little thyroid hormone (hypothyroidism) in men are the same as they are in women, but there are some signs and symptoms that are unique to males.
Thyroid issues in men can affect testosterone levels and, therefore, could impair sexual function. The treatments for thyroid disease in men generally are the same as for women and depend on a diagnosis of hyper or hypothyroidism. There are actions men can take to prevent or reduce their risk of developing thyroid disease.
The thyroid is a small, butterfly-shaped gland located in the neck. The thyroid produces two different “thyroid hormones,” both of which regulate a number of bodily functions from metabolism to the beating of your heart.
In addition to the same role that the thyroid plays in women in energy, temperature regulation, and cholesterol levels, thyroid hormones known as T-3 and T-4 play some unique roles in men. Specifically, since thyroid hormones in men influence the production of sex hormones such as testosterone, hypothyroidism or hyperthyroidism can impact a man’s testosterone levels, affecting fertility and sexual function.
The two thyroid hormones, T-3 and T-4, stimulate the production and release of another hormone known as sex hormone-binding globulin (SHBG). SHBG, in turn, is responsible for the release of the sex hormones estrogen and testosterone. SHBG and the hormone levels it controls in the blood is largely responsible for the gender differences in thyroid function and thyroid disease between women and men. For example, through SHBG, since it is responsible for estrogen production, the thyroid regulates the menstrual cycle; therefore, thyroid disorders in women can lead to irregular periods.
In men, the relationship between SHBG and testosterone is a complex one. Testosterone in the male bloodstream is either “bound” to SHBG or “unbound” and free for the male body to use. If thyroid dysfunction puts out too much SHBG, as in hyperthyroidism, that means more testosterone in a man’s blood is sucked up like a magnet pulling up metal shavings, and less testosterone is available, leading to low testosterone.
On the other hand, if thyroid disease puts out too little SHBG, as in hypothyroidism, more testosterone in the blood remains “unbound.” Now, that might sound like a good thing, but when a man’s testosterone level becomes too high, the body starts to convert that excess testosterone into estrogen, which presents a whole other set of problems for a man.
Either too much or too little thyroid hormone can impact a man’s testosterone, and not in a good way!
The reason thyroid troubles often go undetected in males is that the symptoms of thyroid disease in a man overlap with many other conditions common in men, for example, hair loss, lack of libido, or erectile dysfunction.
The various symptoms of thyroid troubles in men will depend on whether the thyroid is putting out too much or too little thyroid hormone. In addition to sudden hair loss and sexual health issues the other common symptoms of thyroid issues in men include the following:
A 2018 study published in Sexual Medicine Review reported that 59% to 63% of males with hypothyroidism (low thyroid function) experienced low libido, erectile dysfunction, and delayed ejaculation. Among males with hyperthyroidism (overactive thyroid function), 48% to 77% had low libido, erectile dysfunction, and premature ejaculation.
Specific tests are required to diagnose thyroid issues in males. If you are experiencing any of the symptoms listed above, it is imperative that you see your primary care physician to be screened for a thyroid problem.
To diagnose thyroid disease in men, doctors will typically do a physical exam, including an examination of the neck area and blood tests. Your doctor may also use imaging techniques to get a better idea of what’s going on with your thyroid gland.
An overactive thyroid can change testosterone levels and the way testosterone works in a man’s body.
An overactive thyroid, also called hyperthyroidism, occurs when the thyroid makes more thyroid hormone than the body needs. Thyroid hormones help control how the body uses energy, so having too much can affect many different organs and body functions.
Hyperthyroidism can also change the proteins in the blood that carry testosterone. One of the most important is sex hormone-binding globulin, or SHBG. Changes in SHBG can affect the difference between total testosterone and the amount of testosterone that is available for the body to use.
This means a man with an overactive thyroid may sometimes have a total testosterone result that appears normal or even higher than expected while still having changes in available testosterone. Thyroid problems may also contribute to symptoms that overlap with hormone imbalance, including changes in energy, mood, muscle strength, sex drive, and sexual function. Thyroid imbalance is one recognized hormonal cause of erectile problems.
For this reason, testosterone levels should not always be looked at by themselves. If a man has symptoms of low testosterone along with signs of an overactive thyroid, a doctor may need to evaluate both thyroid and sex hormone levels before deciding what treatment is appropriate.
Treating the thyroid problem may also change testosterone measurements and improve some symptoms. The goal is to understand which hormone problem is causing the symptoms rather than assuming that every symptom is due to low testosterone.
An underactive thyroid can contribute to hormone changes that may look and feel very similar to low testosterone.
An underactive thyroid, or hypothyroidism, occurs when the thyroid does not make enough thyroid hormone. When thyroid hormone levels are too low, many body functions slow down. Common effects include fatigue, feeling cold, weight gain, low mood, and problems with memory or concentration.
Many of these symptoms also occur in men with low testosterone. A man may therefore assume that low T is responsible when a thyroid problem is actually contributing to his symptoms.
Hypothyroidism may also affect testosterone production and the proteins that carry testosterone through the blood. In some men, this can contribute to lower testosterone levels or changes in the amount of testosterone available for the body to use.
Sexual symptoms can overlap as well. Men with thyroid imbalance may experience reduced interest in sex or erectile problems. This is another reason a complete hormone evaluation can be more useful than testing testosterone alone. Thyroid testing is commonly used when doctors are looking for possible hormonal causes of sexual problems.
When hypothyroidism is present, treating the thyroid disorder may improve some symptoms and may also change testosterone levels. If symptoms continue after thyroid levels have been brought under control, further testing can help determine whether low testosterone is also present.
Having a thyroid condition does not automatically mean that a man cannot receive testosterone replacement therapy.
TRT may be appropriate when a man has symptoms of testosterone deficiency and testing confirms that his testosterone levels are consistently low. Current treatment guidance stresses the importance of confirming low testosterone and looking for its cause before beginning therapy.
That evaluation becomes especially important when a thyroid problem is also present. Some thyroid symptoms closely resemble low T, and thyroid disease itself may affect testosterone measurements. A doctor may therefore want to identify and address the thyroid problem before deciding whether testosterone treatment is also needed.
Some men may have two separate hormone problems at the same time. For example, a man may have hypothyroidism that requires thyroid hormone treatment as well as true testosterone deficiency that may benefit from TRT.
In those cases, treatment should be coordinated rather than treating each hormone level as an isolated number. Blood testing, symptoms, medical history, medications, and other health conditions should all be considered.
Men who use testosterone therapy also need ongoing medical follow-up and blood testing. The purpose of monitoring is to make sure testosterone levels remain in the desired range, determine whether symptoms are improving, and make changes when needed.
The key is an accurate diagnosis. TRT should be used to treat confirmed testosterone deficiency, not simply because fatigue, weight gain, low sex drive, or another symptom happens to resemble low T.
Thyroid hormones and testosterone are connected in women too, but that relationship is not exactly the same as it is in men.
Women naturally produce testosterone, although at much lower levels than men. Testosterone contributes to sexual health, muscle, bone strength, energy, and overall well-being. At the same time, estrogen and progesterone also have major effects on a woman’s hormone balance.
Both an overactive and underactive thyroid can affect a woman’s overall hormone picture. Thyroid disorders may contribute to fatigue, changes in body weight, mood changes, sexual concerns, and changes in menstrual periods. Because several hormones can produce similar symptoms, it can sometimes be difficult to know which imbalance is responsible without testing.
Age can make the picture even more complex. During perimenopause and menopause, estrogen, progesterone, and testosterone levels are already changing. A thyroid disorder that develops during the same stage of life can add another source of symptoms.
Women can also experience changes in hormone-binding proteins that influence how much testosterone is carried through the blood and how much is available for the body to use. For that reason, looking at a single hormone number may not provide the entire answer.
A woman with symptoms of hormone imbalance may benefit from testing that looks at thyroid function along with other hormones when appropriate. The goal is not simply to find one abnormal number. It is to understand how the different parts of her hormone health may be working together and determine which issues need treatment.
Dietary and lifestyle changes can be enacted that may help prevent or minimize the risk of thyroid disease in men.
There are several lifestyle changes you should make if you are guy concerned about thyroid disorders. One, quit smoking. Smoking cessation is good for any number of reasons, but cigarette smoke is known to contain several toxins that can hurt your thyroid, and being positioned in the throat, it is bathed in these toxins when you smoke.
You should also learn how to do a thyroid self “neck check,” get regular exercise and see your doctor for regular checkups.
One way to manage thyroid issues in men, particularly overactive thyroid, is to eat a “thyroid healthy diet.” According to the American Thyroid Association, that means to consume as little iodine as possible. That means avoiding:
Supplementation with the mineral selenium has also been suggested as way to promote normal thyroid function.
Like all hormones, thyroid hormones must work in harmony and balance with all other hormones. Stress may not directly cause thyroid issues, but the release of stress hormones, like cortisol, can throw off the delicate balance of all your hormones, including your thyroid hormones, potentially leading to thyroid disease.
If you have been given a diagnosis of thyroid disease, do not panic! There are effective treatments available for both hyper and hypothyroidism. Depending on which thyroid disorder is your problem, treatment options typically involve modalities designed to restore the proper hormone balance to your body — up or down. Your doctor will likely also suggest lifestyle modifications such as dietary changes and new exercise regimens.
Specific thyroid disorder treatments for men will depend on your particular diagnosis, presenting symptoms, and medical history.
Treating hyperthyroidism usually entails taking antithyroid medications like Tapazole. This is the safest and most effective way to treat an “overactive thyroid” in men. Older treatment options such as radioactive iodine have fallen out of favor since the introduction of antithyroid drugs, which work very well without the risks associated with radiation or surgery.
Hypothyroidism is treated with hormone replacement therapy, typically a synthetic hormone called Synthroid.
An unusual-sounding but successful alternative treatment for hypothyroidism are drugs made from pig thyroids known as desiccated thyroid extracts (DTE). These drugs, such as Armour Thyroid and WP Thyroid, have been around for many years and are prescribed by naturopathic physicians and other alternative practitioners as a substitute to hormone replacement therapy for underactive thyroid.
A naturally occurring amino acid, L-carnitine is available in supplement form that some say could be effective in treating hyperthyroidism. Evidence is spotty, and the results that have been documented do not compare to antithyroid prescription medication.
Hormone problems are rarely solved by looking at one symptom or one laboratory number.
At the Nexel Medical locations nationwide, our approach starts with a complete look at your symptoms, medical history, lifestyle, and appropriate blood testing. This is especially important because thyroid problems, low testosterone, menopause-related changes, and other hormone imbalances can produce many of the same complaints.
Fatigue, weight changes, poor sleep, low sex drive, mood changes, and trouble concentrating can have several possible causes. Rather than assuming that one hormone is responsible, our medical team works to identify the factors that may be contributing to how you feel.
Your treatment plan is then based on your individual needs. If testing confirms a hormone deficiency and treatment is appropriate, your provider can recommend therapy designed around your hormone levels, symptoms, medical history, and health goals.
Nexel Medical also places strong emphasis on follow-up care. Hormone needs can change over time, so treatment should not be a one-time prescription. Regular testing and medical monitoring allow your provider to follow your response and adjust treatment when necessary.
Qualified patients may also be able to receive ongoing care through telemedicine. When prescription treatment is required, medication is prescribed by a licensed medical provider and obtained through a licensed pharmacy.
If you have symptoms that could be related to low testosterone, thyroid function, or another hormone imbalance, contact Nexel Medical today. A complete hormone evaluation can help you understand what may be causing your symptoms and what treatment options may be appropriate.
Yes. Thyroid disorders can change hormone production as well as the proteins that carry testosterone through the blood. This can affect total testosterone and the amount available for the body to use. Your doctor may therefore look at thyroid results along with testosterone testing when symptoms suggest that both could be involved.
It may be appropriate, especially when your symptoms could have more than one cause. Fatigue, weight changes, low mood, trouble concentrating, and sexual problems can occur with both low testosterone and thyroid disorders. Thyroid blood tests can help your doctor determine whether thyroid function may be contributing to your symptoms.
That depends on your individual situation. Because thyroid disease can affect both symptoms and testosterone measurements, your doctor may want to treat or stabilize a thyroid disorder before deciding whether TRT is needed. If testing confirms that you have true testosterone deficiency as well, both conditions may require treatment.
It can in some men when the thyroid disorder is contributing to abnormal testosterone levels. Once normal thyroid function is restored, hormone levels may change and some symptoms may improve. However, this does not mean that every case of low testosterone will resolve with thyroid treatment.
Symptoms alone may not provide the answer. Both conditions can cause fatigue, changes in mood, lower energy, and problems with concentration. Blood testing and a medical evaluation can help determine whether thyroid disease, low testosterone, another health problem, or a combination of factors is involved.
Usually, yes. Hormone treatment works best when it is followed over time. Your provider may monitor thyroid levels, testosterone levels, symptoms, and other appropriate health markers to see how you are responding and whether your treatment needs to be adjusted.
Yes. Women can have thyroid disease along with changes in testosterone or other sex hormones. This can become particularly important around perimenopause and menopause, when several hormone levels may be changing at once. A broader hormone evaluation can help identify which changes may be contributing to symptoms.
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