What Does Hypothyroidism in Men Even Look Like?
- By Lauren Bedosky
- January 31, 2024
30-Second Takeaway
- Thyroid dysfunction may be more common in women, but men can experience it too, particularly hypothyroidism.
- Symptoms of hypothyroidism in men manifest similarly to how they do in women. However, the condition can especially affect a man’s sexual health.
- Doctors break down the various tests your physician will run to check your thyroid levels.
While women are more likely to experience thyroid issues than men, hyperthyroidism (an overactive thyroid) and its opposite cousin, hypothyroidism in men also exist (1).
“The thyroid gland is a very important organ responsible for the function of all our other major organs and is in charge of our metabolism,” says Deena Gupta-Adimoolam, M.D. Your thyroid plays a big role in your weight and your sex drive, so if the gland isn’t functioning properly, it could stir up some trouble in your body.
Hypothyroidism, also known as an underactive thyroid, may be more common than hyperthyroidism in the U.S. Still, less than four percent of men are believed to have the condition. Read on to learn more about what the condition is, common symptoms to watch out for, and how it’s treated.
About the Experts:
Deena Gupta-Adimoolam, M.D., a specialist in endocrinology and obesity medicine in private practice.
Marc Kai, M.D., Ph.D., a primary care physician with Mercy Family Care Physicians in Baltimore, Maryland who cares for patients with chronic conditions like hypothyroidism.
What Is Hypothyroidism?
Hypothyroidism occurs when the thyroid gland doesn’t make enough thyroid hormone (2). Thyroid hormone is made up of two other hormones, thyroxine (T4) and triiodothyronine (T3), and it controls how your body uses energy from food (3). When thyroid hormone is in short supply, you may deal with a wide range of symptoms, including fatigue, weight gain, low libido, depression, and constipation (4).
Over time, untreated hypothyroidism can lead to other more serious health problems like a higher risk of heart disease, nerve damage, obesity, infertility, and an enlarged thyroid gland that causes problems with swallowing or breathing (4).
However, some folks are more likely to get hypothyroidism than others. Some groups of men at higher risk include (2):
- Men older than age 60
- Men with a family history of thyroid disease
- Men who had surgery or radioactive iodine to fix a thyroid problem
- Men who received radiation treatment to the thyroid, neck, or chest
- Men with other health problems, including diabetes, rheumatoid arthritis, lupus, and Celiac disease
Across the globe, the most common cause of hypothyroidism is a lack of iodine—a mineral that’s vital for thyroid health—in the diet (5, 6). But, iodine deficiencies are pretty rare in the U.S., so the most common causes of hypothyroidism stateside are actually autoimmune conditions, such as Hashimoto’s disease (more on that below). And, 80 percent of autoimmunity is in women, hence why it is far more common in women than men (6).
“We still don’t know why women are more prone to autoimmune diseases, but that’s likely the reason for the difference,” says primary care physician Marc Kai, M.D., Ph.D.
Self-treating with iodine supplements may make matters worse, he adds.
Hypothyroidism in Men
Women are five to eight times more likely to have thyroid problems than men, reports the American Thyroid Association (7). Hypothyroidism is no exception, but why?
There are dozens of possibilities, however, it’s probably because the most common cause of hypothyroidism in the U.S. is Hashimoto’s disease, which happens when the immune system mistakenly attacks the thyroid (8). Like other autoimmune conditions, Hashimoto’s disease is more common in women than men (9).
Symptoms of Hypothyroidism in Men
Just because men have lower odds of developing hypothyroidism, that doesn’t mean there’s no risk at all. You should see your doctor if you notice any of the following symptoms of hypothyroidism.
Fatigue
Fatigue is one of the most common symptoms of hypothyroidism (10). Your thyroid is behind the control board when it comes to energy production, but it needs adequate amounts of thyroid hormone to do its job. When you don’t have enough of this hormone, your energy production slows, causing you to feel drained, Gupta-Adimoolam explains. And it won’t matter how much sleep you get, either.
Depression
There’s a strong link between depression and hypothyroidism. One 2022 review, suggests having low thyroid hormone affects brain functioning, which can play a role in developing depression (11).
Of course, there’s a difference between having the blues and legitimate depression. To be diagnosed with depression, you must feel symptoms most of the day, nearly every day, for at least two weeks, according to the National Institute of Mental Health (12). The symptoms include:
- A persistent sad, anxious, or “empty” mood
- Feelings of hopelessness
- Loss of interest or pleasure in hobbies and activities
- Fatigue
- Difficulty concentrating, remembering, or making decisions
- Physical aches or pains that don’t have a clear cause
- Changes in appetite
- Difficulty sleeping, waking early in the morning, or oversleeping
Weight Gain
One of your thyroid’s roles is to regulate your metabolism or the many chemical reactions that change food into energy (13). Specifically, the thyroid hormone tells your body when to burn calories, where to pull those calories from (think: fat versus carbs), and when to store energy as fat (14).
When you have enough thyroid hormone to run the show, your metabolism hums at a healthy rate for your body size and activity level, making it easier to manipulate your calorie count for weight loss or maintenance.
But when the thyroid hormone level is low, it may slow down metabolism and lead to difficulty with weight loss, Gupta-Adimoolam says. In fact, many people with hypothyroidism might put on 5 to 10 pounds from the condition alone (15).
Constipation
In addition to weight gain, the changes to your metabolism can also lead to constipation. According to Gupta-Adimoolam, low thyroid hormone levels cause your food to move more slowly through your gut, and the sluggish pace can get you pretty backed up.
You can probably tell if you’re constipated. But if you’re unsure, it’s when you clock fewer than three bowel movements per week, and/or your stools are hard, dry, lumpy, or challenging to pass (16).
Joint and muscle pain
Roughly 79 percent of people with hypothyroidism complain of general muscle and joint pain and weakness (17). Why? Because the thyroid hormone controls the body’s metabolism, including how much energy gets allocated to your muscles and joints.
When your muscles and joints get deprived of energy—particularly in the form of muscle proteins—your tissues can feel weak and stiff (17). If you’re having a rough time recovering from your workouts, that may be a sign that something’s up with your thyroid.
Cold intolerance
Always freezing while everyone else is burning up? It could be a sign that your thyroid, which controls your body temperature, isn’t producing enough regulating hormones (18). If you’re always frigid, bundle up—and get your thyroid hormone checked.
The Connection Between Thyroid, Low libido and ED
Hypothyroidism can seriously mess with your sex life. According to research, your thyroid hormone plays a role in creating sex hormones like testosterone (19). With less thyroid hormone available, your testosterone supply may fall short.
That’s because low thyroid hormone may also negatively affect your sex hormone-binding globulin (SHBG) levels, which is what shuttles testosterone to cells in the body that need it. And testosterone, as you know, is a key hormone for fueling sex drive and performance—which is why hypothyroidism can make you less interested in sex.
You may also develop erectile dysfunction (ED) or the inability to get or keep an erection long enough to have sex, along with delayed ejaculation (20). In fact, research suggests that 60 to 70 percent of men with thyroid diseases like hypothyroidism also experience ED (21).
How Is Hypothyroidism Diagnosed?
Because many hypothyroidism symptoms are the same as those of other health conditions, your doctor may use blood tests to check whether your symptoms are due to hypothyroidism (2).
There are a few different blood tests your provider can order to check your thyroid function. These include (22):
- TSH test: Your provider will likely check your TSH levels first. TSH stands for thyroid stimulating hormone. This hormone is made in the pituitary (a pea-sized gland at the base of your brain) and tells your thyroid how much T3 and T4 to make. If your TSH levels are high, your thyroid likely isn’t making enough hormones (hypothyroidism). This prompts the pituitary gland to keep pumping out TSH.
- T4 test: If your TSH test suggests something is wrong, your provider might run a T4 test to confirm your diagnosis. If you recall, T4 is one of the primary thyroid hormones. A blood test can reveal whether you have adequate levels of T4; low levels indicate hypothyroidism.
- Thyroid antibody test: Your immune system creates thyroid antibodies to help fight foreign substances, such as viruses and bacteria. But sometimes, thyroid antibodies attack healthy thyroid tissue by mistake, as in Hashimoto’s disease. Measuring the types and levels of thyroid antibodies in your blood helps your provider tell if you have an autoimmune disorder that causes hypothyroidism.
How Can You Treat Hypothyroidism?
If your doctor diagnoses you with hypothyroidism, they’ll likely discuss medication options with you. “Similar to how people with diabetes need insulin, most people with hypothyroidism need replacement therapy,” Kai says. Levothyroxine, for instance, is a drug that replaces the hormones your thyroid can’t make on its own (2).
Research shows that patients with hypothyroidism who took levothyroxine reported a significant improvement in fatigue after six months of treatment (23). This medicine is usually prescribed as a pill, but you can also get it as a liquid or soft gel capsule.
Medication is the best way to get hypothyroidism under control. However, lifestyle strategies like stress management may help too. One 2019 study found that practicing stress management techniques such as deep breathing and progressive muscle relaxation (a series of tensing and relaxing muscles) boosted mental health and lowered thyroid antibodies in people with Hashimoto’s disease (24).
The Bottom Line
Perhaps the biggest misconception about thyroid disease is that it only affects women. While it’s far more common in women, men aren’t exempt from the condition. Symptoms to watch for include weight gain, fatigue, low libido, depression, constipation, cold intolerance, and joint and muscle pain. However, considering that these symptoms also appear in other health conditions, a blood test is the only way to be sure whether hypothyroidism is the cause.
If your blood test indicates your thyroid hormones are low, your doctor will prescribe medicine to replace these hormones. Healthy lifestyle habits like stress reduction may also help you manage the symptoms of hypothyroidism.
References
1. U.S. Department of Health & Human Services Office on Women’s Health. Thyroid disease.
2. National Institute of Diabetes and Digestive and Kidney Diseases. Hypothyroidism (Underactive Thyroid).
3. Maggie Armstrong, et al. (2023). Physiology, Thyroid Function.
4. Mayo Clinic. Hypothyroidism (underactive thyroid).
5. National Institutes of Health Office of Dietary Supplements. Iodine.
6. Nikita Patil, et al. (2023). Hypothyroidism.
7. American Thyroid Association. General Information/Press Room.
8. U.S. Department of Health & Human Services Office on Women’s Health. Hashimoto’s disease.
9. Fariha Angum, et al. (2020). The Prevalence of Autoimmune Disorders in Women: A Narrative Review.
10. Layal Chaker, et al. (2017). Hypothyroidism.
11. Surya P. Nuguru, et al. (2022). Hypothyroidism and Depression: A Narrative Review.
12. National Institute of Mental Health. Depression.
13. Arturo Sanchez Lopez de Nava, et al. (2022). Physiology, Metabolism.
14. Rashmi Mullur, et al. (2014). Thyroid Hormone Regulation of Metabolism.
15. American Thyroid Association. Thyroid and Weight.
16. National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms & Causes of Constipation.
17. Maria M. Fariduddin, et al. (2023). Hypothyroid Myopathy.
18. Penn Medicine. Hypothyroidism (Underactive Thyroid).
19. Anand Kumar, et al. (2014). Thyroid and male reproduction.
20. Robert Krysiak, et al. (2018). Sexual function and depressive symptoms in young men with hypothyroidism receiving levothyroxine/liothyronine combination therapy.
21. Mario Maggi, et al. (2013). Hormonal Causes of Male Sexual Dysfunctions and Their Management (Hyperprolactinemia, Thyroid Disorders, GH Disorders, and DHEA).
22. National Institute of Diabetes and Digestive and Kidney Diseases. Thyroid Tests.
23. Maria Guadalupe Ruiz-Pacheco. (2023). Severity of Fatigue and Its Relationship with TSH before and after Levothyroxine Replacement Therapy in Patients with Primary Hypothyroidism.
24. Zoe S Markomanolaki, et al. (2019). Stress Management with Hashimoto’s Thyroiditis: A Randomized Controlled Trial.
