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Hidden Thyroid Issues in Men: Are You at Risk?

Here's how to tell if your gland is glitchy.

By Ingrid Yang, M.D., J.D.
Medically reviewed by Kristin Fuller, M.D.
December 13, 2023

Chances are good you know at least one woman with a thyroid disorder. After all, 1 in 8 women will have an issue with their thyroid gland (1). But men aren’t immune—in fact, experts say that thyroid disease in men is likely underestimated and approximately 20% of thyroid disorders are found in men.

If your thyroid—a butterfly-shaped gland at the base of your throat—pumps out too much or too little hormone it can have a major impact on your life.

An out-of-whack thyroid can impact your weight, your energy levels, your digestive system, your immune system, your sex life, and more.

The good news: correcting thyroid issues can help you get back to normal (2).

The best way to get thyroid issues under control before they can control you: learn the signs of an over- and under-active thyroid gland.

If any of the symptoms below feel familiar, make an appointment with your doctor.

Signs You Might Have a Thyroid Problem

The symptoms of thyroid disease vary based on how much—or how little—of the hormone is in your system.

They’ll also vary based on what’s causing the problem.

If the issue develops in the thyroid gland itself, you’ll likely have different symptoms than if the issue stems from another disorder related to the thyroid, such a problem with the pituitary gland.

Your thyroid can work too hard, or not hard enough. Let’s look at the signs and symptoms of both:

Hypothyroidism

Having too little thyroid hormone (called hypothyroidism) can impact literally every organ system in your body.

In many cases, hypothyroidism is caused by Hashimoto’s disease, an autoimmune condition where your immune system attacks your thyroid gland and damages it.

Symptoms of hypothyroidism can be wide-ranging and may come on suddenly (like a bump on your thyroid gland) or emerge slowly, making it harder to identify that the problem is with your thyroid rather than another hormonal imbalance such as low testosterone.

Some of the most common symptoms of hypothyroidism in men include:

Fatigue
Shortness of breath
Low sex drive
Dry skin, coarse hair, and brittle nails
High cholesterol
Achy joints
Muscle pain and weakness
Weight gain

Hypothyroidism at a Glance

If your thyroid doesn’t produce enough thyroid hormone, it’s called hypothyroidism
Most cases of hypothyroidism in men are caused by an autoimmune condition called Hashimoto’s disease
Hypothyroidism can show up as fatigue, weight gain, a low sex drive, dry skin, and other symptoms.

Hyperthyroidism

If having too little thyroid hormone can make you feel so awful, you might think more thyroid hormone is better. You’d be wrong.

Hyperthyroidism—an excess of thyroid hormone—can also cause full-body symptoms that vary from person to person. But some of the more common red flags include (3):

Excessive sweating
Weight loss—even through your appetite may increase
Sensitivity to heat and cold
Rapid heartbeat (100+ beats a minute)
Irregular or pounding heartbeat
Feeling nervous, anxious, or irritable
More frequent bowel movements
An enlarged thyroid gland (goiter), which may appear as a swelling just below your Adam’s apple.
Fatigue, muscle weakness
Difficulty sleeping
Thinning skin
Brittle hair

Hyperthyroidism at a Glance

If your thryoid produces too much thryoid hormone, it’s called hyperthyroidism
Signs of hyperthyroidism include weight loss, fatigue, excessive sweating and a sensitivity to heat or cold

Thyroid Issues in Men

In addition to the above symptoms (which can impact women, too) men have unique symptoms when it comes to thyroid disease, including premature balding, a diminishing sex drive, erectile dysfunction, and delayed ejaculation.

In guys, glitchy thyroids can cause below-the-belt troubles. Both hypo- and hyperthyroidism alter the amount and effects of circulating sex hormone levels and cause changes in libido and sexual function. A whopping 64 percent of hypothyroid men report having a low libido, erectile dysfunction, and delayed ejaculation (4).

Hyperthyroidism is also linked to a low libido (5) and erection issues, except instead of finding it hard to ejaculate, you may find yourself shooting earlier than you’d like (6).

Premature ejaculation (PE) has been linked to hyperthyroidism, though experts aren’t quite sure why. Fortunately, studies show treating thyroid issues can substantially improve the problem (7).

Thyroid issues can also crash your mood. Some men with thyroid issues are mistakenly diagnosed with depression since the symptoms are so similar. So if you’re being treated for depression and the meds don’t appear to be helping, it’s worth asking your doctor to check your thyroid.

Do I Have Low Testosterone? 13 Symptoms to Look for

Common Conditions That Mess With Your Hormones

20 percent of thyroid disorders are found in men

How Do I Know If I Have a Thyroid Problem?

If your spidey senses are tingling after reading the symptom list above, make an appointment with your doctor. He or she can order some blood tests to determine if your gland is at the top of its game:

Serum TSH concentration. TSH (Thyroid Stimulating Hormone) controls the production of two main hormones, T4 (thyroxine) and T3 (triiodothyronine). A TSH test is the most sensitive test for hypothyroidism, according to the American Thyroid Association.
T3. This test measures the amount of T3—the biologically active form of the thyroid hormone—in your blood. A high level of T3 suggests that you have hyperthyroidism. Too little can be a sign of too little thyroid hormone.
T4. A T4 test measures the amount of T4—the main form of thyroid hormone—in your blood. Most of the T4 in your blood is bound to T3, and shuttles it to where it’s needed in your body. About 1-2% of T4 is unattached or “free” and can get into your blood (it’s a bit like the difference between total and free testosterone). A T4 test measures how much “free” T4 is in your blood. Having a low TSH and a low T4 suggests that you have hypothyroidism; a low TSH coupled with a high T4 may signal you have hyperthyroidism.

Treatment for Thyroid Issues in Min

Treatment of thyroid disorders will largely depend on whether you’re producing too much or too little thyroid hormone, and what’s causing it. If your thyroid isn’t producing the right level of hormones because of a nodule or tumor, you may need a biopsy to determine whether it is cancerous or benign.

Hypothyroidism

If your thyroid levels are too low, your doctor can prescribe daily synthetic thyroid hormone to get them back where they belong.

As your hormone levels rise, your symptoms should diminish.

Hyperthyroidism

An autoimmune disorder called Grave’s disease is the most common cause of hyperthyroidism for men, though tumors can also make the thyroid gland overproduce.

To get your production of thyroid hormone back to where it should be, your doctor has a few options:

Antithyroid medications. Antithyroid drugs that cause the gland dial back hormone production.
Surgery to remove part or all of the thyroid. If your thyroid is removed, you’ll need to take synthetic thyroid since you won’t be able to produce it on your own.
Radioiodine therapy, which is a pill that gradually shrinks a portion of your or all of the gland to alleviate your symptoms of hyperthyroidism.

FAQs

What are the risk factors for thyroid problems in men?

Any man can develop thyroid issues but your odds increase if:

You’re over 60
You have a family history of thyroid disease
You have an autoimmune disease, such as type 1 diabetes or celiac disease
You’ve been exposed to high levels of radiation (such as for cancer treatment or environmentally, ie. you work with radioactive materials).

How do I do a self-check?

Lab tests are the best way to determine if you have thyroid disease. But if you see or feel any irregularity over the front of your neck just below your Adam’s apple, it’s a good idea to have your doctor check it out.

The Bottom Line

Thyroid issues may seem like they don’t impact men, but are actually most likely underreported. If you are feeling symptoms of fatigue, unusual weight gain or loss, decreased libido or sexual dysfunction, talk to your doctor.