A Guide to Hypothyroidism in Men

Written by
The Manual Team
Medically approved by
Dr Earim Chaudry
Last updated
7th January 2022

In 30 seconds…

Though more common in women, thyroid problems do affect men, too, and can be very serious. When your thyroid is underactive, producing less thyroxine than it should, you may experience weight gain, tiredness, depression, and/or sexual health problems. Thankfully, effective treatments do exist.

Underactive Thyroid in Men

You may know that thyroid disease is quite common amongst women. However, what you might not realise is that men can experience it too. While men tend to be less vulnerable to autoimmune disease, the most common cause of hypothyroidism, they can still develop these disorders. 

Here, we take you through everything you need to know about hypothyroidism in men, from the common symptoms and likely causes to your treatment options.

What Does the Thyroid Do?

The thyroid gland is a butterfly-shaped gland in the neck that produces a hormone that affects pretty much every organ in your body. That hormone is known as thyroxine. Its job is to regulate your metabolism, weight, and body temperature, control your heart rate, and maintain digestive and muscle function.

While it goes overlooked by most of us, it can have a significant impact when things go wrong. The most common thyroid disorders are:

  • Hypothyroidism: That’s an underactive thyroid. It means that the gland is not producing as much thyroxine as it should.
  • Hyperthyroidism: Otherwise known as an overactive thyroid, it means too much thyroxine is produced and the processes that rely on this hormone speed up. You can find out more about hyperthyroidism in men here.

There are many reasons why your thyroid could be overactive or underactive. But before we go there, let’s now turn to the symptoms.

Symptoms of Hypothyroidism in Men

There are some symptoms of hypothyroidism that are specific to men. But first, let’s take a look at the most common symptoms, which tend to be shared across genders:

  • Tiredness and fatigue
  • Oversensitivity to cold
  • Weight gain
  • Pain or numbness in the extremities
  • Constipation
  • Depression
  • Slower movements or thoughts than usual
  • Muscle aches, cramps, or weakness
  • Dry skin
  • Brittle hair and nails

In older people, memory problems are possible signs of hypothyroidism. Unfortunately, this is often misdiagnosed as cognitive decline

Male Underactive Thyroid Symptoms

On top of these symptoms, men may experience some of the following too:

  • Sexual health problems: Thyroid conditions affect your hormonal balance, which can have unwanted effects on your sexual health. Sexual dysfunctions associated with hypothyroidism in men include:
    • Erectile dysfunction (ED): Thanks to the link between erections and thyroid hormones, some researchers recommend that men with ED be tested for thyroid issues.
    • Delayed ejaculation: Studies suggest a strong association between ejaculatory problems and hypothyroidism.
    • Low sex drive: It’s common for both men and women to experience low libido due to thyroid disorders. This is likely the result of fatigue and low energy.
    • Low sperm quality: In some cases, hypothyroidism has been found to increase your risk of infertility.
  • Hair loss: All thyroid problems can cause hair loss. It’s distinguishable from the more common male pattern baldness because it happens across the scalp and body.
  • Gynecomastia: Swollen breasts can be a sign of thyroid problems – both underactive and overactive.

Note: Feeling tired or having dry skin alone is not likely down to hypothyroidism. However, if you feel like you’re experiencing a number of these symptoms, it’s important to talk to a doctor. Complications of untreated hypothyroidism can include heart disease, loss of sensitivity in the extremities, and some mental health conditions, which can all be avoided if you address it early.

Causes of Male Hypothyroidism

In men, hypothyroidism is usually the result of one of the following causes:

  • Hashimoto’s thyroiditis: The most common cause of hypothyroidism is more likely to present in women, but it can still affect men. Hashimoto’s disease happens when your immune system starts to attack your thyroid. It’s more common in those with a family history of the condition or other autoimmune disorders like type 1 diabetes.
  • Problems with the pituitary gland: The pituitary gland releases a hormone that stimulates the thyroid (known as thyroid-stimulating hormone, or TSH). If nodules or cancers damage the pituitary gland, it can cause problems with the thyroid that can make it underactive.
  • Medications: Some medications can cause hypothyroidism, including:
    • Amiodarone, a medicine for irregular heartbeats.
    • Interferons, which treat some cancers and hepatitis C. 
    • Lithium, sometimes used to treat mental health conditions.
  • Overactive thyroid treatment: In rare cases, radioactive iodine treatment or a thyroidectomy – treatments for hyperthyroidism – can cause hypothyroidism.

Managing Hypothyroidism for Men

These days, medical professionals can help you successfully manage hypothyroidism. However, first, you’ll need to take some tests to assess the degree and cause of your underactive thyroid. These can include:

  • Thyroid function tests: These blood tests check your TSH levels and the amount of thyroxine you’re producing. Sometimes, your thyroid test will test for a hormone known as triiodothyronine too.

Find out more: Understanding thyroid function test results.

  • Thyroid antibody test: A thyroid antibody test is sometimes offered to confirm whether or not you have an autoimmune disease such as Hashimoto’s. It assesses whether you have antibodies that are attacking the thyroid.
  • Isotope scan: You may be asked to take a thyroid isotope scan too. For this, you’ll swallow a small amount of a radioactive substance. How much of this substance is absorbed by the thyroid will tell doctors what is causing your thyroid problem.

Treating Hypothyroidism

Treatment of hypothyroidism is usually with levothyroxine, a synthetic (man-made) form of the thyroid hormone thyroxine.

As your thyroid isn’t producing all of the hormone your body needs, you will likely have to take levothyroxine for the rest of your life. It’s a pill that is best taken every morning on an empty stomach.

The correct dosage of levothyroxine does not have any side effects, as it simply replaces a hormone you would normally have in your system anyway. However, taking too much can cause illness, including headaches, diarrhoea and sweating.

You should also be aware that levothyroxine is thought to interact with certain drugs, including statins, amiodarone, and proton pump inhibitors.

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Key Takeaways

Hypothyroidism in men can cause a range of symptoms – from weight gain and fatigue to low libido and hair loss. While it’s not as common as in women, it can be a life-changing condition for men too.

Managing the condition is relatively straightforward, however. A thyroid function test should be your first port of call. If hypothyroidism is confirmed, treatment is with levothyroxine.

FAQs

Where is the thyroid and what does it do?

Your thyroid is a gland in your neck, and it produces a hormone called thyroxine which affects almost every organ in the body. Mainly, thyroxine regulates your metabolism, weight, body temperature, heart rate, digestion and muscle function.

What are the symptoms of Hypothyroidism in men?

Signs that you are suffering from hypothyroidism include: tiredness and fatigue, oversensitivity to cold, weight gain, pain or numbness in extremities, constipation, depression, muscle aches, cramps, or weakness, dry skin, sexual health problems, and/or brittle nails and hair.

How do I know for sure if I have hypothyroidism?

If you think you may have hypothyroidism, you should speak with your doctor, who will likely first administer a blood test. This blood test will tell your doctor how active or inactive your thyroid is. Your doctor may also recommend an antibody test, to see if you have a disease which is attacking your thyroid, or an isotope scan, to see more specifically what’s wrong with your thyroid. All tests are perfectly normal and safe.

What is the treatment for an underactive thyroid?

Levothyroxine is a synthetic hormone which does the same job as thyroxine, and is known to be an effective treatment for hypothyroidism in men and women. Only your doctor can prescribe you levothyroxine. The correct dosage of levothyroxine is completely safe to take, but too high a dose may have side effects.

References

  1. S.T.Ngo, F.J.Steyn, P.A.Mc Combe (2014). Gender differences in autoimmune disease – https://www.sciencedirect.com/science/article/pii/S0091302214000466

  2. American Thyroid Association – Older Patients and Thyroid Disease – DEFINITION: WHAT DO THE FOLLOWING PATIENTS OVER THE AGE OF 60 YEARS HAVE IN COMMON? – https://www.thyroid.org/thyroid-disease-older-patient/

  3. Dawei Chen, Yuerong Yan, Hui Huang, Qiang Dong, and Haoming Tian (2018). The association between subclinical hypothyroidism and erectile dysfunction – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6041544/

  4. Andrew T GabrielsonRita A SartorWayne J G Hellstrom (2019). The Impact of Thyroid Disease on Sexual Dysfunction in Men and Women – https://pubmed.ncbi.nlm.nih.gov/30057137/

  5. manual.co – Is Your Thyroid The Real Reason For Your Hair Loss? – https://www.manual.co/guided/hair-loss-and-thyroid

  6. Valeria CalcaterraEdoardo ClericiValeria CeolinCorrado RegalbutoDaniela Larizza (2018). Gynecomastia after euthyroidism restoration in a patient with type 1 diabetes and Graves’ disease – https://onlinelibrary.wiley.com/doi/full/10.1002/ccr3.1565

While we've ensured that everything you read on the Health Centre is medically reviewed and approved, information presented here is not intended to be a substitute for professional medical advice, diagnosis, or treatment. It should never be relied upon for specific medical advice. If you have any questions or concerns, please talk to your doctor.

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