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Hypothyroidism and Low Testosterone: Diagnosis and Treatment

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When it comes to family planning, it is a misconception that it is the female who always lacks the necessary hormones. In some cases, males have reduced free testosterone due to hypothyroidism. Since hypothyroidism-related problems are often misdiagnosed or completely disregarded, people don’t often correlate hypothyroidism and low testosterone.

Correlation Between Hypothyroidism and Low Testosterone

A lack of thyroid hormone has effects on all the tissues in the body, including gonadal function. This is why males can be diagnosed with both hypothyroidism and low testosterone. It is observed that males afflicted with primary hypothyroidism also have hypogonadotropic hypogonadism; this is treated with thyroid hormone replacement therapy. This form of therapy increases the free testosterone, which is reduced with hypothyroidism.

Serum testosterone is reduced by hypothyroidism in males, which can be reversed through thyroxine replacement therapy. However, it is still questioned why subclinical hypothyroidism, which has the same effect as primary hypothyroidism, responds positively to thyroxine therapy when it is technically just a lowered amount of thyroid hormones and not full-blown hypothyroidism.

Difference Between Subclinical Hypothyroidism and Low Testosterone

TSH Levels

Normally, when the TSH level rises to a 5, it is considered hypothyroidism; however, even at level 3, the TSH level can be diagnosed as subclinical hypothyroidism. Since the normal TSH levels are between 1 and 2, any elevation above that normal range requires treatment.

Thyroid Antibodies

Something most males are not aware of is the fact that hypothyroidism is an autoimmune disease. This conditions is also known as Hashimoto’s Thyroiditis, which means your immune system battles the thyroid, and its function slowly degrades through the years. This can be identified by two thyroid antibody tests. Two of the most critical tests to detect these antibodies are Thyroglobulin Antibodies and Thyroid Peroxidase Antibodies.

Elevated Reverse T3

Most of you are aware of the primary thyroid hormones namely T3 and T4. TSH triggers the release of these hormones at 17:1 ratio, which means 17 T4 hormones per one T3 hormone. A large portion of T4 is converted to T3 in different tissues in the body. However, the liver converts 20% of T4 into reverse T3 (rT3), which is part of the body’s feedback mechanism. The problem with this is that rT3 can be elevated in some individuals, which is expressed as hypothyroidism. This can happen despite having a normal amount of TSH.

Free T4 and T3

The primary thyroid hormones are similar to that of testosterone and estradiol because they have unbound and bound forms. If your body is low on free T3 or T4, you can be diagnosed with hypothyroidism. This is sensible because it does show a decrease in thyroid hormones.

Treatment of Hypothyroidism and Low Testosterone

If you are a male who is afflicted with primary hypothyroidism, there are multiple treatments that you can undergo to treat hypothyroidism and low testosterone. Before you start taking thyroid hormone replacement medication, it would be smart to try to take the natural route first. What most males don’t know is that thyroid function can be improved with some simple changes in lifestyle habits. When going with natural treatment, four things are affected: stress, diet, inflammation, and infection.

As mentioned previously, hypothyroidism is an autoimmune disease. When you are stressed, the production of cortisol can cause the inhibition of converting T4 to T3. This means that when you are stressed, your cortisol levels increase, thus causing hypothyroidism due to the decreased levels of T3 and increased levels of rT3. Dealing with stress can change this and can cause an increase in testosterone levels and erectile functions.

When doing natural treatments, dieting is a common factor in any lifestyle change. However, something most people aren’t aware of is how dropping too many calories can actually cause hypothyroidism and low testosterone. Due to the low-calorie level, the body will compensate by decreasing the T3 output. Treating hypothyroidism works by eating the required baseline amount of calories.

When it comes to inflammation and infection, you should always check your C-reactive protein to prevent excessive inflammation, which goes hand in hand with infection.

Other treatments like thyroid medications that can focus solely on T3 or T4 may have different effects. Depending on what needs to be seen, thyroid medication is considered more of an art than science, which has grounds for experimentation of treating both hormones.

Finally, some patients respond better with desiccated thyroids when it comes to treating their hypothyroidism and low testosterone. Desiccated thyroids are dried pork and beef thyroid, which have a combination of T3, T4, and rT3 and their own thyroid hormones. This treatment with its variety of hormone range is considered a more natural treatment, which accounts for why the treatment works for some but not most of the people.

Hypothyroidism and low testosterone are not incurable ailments; ask your endocrinologist what works best for you and how you can improve the situation.

Further Reading:

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-2605.2006.00705.x

https://www.ncbi.nlm.nih.gov/pubmed/15142373

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