It is fairly common that when a man feels depressed, fatigued or uninterested in romance, he may chalk it up to aging. However, contrary to what some commercials would have us believe, a man over the age of 30 shouldn’t have to depend on prescription drugs in order to feel “normal.” If some troubling symptoms have cropped up, it is reasonable to suspect thyroid imbalance as a potential cause. 

The thyroid gland is a part of the endocrine system, located just below the Adam’s apple. Its primary function is to regulate metabolism and produce two hormones, inactive thyroxine (T4) and active triiodothyronine (T3). These hormones are essential for proper digestion, muscle function, internal temperature control, sexual function, cholesterol maintenance, brain function and more. In many ways, the thyroid can be regarded as the command center for many of the rest of the systems in our bodies. When it isn’t functioning properly, nothing else seems to either. 

There are two main types of thyroid disease; overactive (hyperthyroidism) and underactive (hypothyroidism). Thyroid disease is believed to be far more prevalent in women, which is why most medical articles and treatments are focused on this gender. With two out of 10 cases of thyroid disease found in men, there is increasing awareness of how often it is overlooked. There are several reasons for this. 

“Throughout their lives, males are less likely to be diagnosed as hypothyroid than women,” says Michael Doyle, MD, of Stamford Integrative Medicine. “I believe some of this is because hypothyroidism is actually less common in males, but also because males with hypothyroidism are less likely to seek medical attention.”

Appropriate testing for thyroid dysfunction is key, in part because symptoms or reporting of symptoms may be unclear. As Dr. Doyle notes, “I find that while many women come in complaining of classic hypothyroid symptoms, a large number of men did not report any major physical symptoms. On the other hand, they often have physical signs of low thyroid including high blood pressure, high cholesterol and abnormal thyroid levels on blood tests.”

“The most common autoimmune disease I see in my practice is hypothyroidism,” says Ellen Lewis, ND, of Shalva Clinic in Westport. Since the current conventional medical model looks more closely at the symptom (malfunctioning thyroid) rather than the cause (reason for thyroid malfunction), opportunities for treatments may be missed, Lewis believes.

 

Do These Symptoms Sound Familiar? 

Hyper- and hypothyroidism each presents its own unique brand of symptoms, though some may overlap between conditions. Dr. Doyle says, in his experience, men seem less likely than women to notice the coldness, fatigue or muscle aches of hyperparathyroidism. They also seem to be much slower to seek medical attention when they do experience symptoms of hypothyroidism. He points out that denial can be a very important risk factor for men to overcome. 

 

Signs of Hyperthyroidism

In hyperthyroidism, the thyroid produces too much of the thyroid hormone, causing symptoms such as: 

Mood and Cognitive Changes: According to a study published by the Journal of Neuropsychiatry, 137 patients with Grave’s disease reported anxiety and irritability as well as significant cognitive symptoms such as poor memory, attention, planning and productivity.  

Hyperhidrosis: When the thyroid produces too much of the hormones, it confuses the endocrine system, which can result in excessive sweating. The medical term for this condition is called hyperhidrosis. 

Frequent, Loose Stools: Hyperthyroidism causes increased digestive motility due to overstimulation of the vagus nerve. This nerve conveys sensory information from the digestive system to the central nervous system and back. 

Hair Loss: What is usually referred to as “male pattern baldness” might be a sign of hyperthyroidism. Hair loss in relation to thyroid disease is called telogen effluvium, which greatly reduces the number of hair follicles actively growing hair at any one time. This type of hair loss often affects the top of the head with no noticeable hairline recession. 

Erectile Dysfunction: Erectile dysfunction has a definite thyroid connection. According to the International Society for Sexual Medicine, it is estimated that up to 60 percent of men with hyperthyroidism may experience sexual dysfunction due to a decrease in testosterone.  

 

Signs of Hypothyroidism

In hypothyroidism, the thyroid gland does not produce enough of the thyroid hormone, resulting in symptoms such as: 

Depression: A study published by the Department of Neurology in Turkey revealed that hypothyroidism can cause “multiple morphological alterations in the brain.” This could result in depression, mood swings and even psychotic behavior. 

Fatigue: With the complaint of fatigue being such a generic symptom, it can be difficult to pinpoint its medical cause. Fatigue related to thyroid disease often presents differently. Lacking the energy to exercise or not being able to exercise consistently is a common symptom, as is a feeling of heaviness in the head during the evening. Falling asleep immediately upon sitting or lying down is another telltale sign fatigue may be related to a thyroid imbalance.

Constipation: Multiple studies have shown that poor thyroid health has a strong link to poor gut health. Healthy gut bacteria is essential for the inactive thyroid hormone (T4) to be turned into active thyroid hormone (T3). Without this healthy bacteria, the thyroid output leads to slow-transit constipation.  

Weight Gain: Hypothyroidism often results in a poor appetite due to a sluggish metabolism. Despite this, the weight may still pile on. Slow-transit constipation can make proper elimination difficult, further complicating the weight-loss issue.  

Infertility: A study published in the Winter 2012 issue of Urology Journal found that men with hypothyroidism had low sperm counts that could interfere with conception, compared with a control group. Hypothyroidism leads to overproduction of a pituitary hormone called prolactin. Too much of this hormone causes a drop in testosterone production, which can result in lowered sperm count. 

 

Testing for Thyroid Disease 

Dr. Doyle believes the key to arriving at an accurate diagnosis of thyroid disease requires medical practitioners to go beyond the standard TSH blood test. “I believe nearly every doctor has seen patients who have classical complaints and physical changes indicating low thyroid who have a normal TSH blood test,” he says. 

This is because the TSH blood test only measures the inability of the thyroid gland to produce enough thyroid hormone. There are several other causes of thyroid disease. 

“In particular, a part of the brain called the hypothalamus and also the pituitary gland control the thyroid gland. If these areas are not working properly, the TSH test becomes inaccurate or irrelevant.  Also, if the tissues in the body do not respond properly to thyroid hormone, the TSH may again be inaccurate or irrelevant,” Doyle explains. Lewis concurs, stating that she recommends “that any patient presenting with thyroid dysfunction be tested with a blood antibody test first, before other tests are offered.” 

In addition to the blood test, Doyle recommends a basal body temperature test as most hypothyroid patients have low body temperature and a 24-hour urine thyroid test, which measures T4 and T3 metabolites released by the kidneys.

 

Jaime A. Heidel is a Connecticut-based freelance writer  whose passion for natural health began when her life-long  mystery symptoms were diagnosed as gluten intolerance by a  naturopathic physician. Connect with her at itoldyouiwassick.com.