Hypothyroidism in men: everything you need to know

Fatigue. Weight gain. Low mood. 

In women, these are often recognised as signs of an underactive thyroid (hypothyroidism), a condition where the thyroid gland doesn’t produce enough thyroid hormones.

But what about men?

A commonly recognised condition amongst middle-aged women, hypothyroidism can actually affect men and women of all ages - even children. With hypothyroidism being 5 to 10 times more common in women than men, men may not so frequently make the link between fatigue and weight gain, and possible hypothyroidism.

Dr Luke Pratsides, our lead GP, has noticed some differences between how men and women approach their doctors with symptoms of hypothyroidism: 

“Men are less likely to come to the doctor with the symptoms of hypothyroidism and ask to get their thyroid function checked. Men are often less specific when it comes to health concerns; women are much more likely to come armed with ideas of what they want the next steps to be.”

As a man, it’s important to be aware of the signs of hypothyroidism and to know when to get your bloods checked.

With that said, what is hypothyroidism and how do you know if you might have it?

What is hypothyroidism?

Hypothyroidism is a condition marked by thyroid hormone deficiency. This includes primary hypothyroidism (caused by a problem with the thyroid gland - a butterfly-shaped gland located in your neck) and secondary hypothyroidism (caused by a problem with the pituitary gland or hypothalamus, both located in the brain).

Primary hypothyroidism can be caused by a number of factors, such as an iodine deficiency, an autoimmune disease, or problems located within the thyroid gland itself. Secondary hypothyroidism is much rarer and is caused by problems with the pituitary gland or hypothalamus, which are both involved in sending signals to the thyroid to prompt it to produce hormones. 

Signs and symptoms

Being male is no excuse not to look out for signs and symptoms of hypothyroidism. In fact, evidence has shown that the presence of symptoms in men is more indicative of hypothyroidism than it is in women. This means that although you may be less likely to get hypothyroidism, you need to pay attention if you have the symptoms.

Here are some of the common symptoms of hypothyroidism in men and women alike:

• Weight gain.

• Fatigue. 

• Cold intolerance.

• Constipation.

• Depression.

• Reduced libido.

Dr Pratsides says: “I see more men coming to me where the symptom they’re most concerned about is reduced libido, whereas women will be more likely to be concerned about other symptoms in particular tiredness and low energy, despite having reduced libido as well.”

In men there is also evidence which links hypothyroidism with sexual dysfunction, meaning that if you experience ED alongside some of these signs it could be useful to check whether hypothyroidism is the culprit. It can also increase the risk of infertility or subfertility in men and women, so it’s really important not to ignore the signs, especially if you want to have a baby. 

When properly treated, sufferers can enjoy a good quality of life. However, when untreated (or undertreated) hypothyroidism can cause heart problems, poor attention and memory skills, and in severe cases myxoedema coma (a rare but life-threatening condition which can cause hypothermia and drowsiness).

How is hypothyroidism diagnosed?

Hypothyroidism is diagnosed based on levels of thyroid-stimulating hormone (TSH) and free thyroxine (FT4) - the main thyroid hormone - as identified by a blood test. If you experience overt hypothyroidism, your FT4 levels will be below the average, while your TSH levels will be above average. This is indicative of overt hypothyroidism because it means your pituitary gland is working harder to compensate for the thyroid hormone deficiency, by producing more TSH in an effort to prompt the thyroid to produce more thyroid hormones.

Subclinical hypothyroidism means that you have normal levels of FT4, but raised levels of TSH - indicating a problem located within the thyroid that the pituitary gland is trying to compensate for. Secondary hypothyroidism is much rarer and is characterised by low or normal TSH levels, alongside low FT4 levels, indicating a problem located in the pituitary gland or hypothalamus.

The numan take

Men are not immune to hypothyroidism, and ignoring the signs and symptoms can lead to poor quality of life. Hypothyroidism is easy to treat; once you’ve found the right dose it is likely you will be able to live your life as normal, symptom-free. However, getting treatment requires being aware of the symptoms and speaking to your doctor if you notice anything unusual. Don’t ignore the signs: hypothyroidism can affect men too.