You are not lazy, you have not suddenly become a different person, but lately everything seems to take more effort. You feel cold faster than you used to, you weigh a bit more without eating differently, and your head feels slow. Each one a vague symptom, and that is exactly why they sometimes stay unexplained for a long time.
With an underactive thyroid your body literally runs at a lower setting. And because the symptoms come so gradually and seem so ordinary, the cause often gets overlooked in men.
What is an underactive thyroid?
An underactive thyroid, in medical terms hypothyroidism, means your thyroid makes too little thyroid hormone. As a result your metabolism drops, and almost every system in your body works a little slower.
In your blood you often see this as a raised TSH and a lowered free T4. Your pituitary effectively calls louder, with more TSH, because too little thyroid hormone is coming in.
Which symptoms does it cause in men?
The symptoms of an underactive thyroid are broad and not very specific, which is what makes them so hard to recognise. It is often a combination that slowly worsens, not one clear symptom.
The table below lists common symptoms, with why they are easily attributed to something else in men.
| Symptom | How it feels | What it is often confused with |
|---|---|---|
| Fatigue | Tired despite enough sleep | Being busy, stress, ageing |
| Feeling cold | Quickly cold hands and feet | Just being sensitive to cold |
| Weight gain | Gaining without eating differently | Less exercise, age |
| Low libido | Less interest in sex | Low testosterone, relationship, stress |
| Low or slow mood | Mentally foggy, less sharp | Burnout, depression |
What are the causes?
The most common cause of an underactive thyroid is Hashimoto’s disease, an autoimmune reaction in which your immune system slowly attacks your own thyroid. In the blood you then often see antibodies against your thyroid, such as anti-TPO.
Other causes include a previous thyroid treatment or certain medicines. If you want to know whether an autoimmune cause is at play, a doctor can measure your anti-TPO alongside your TSH.
Which blood values fit?
The combination that fits an underactive thyroid is a raised TSH with a lowered free T4. Sometimes only the TSH is slightly raised while the free T4 is still normal, which doctors call a subclinical form.
According to the NHG-Standaard Schildklieraandoeningen, such a slightly abnormal result is often repeated first before conclusions are drawn, because the value can fluctuate. So one result is rarely enough, and you always discuss the picture with a doctor.
Underactive thyroid, or low testosterone after all?
This is the key trap for men. Fatigue, low libido and loss of energy fit low testosterone just as well as an underactive thyroid. If you look at only one of the two, you can miss the mark.
That is why it is smart to map them together. How thyroid and testosterone influence each other is in our piece on thyroid and testosterone. If you doubt whether your fatigue comes from your thyroid, our piece always tired as a man helps you further.
How is an underactive thyroid treated?
Treatment of an underactive thyroid is often surprisingly straightforward. Usually you get the missing thyroid hormone in tablet form, so your body gets enough again. The dose is set based on your blood values and your symptoms.
Getting that dose right is a matter of patience, though. It can take a few weeks before you notice a difference, and your doctor sometimes adjusts the dose a few times until your values settle. Never stop a prescribed treatment on your own.
The good news is that many symptoms gradually ease once your thyroid is well managed. Not fully for everyone, but for most men it makes a noticeable difference in energy and clarity.
What now?
If you recognise yourself in these symptoms, and they persist, your thyroid is worth measuring. An underactive thyroid is very treatable, but it does need to be identified first.
Discuss your symptoms with your GP, or map your thyroid values yourself with the Thyroid Function panel. For the broader picture of your men’s health there is the Complete Men’s Health Panel. A result is a snapshot; always discuss a deviation with a doctor.
Sources
- NHG (Dutch College of General Practitioners). NHG-Standaard Schildklieraandoeningen.
- Thuisarts.nl. I have an underactive thyroid.
Disclaimer
Caliberhealth works with BIG-registered doctors who review your blood results. This article provides general information and is not a substitute for medical advice from a GP or specialist. A blood test is a tool, not a diagnosis in itself. For serious or persistent symptoms, contact your GP, or call 112 in an emergency.
Author
Caliberhealth
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