Thyroid diseases are five times more likely in women than men. Healthcare professionals aren’t sure why, but they believe the imbalance is related to female hormone levels and autoimmune diseases in women. As in women, men with thyroid function issues will either have an overactive thyroid (hyperthyroidism) or an underactive thyroid (hypothyroidism). Because thyroid hormones affect energy and growth, symptoms of hypothyroidism are usually the opposite of hyperthyroidism: fatigue or restlessness, sensitivity to cold or heat, gaining weight or losing weight, and so on. However, men may also experience sex-specific symptoms such as low testosterone, erectile dysfunction, ejaculation problems, low sperm count, and may even develop female breasts.
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Thyroid symptoms in men are an uncommon health condition that can affect any man regardless of age, race, or ethnicity.
Early signs of thyroid symptoms in men include fatigue, depression, sluggishness, restlessness, nervousness, and decreased sexual drive.
Serious symptoms of thyroid symptoms in men, such as high fever, slowed breathing, low body temperature, racing heart rate, confusion, severe agitation, or coma, may require immediate medical attention.
Thyroid symptoms in men are caused by autoimmune disorders, thyroid enlargement, overactive pituitary gland, thyroid cancer, thyroid nodules, iodine intake, and medication side effects. You may be at risk for developing thyroid symptoms in men if you are older, have had thyroid surgery or radiation therapy to the neck, or have thyroid cancer.
Thyroid symptoms in men usually require a medical diagnosis.
Thyroid symptoms in men generally require treatment. Thyroid symptoms in men typically resolve with treatment, but the timeline may vary.
Treatment of thyroid symptoms in men may include thyroid hormone replacement, prescription medications, radiation therapy, or surgery. Read more about treatments for thyroid symptoms here.
Untreated thyroid symptoms in men could result in complications like infertility, erectile dysfunction, goiter, osteoporosis, blood clots, stroke, heart problems, and eye problems.
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In men, the earliest signs of thyroid disease are changes in energy levels and mood. These might include:
Low energy
Mood swings
Sluggishness
Depressed mood
Restlessness
Agitation
Irritability
Decreased sex drive
Men with a thyroid condition have many of the same symptoms as women. The symptoms will depend on whether the thyroid produces too much thyroid hormone (hyperthyroidism) or too little (hypothyroidism).
Like women, men are more likely to have a thyroid condition that reduces hormones in the body. The most common symptoms of hypothyroidism include:
Low energy
Tiredness
Depression
Sluggishness
Slow heart rate
Weight gain
Constipation
Cold intolerance
Slowed reflexes
Facial swelling
Dry skin
Muscle aches
Hypertension (elevated diastolic blood pressure—the bottom number)
Decreased libido
Excess thyroid hormone speeds up the body, so common symptoms of hyperthyroidism include:
High energy
Restlessness
Irritability
Agitation
Jitteriness
Rapid talking
Fast heart rate
Irregular pulse
Weight loss
Increased bowel movements
Heat intolerance
Overactive reflexes
Hypertension (elevated systolic blood pressure—the top number)
“Thyroid stare” (“bulging” eyeballs)
Nail separation
Both hypothyroidism and hyperthyroidism cause similar symptoms unique to men. As in women, thyroid hormones affect sex hormone production. Hypothyroidism causes downstream effects on the stimulation of testosterone, so men with underactive thyroid experience low testosterone. Decreased thyroid function can also stimulate prolactin, which is a hormone known to stimulate lactation. Hyperthyroidism can increase specific circulating proteins that bind and ultimately decrease testosterone levels, so men with overactive thyroid experience low testosterone. These two opposite reactions produce strikingly similar symptoms in men:
Decreased libido
Depression
Loss of muscle mass
Delayed ejaculation (hypothyroidism)
Premature ejaculation (hyperthyroidism)
Low sperm counts
Decreased fertility
Testicle shrinkage
Female breasts (gynecomastia)
RELATED: Low testosterone treatments and medications
Thyroid disorders are closely linked to depression. Not only do many of the symptoms of depression overlap with thyroid symptoms, thyroid conditions are a prominent cause of depression. For this reason, healthcare professionals always consider thyroid disease when they first see a patient with depression. Although the symptoms overlap, thyroid disorders may have other symptoms. The only sure way to tell is a blood hormone test.
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RELATED: What causes depression? Diagnosis, prevention, and treatment
Thyroid symptoms are based on whether the thyroid produces too little or too much thyroid hormone. The thyroid is a small, butterfly-shaped gland in the neck. The thyroid hormones—T3 (triiodothyronine) and T4 (thyroxine)—affect the entire body. They regulate energy use, body temperature, body weight, skin growth, hair growth, and nail growth. The thyroid hormones also regulate some of the body’s other hormones, including sex hormones.
The body slows down when the thyroid does not produce enough thyroid hormone. As a result, people feel tired, worn out, depressed, and sluggish. Physical problems include constipation, slow heart rate, dry skin, hair loss, and weight gain.
On the other hand, when the thyroid kicks out too much thyroid hormone, it speeds up the body. People feel energetic, agitated, restless, jittery, and anxious. Physically, the heart beats faster, weight decreases, and sweating increases. Believe it or not, depression and fatigue are common symptoms because the body runs out of energy more quickly.
For men, both hypothyroidism and hyperthyroidism cause the same unique symptoms: decreased sexual desire, erectile dysfunction, low sperm counts, ejaculation problems, shrunken testicles, and female breasts.
Thyroid symptoms are readily treatable and may sometimes be signs of a serious illness. For both those reasons, see a doctor if experiencing thyroid symptoms. The problem is that thyroid symptoms are diffuse, nonspecific, and sometimes not very serious. It’s easy to brush them off or confuse them with another problem. Additionally, men don’t commonly have thyroid conditions, so thyroid problems may not be on the radar.
Men with thyroid symptoms may start with a primary care physician but end up in the care of an endocrinologist, a specialist in the body’s hormone systems. Thyroid problems are primarily diagnosed through a medical history of the symptoms, a physical exam, and a blood test that measures thyroid stimulating hormone (TSH). Further blood tests to measure thyroid hormone levels and thyroid antibodies may also be necessary.
In some cases, thyroid symptoms may require emergency treatment. Extremely high or low levels of thyroid hormone can be life-threatening, so immediate medical care is needed if someone has racing heartbeats, irregular heartbeats, slowed breathing, cold skin, extreme agitation, impaired mental status, psychosis, or coma.
RELATED: How to understand thyroid panel results
Depending on whether thyroid hormones are too low or too high, complications of thyroid symptoms in men could include:
Goiter
Hair loss
Breathing problems
Erectile dysfunction
Infertility
Irregular heartbeats (arrhythmias)
Blood clots
Thyroid eye disease (TED)
Stroke
Myxedema coma (a life-threatening condition caused by severe low thyroid hormone levels)
Thyroid storm (a life-threatening condition caused by severely high thyroid hormone levels)
Men with thyroid symptoms usually require treatment. As can be expected, treatments for hyperthyroidism and hypothyroidism are different. Hyperthyroidism requires thyroid hormone levels to be reduced, while hypothyroidism needs treatments that increase thyroid hormone levels. However, the cause itself may also require separate treatment. If the cause is simple such as diet or medication side effects, then the treatment is straightforward and may not require adjusting thyroid hormone levels.
Men with hypothyroidism will take a thyroid hormone replacement medication, usually levothyroxine pills, to increase thyroid hormones.
Men with hyperthyroidism usually take antithyroid drugs called thionamides, which include methimazole and propylthiouracil, that block thyroid hormone production. They may also take beta blockers to reduce the effects of thyroid hormones. In the worst cases, doctors surgically remove the thyroid gland or kill it with radioactive iodine. In those cases, men will take thyroid replacement medications for the rest of their lives.
For most men, thyroid symptoms are due to a chronic and lifelong illness, usually an autoimmune disease such as Hashimoto’s disease or Grave’s disease. Even so, that doesn’t mean thyroid symptoms are a chronic and lifelong condition. Thyroid symptoms, including those unique to men, can be minimized and eliminated with treatment. See a healthcare professional, get tested, and take all medications as instructed.
Thyroid symptoms in men are not only difficult to live with, they’re difficult to interpret. They are often diffuse, indeterminate, and sometimes very minimal. It’s easy to think the symptoms are due to lifestyle and can be fixed by eating better, exercising more, or losing weight. These are all great things to do, but they won’t fix a thyroid condition. If you’re not feeling yourself or experiencing a cluster of unrelated symptoms, talk to your primary care physician or other healthcare provider. The solution may be to eat better, exercise more, and lose weight. It’s also possible that the solution may be to fix a thyroid problem. A healthcare provider can easily spot a thyroid issue with a simple blood test. Treatment is usually inexpensive and relatively painless, but it makes a difference in how a man feels.
How to understand thyroid panel results, SingleCare
Hyperthyroidism: diagnosis and treatment, American Family Physician
Hypothyroidism: diagnosis and treatment, American Family Physician
What is a TSH test and what do the results mean?, SingleCare
Hyperthyroidism: diagnosis and treatment, American Family Physician
Hypothyroidism: diagnosis and treatment, American Family Physician
Hypothyroidism vs. hyperthyroidism: Compare causes, symptoms, treatments, and more, SingleCare
Hypothyroidism treatments and medications, SingleCare
Gender in endocrine diseases: role of sex gonadal hormones, International Journal of Endocrinology
The impact of thyroid disease on sexual dysfunction in men and women, Sexual Medicine Review
Depression treatments and medications, SingleCare
Erectile dysfunction treatments and medications, SingleCare
Hypothyroidism vs. hyperthyroidism: causes, symptoms, treatments & more, SingleCare
Low testosterone treatments and medications, SingleCare
What causes thyroid problems? Related conditions and treatments, SingleCare
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