I have low testosterone as well as thyroid. Wha... - Thyroid UK

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I have low testosterone as well as thyroid. What do I do.

StuArtZen profile image
22 Replies

I have had low thyroid for years. I have been through the process of haveing symptoms but being told my dose is right because my TSH is alright.

I bought a testorone test from a reputable shop and it turns out to be low. I am 29 so I am not allowed to buy the treatment. It's only available for those older than 40.

Has anyone here delt with both at once thyroid and testosterone? What magic word guide a GP to actually do something?

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StuArtZen profile image
StuArtZen
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22 Replies
aspenca profile image
aspenca

The Thyroid effects all hormones so yes it will impact testosterone. What exactly are your levels/labs? You can do a quick search but physicians that rely only on TSH will keep their patients continually sick. You may have to run your own tests/labs (FT3/FT4/etc.). How are your antibodies TPOAb/TgAb? What exactly are you currently taking for your low Thyroid?

userotc profile image
userotc

Personally I'd be interested to know possible root cause(s) of your 2 conditions before commenting. I can't find anything on your profile and maybe you'd prefer not to share that or your T and thyroid test results?

userotc profile image
userotc

You're welcome to private message me

Hashihouseman profile image
Hashihouseman

Take a full male hormone profile to check other testosterone related indicators especially SHBG, thyroid treatment can raise shbg which sucks up free testosterone and give symptoms of deficiency. Also thyroid doses that are too low for you, whatever tsh tells the doctor, can increase prolactin by over stimulation of the pituitary gland - also affects testosterone and related symptoms. So you need full thyroid function test including ft4 ft3 and tsh plus full male hormone function test including shbg, testosterone, oestrodial, prolactin etc. Most important to figure all this out in case it’s thyroid related or something else then complain to PALS if docs do not take your symptoms and results seriously.... keep a detailed symptom diary.

SlowDragon profile image
SlowDragonAdministrator

Looking at previous post you were/are taking T3

Just testing TSH is completely inadequate but especially because on any dose of T3 TSH will be suppressed

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies....or if under medicated

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

If/when also on T3 or NDT make sure to take last half or third of daily dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

Is this how you do your tests?

Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus vitamins including folate (private blood draw required)

medichecks.com/products/thy...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/thyr...

Medichecks - JUST vitamin testing including folate - DIY finger prick test

medichecks.com/products/nut...

Medichecks often have special offers, if order on Thursdays

StuArtZen profile image
StuArtZen in reply to SlowDragon

I have Hashimotos. When I first got tested I they did check and I have the autoimmune version.

My vitiman d was tested and found to be low so I try and supplement that. No guidance on how low I was or how much to take.

My b12 and iron folates where fine last I checked.

Is their any difference in treatment between autoimmune and normal hypothyroid.

As for taking T3

First time I added some to my treatment it helped. I felt a bit better. Looked a bit better. The source I was using went offline. I then tried an other and I think I was sold sugar pills. Or old stock that has lost its potency. As I can't feel any difference. I couldn't even get negative side effects if I took too much.

So right now I am just taking t4 as proscribed. If you have a better source of T3 and you don't mind sharing please PM me.

I can also second that recommendation of not taking your thyroid before the test and also not mentioning that to your gp/ nurse. It is a hell of a look the nurse can give you.

SlowDragon profile image
SlowDragonAdministrator in reply to StuArtZen

How much levothyroxine are you currently taking

Do you always get same brand of levothyroxine

Please add most recent thyroid and vitamin results and ranges

Vitamin levels need to be optimal.....not just within range

HLAB35 profile image
HLAB35

SHBG is often high when vitamin D levels are deficient. It'd be prudent to check vitamin D.

Improving vitamin D should help raise hormones across the board. Taking Magnesium will activate vitamin D and get your levels up more rapidly.

N.B. Many doctors will not prescribe sufficient loading doses.

Thyroid-male profile image
Thyroid-male in reply to HLAB35

I'm having issues with Thyroid too, I'd heard Testosterone levels improved with thyroid treatment?

I have below range SHBG and normal Testosterone- if I take Thyroid meds should I then expect a reduction in testosterone levels?

HLAB35 profile image
HLAB35 in reply to Thyroid-male

It's completely logical that thyroid treatment, especially with the active form, t3, will help restore balance with other hormones. However, I expect it depends on how you respond to thyroid treatment if you are on t4 only, as you need good levels of trace minerals and vitamins to help conversion among other factors (less stress, normal cortisol levels, good fats in the diet etc).

Below range SHBG is associated with high cortisol, fatty liver and insulin resistance (in females with PCOS) so I'd be looking at vitamin B levels as well as ferritin, vitamin D and t3 and maybe checking cortisol, blood sugar and liver function.

Thyroid-male profile image
Thyroid-male in reply to HLAB35

Thanks for this, really helpful, one of my previous posts has these results-would you be ok to have a quick look and see what you think?

I think my cortisol was around the low end of the range, and liver was generally ok but lipids were high. My diet is quite healthy. It sounds as though you know your stuff

HLAB35 profile image
HLAB35 in reply to Thyroid-male

I've responded to your original post. I suspect it could be a non-alcoholic liver issue as you have a handful of other indicators, especially high ALT and cholesterol, but it definitely needs further investigation (my mum developed this from all her meds, but there are numerous causes).

boostthyroid.com/blog/fatty...

StuArtZen profile image
StuArtZen in reply to HLAB35

I try to take those. My vit d has dropped to low before. What doses do you recommend. I have heard that if you are low you do need to load more. I just don't know how much.

HLAB35 profile image
HLAB35 in reply to StuArtZen

Best thing to do is get retested now... and post the results for Seaside Susie to look at. It's a good time to do it as light levels are already diminishing at Northern latitudes. I couldn't 'prescribe'*dosing without knowing levels or how you've managed in the past. For me, I am on a plateau at 2,000 iu daily in a gel capsule and taking Magnesium Chloride and Magnesium Citrate (Dr Sarah Myhill sells both of these soluble forms) spaced out throughout from mid morning onwards. I'm going to retest soon to see if I am tapering off as it's been so cloudy and I am eating less fish. My husband likes using the spray form of 3,000 iu; he takes it at weekends, as I remind him ;-) but he is outdoors a lot during the week. He uses Magnesium Glycinate capsules for energy, but I prefer the soluble stuff as it suits my gut.

*The Vitamin D council makes suggestions based on blood tests.

ncbi.nlm.nih.gov/pmc/articl...

SlowDragon profile image
SlowDragonAdministrator in reply to StuArtZen

With Hashimoto’s we frequently need to supplement continuously to maintain optimal vitamin levels

If you were on vitamin D supplements but then stopped levels likely dropped

GP will often only prescribe to bring vitamin D levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

NHS Guidelines on dose vitamin D required

ouh.nhs.uk/osteoporosis/use...

But with Hashimoto’s, improving to around 80nmol or 100nmol by self supplementing may be better

ncbi.nlm.nih.gov/pubmed/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly via vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function. There’s a version made that also contains vitamin K2 Mk7

It’s trial and error what dose we need, with hashimoto’s we frequently need higher dose than average

Calculator for working out dose you may need

40ng/ml = 100nmol

grassrootshealth.net/projec...

Government recommends everyone supplement October to April

gov.uk/government/news/phe-...

Also read up on importance of magnesium and vitamin K2 Mk7 supplements when taking vitamin D

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

Come back with new post once you get vitamin D results

in reply to HLAB35

That´s interesting info, thanks!

Thyroid-male profile image
Thyroid-male

If you're below 12 then BSSM testosterone guidance says they can treat you if you're symptomatic, and should treat you if you're below 8 in the US if you're below 11 then they treat you

If you Google testosterone units converter you can see how your levels compare in terms of the units used elsewhere (the US use a different system)

annnsandell profile image
annnsandell

Let's start at the beginning StuArtZen. Are you having symptoms of low Testosterone which prompted you to have it tested? For how long? Why not go to the GP with that? Do a little research first so you can ask the right questions. Full blood tests will tell a better picture. I think most GPs will be more sypethetic than you think. One thought, is this recent and a possible aftereffect of COVID-19?

StuArtZen profile image
StuArtZen in reply to annnsandell

I have been symptomatic despite haveing my thyroid level apparently sorted. So I don't know how long it could have been present as both conditions can look similar on men. With them overlaping and my levels being as low as they are it might be why my thyroid treatment is wholly effective. But right now I defiantly had a dive bomb in libedo and strength. Which is annoying because this last 7 months I have been the most consistent in exercise I have ever been. Untill that last two months where my energy and recovery and mood just made it impossible to continue. So I am not overtrained when I tested.

I doubt its covid related.

SlowDragon profile image
SlowDragonAdministrator in reply to StuArtZen

Low testosterone can be symptom of being under treated thyroid wise

thyroidpharmacist.com/artic...

Essential to test Ft3 and Ft4.

Dosing by TSH alone will leave you under medicated

guidelines on dose levothyroxine by weight

Even if we don’t start on full replacement dose, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until on full replacement dose

NICE guidelines on full replacement dose

nice.org.uk/guidance/ng145/...

1.3.6

Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.

gp-update.co.uk/Latest-Upda...

Traditionally we have tended to start patients on a low dose of levothyroxine and titrate it up over a period of months. RCT evidence suggests that for the majority of patients this is not necessary and may waste resources.

For patients aged >60y or with ischaemic heart disease, start levothyroxine at 25–50μg daily and titrate up every 3 to 6 weeks as tolerated.

For ALL other patients start at full replacement dose. For most this will equate to 1.6 μg/kg/day (approximately 100μg for a 60kg woman and 125μg for a 75kg man).

If you are starting treatment for subclinical hypothyroidism, this article advises starting at a dose close to the full treatment dose on the basis that it is difficult to assess symptom response unless a therapeutic dose has been trialled.

A small Dutch double-blind cross-over study (ArchIntMed 2010;170:1996) demonstrated that night time rather than morning dosing improved TSH suppression and free T4 measurements, but made no difference to subjective wellbeing. It is reasonable to take levothyroxine at night rather than in the morning, especially for individuals who do not eat late at night.

BMJ also clear on dose required

bmj.com/content/368/bmj.m41

bestpractice.bmj.com/topics...

Rare to need less, often need higher dose than guidelines

annnsandell profile image
annnsandell

I can't comment on your Thyroid treatment or levels, just to say that under and over treatment can have some similar symptoms. Your low testerone may be connected or not hence you need a GP or Endocrinilogist to do a full assessment with all the facts. By low Testosterone symptons, I meant primarily - Physical changes: increased body fat and reduced muscle bulk. Sexual changes: reduced sexual desires, sexual dysfunction, or infertility. Emotional changes: decreased motivations, depression.

It is known that COVID-19 can reduce Testosterone in men but not whether this is temporary and of course also presents low energy for many months. Just a thought.

GP and more tests please.

simonculley67 profile image
simonculley67

Hi

I too suffer from low thyroid and low testosterone.What has age got to do with it?If your body does not produce enough testosterone ,you need to supplement from outside sources.As far as I know you can be treated for both.Im taking nebido injections for low test, thyroxine and t3 for low thyroid.I hope this helps.

Best regards

Simon

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