Sexual dysfunction (male)

[UKmale_hypo]

For many years I have suffered from sexual dysfunction which has been extremely labile/sporadic, as were all my symptoms. I could have 100% function one day, and then absolutely nothing the next. The problem seems to be twofold, with both a lack of libido and also coldness and shrivelling in my entire genital area to the point of pain.

After a decade of ill health, only part of which was this problem, I was diagnosed with and treated for Growth Hormone Deficiency (GHD) from Nov 2020. This has improved my life enormously in many ways, but not helped the sexual dysfunction.

Recently I had more testing which has revealed central hypothyroidism and I started on Levo (GH treatment can often 'unmask' hypothyroidism, and this is what seems to have happened with me). My endo told me to start on 75mcg, but I instead titrated my dose up, and have just hit 75mcg since starting just over 2 months ago. Endo says I can go up to as high as 125mcg and to target FT4 in top half of range. I haven't had any further thyroid testing yet as I was told to wait 4-6 weeks after being on 75mcg. In the recent testing my SHBG was also below range (16.3 [20.6-76.7]), and Testosterone low in range (10.3 [8.6-29.0]). I have been told that low SHBG can, perhaps counterintuitively, limit testosterone.

My theory is that both the lack of libido and cold and shrivelled genitals (cold extremities) are known hypothyroid symptoms, and my hope is that treatment will sort this problem out. I have suffered from cold hands and feet for ages also. But I am still waiting for things to change. I have felt a slight improvement in temperature overall, but not a lot, and in fact there's been very little change in symptoms so far. This is not that surprising to me, as I know it's not an overnight fix and getting on the right dose/to the right levels is critical. But I had hoped for at least a glimmer of hope at this stage.

Any guys here who can relate? Any advice from anyone? (Happy to hear male and female advice, of course).

TIA

[Danielj1]

Hi sorry to hear about all your issues much of which I do not have the expertise to comment on I am afraid. The one thing I can talk about is cold hands and feet that were causing huge issues for me over the years.

Changes I have made to diet and supplements have cured the problem so completely that I am able to live and enjoy what would have been a freezing house last November even with some heat - to no angst unheated this year.

In case you think it was changes to medicine I have been on 100 Levo for quite some while although at times think I need to reduce this but have not got round to doing so. So I put the results down to diet/supplements changes.

If you want me to unpack them if you are interested I can - i have mentioned them before on this board so some will need to ignore the post who have read that

Do have hope the body is amazingly adaptive - and I am probably a lot older than most here tbh ..

[Danielj1 in reply to Danielj1]

I meant to add, my basal temperature would drop during many days way off the scale down from c36-c37 to about 34-35 which is not safe long term really and feels horrible and shivery - I very rarely have any times under 36 even on a tough day

What are your temperatures when you wake up, after lunch and in the evening as a reference point ?

[UKmale_hypo in reply to Danielj1]

I have been checking basal temps (on waking) and average is 36.4 (lowest is 36.0), so a little on the low side, but not dreadful.

[UKmale_hypo in reply to Danielj1]

I'd be interested to hear about the diet and supplement things that helped ...

[Danielj1 in reply to UKmale_hypo]

I have suffered for so long with cold hands/feet etc - it is really weird that I can seem now to cope with way more cold than almost all our entire family.

Giving up milk and moving 100% to oat milk plus the high cross reactivity between milk and caffeine (for some a really bad combination inflammation wise)- so oat coffee fine but milk coffee awful.

I abide by the medical medium ideas on fruit and veggie shakes each morning - for me I add celery/ton of spinach/celery/carrots/radishes/blueberries/oats/salt/oat milk in a large blender and am always full to lunch.

Beyond that live largely off fish - sardines /cod/salmon and eggs for protein with a load of salad and vegetables

Not fanatical over avoiding gluten - but I try to not take too much. I do add quite a lot of salt (won’t be right for everyone) and try to cut back on sweet things.

Of all the above avoiding mixing dairy and coffee was probably the biggest improvement to body warmth - odd really as oat milk and caffeine is fine

None of the above may work for anyone else but for me has been staggering really - blown away that such minor changes can help so much.

Good luck of course - we all seem to have different inflammatory triggers and identifying and removing them are key I now realise

[jimh111]

Not an expert in this area. If you have GH deficiency and central hypothyrodism you should have your pituitary tested along with testing the levels of gonadotrophin hormones. If this hasn't been done request it.

[UKmale_hypo in reply to jimh111]

Had luteinizing hormone (LH) and follicle-stimulating hormone (FSH) tested and results are:

FHS - 8.7 [1.5-12.4]

LH - 7.1 [1.7-8.6]

These seem to be OK.

[jimh111 in reply to UKmale_hypo]

That looks good although I have no detailed knowledge. I would wait until you are on 125 mcg levothyroxine and then see how you are and measure TSH, fT3, fT4 and testosterone.

[Danielj1]

your basal temps are fine then which is good news - are you taking any measures to adapt your diet and take specific supplements ?

[UKmale_hypo in reply to Danielj1]

I haven't changed my diet, although I think it is reasonably good. Also not taking any supplements - don't know what I should be taking.

[Danielj1]

if it helps you at all, I have known all my life dairy is not great for me, but challenged myself to give it up entirely and move to oat milk etc and that alongside eating a ton of spinach/blueberry/spinach/oat smoothies made a huge difference a while back and the cold hands and feet “warmed up” - never gone back to be cold at all - magnesium glycinate/zinc/selenium/D were also really beneficial - but giving up milk was the real biggie of the lot. If someone has told me at the time such small food changes could have had such an impact I would have struggled to believe them

[jrbarnes]

Here's a few links about the SHBG and testosterone. He has some good blogs about this stuff on his site. SHBG will be low if you're still hypo and also low libido.

restartmed.com/shbg/

restartmed.com/?s=testosterone

[userotc]

Not sure how low shbg limits T as generally opposite eg 1st link earlier from jrbarnes?.