Men’s Thyroids Are Often Overlooked
I have many gentlemen clients with Hashimoto’s. This is fascinating to me because typically, Hashimoto’s is a women-dominant illness.
But, what I am seeing most commonly in my practice is that autoimmune thyroid affects everyone - the young, the wise, guys and girls, every race, and every socio-economic group.
What is it about Hashimoto’s and the emerging group of men with the illness?
Hashimoto's thyroiditis affects about 14 million Americans, of which about two million are men.
While it's true that women are more likely to develop problems with their thyroid, increasingly more and more men are finally being diagnosed.
The majority of research published currently focuses on ways hypothyroidism can affect women, and in particular, women’s other hormones.
This is partly why men are excluded from the conversation. Men have their own specific physiological and hormonal challenges they face with Hashimoto’s.
It’s pretty easy to understand that Hashimoto’s wasn’t always on the checklist of health conditions many health care practitioners look for in working with male patients.
Add to that, it can be difficult for men to talk about changes in their bodies that are impacting things like healthy libido and brain function.
It gets even more complicated when the general population experiences a considerable amount of undiagnosed Hashimoto’s.
Hashimoto's disease is the most common cause of hypothyroidism in the United States.
For both men and women, Hashimoto’s is (simply put) commonly missed by routine testing.
Most often, a patient might be given a diagnosis of HYPOTHYROID without being tested for or told they have the autoimmune thyroid disease Hashimoto’s.
Hashimoto's disease is a condition in which the immune system attacks the thyroid, a small gland at the base of the neck below the Adam's apple.
The thyroid gland is part of the endocrine system, which produces hormones that coordinate many of the body's functions.
Inflammation from Hashimoto's disease, also known as chronic lymphocytic thyroiditis, often leads to an underactive thyroid gland (hypothyroidism).
When it comes to men, many doctors simply overlook low thyroid, ignoring the signs and failing to put all the pieces together simply because it's more common for women to be affected.
My male clients all wonder if their problems are all in their heads, while their doctors might suggest they're just working too hard or getting older – or even that they need to go on antidepressants.
How Hashimoto’s Disease Affects Men
The thyroid regulates the energy production and metabolism of every cell in the body, so changes in its function can affect every system and look very different from person to person.
Many of the symptoms that affect men are similar to those that affect women, such as dry skin, exhaustion, cold extremities and constipation.
Men, however, also have their own special set of concerns. For example, while women tend to have unexplained weight gain, men may lose muscle mass and strength.
Symptoms of Hashimoto’s disease in Men
Here is a list of typical symptoms my male Hashimoto’s clients often report:
- Brain Fog: Diminished ability to think clearly and make decisions
- Changes in Digestion: Gas, Bloating, Constipation, Irregularity
- Lack of Drive: Reduced feeling of empowerment and self-assuredness
- Lowered Libido: Decrease in sex drive, passion, erectile dysfunction
- Signs of Rapid Aging: Including intolerance to extreme temperatures, balding/hair loss, reduced energy and fatigue, changes to skin tightness and texture, loss of muscle mass and strength in large muscle groups
- Mood Changes: Decreased ability to deal with stress, irritability, depression, anxiety
The symptoms of Hashimoto’s in men are typically first diagnosed as low testosterone, because in fact, low thyroid function actually cause low testosterone levels. And vice versa. I will elaborate on that in a moment.
I often work with clients who have been treated by their doctor for just having low testosterone, but in reality the underlying thyroid condition was missed or dismissed.
Low thyroid function can lead to lowered amounts of sex hormone-binding globulin (SHBG).
SHBG is important because it carries testosterone through the body, making it available to cells and tissues.
Without it, there will be a decrease in the amount of usable testosterone. Commonly, lowered SHBG and testosterone are related to a drop in fertility.
There are many other ways low thyroid can manifest itself in men: Undiagnosed hypothyroidism is a health risk that can lead to poor circulation, increased infections and serious conditions like cardiovascular disease.
Guys, I suggest you order the following lab panel: Extended Thyroid Test for Hashimoto’s Thyroiditis. It costs just $129 but is valued at over $400.
The good folks at True Health Labs allow you to directly order labs that make the most sense for your health condition, allowing you to better participate in the overall management of your health.
If you do order these labs, be sure to take them with you to your next provider appointment.
Show them that you are willing to do what it takes to get the correct information for the best treatment plan possible.
What Causes Hashimoto’s In Men?
Just like with women, there are many triggers for Hashimoto’s in men. This includes chronic bacterial or viral infections, stressful life events, leaky gut, and an accumulation of harmful toxins from food, medicines, heavy metals or the environment.
You can read more about the incidence of elevated auto-antibodies in autoimmune thyroid disease (and how to eat to help lower them!) here.
Hormone imbalance is often one of the biggest precursors to Hashimoto’s - in both women and men!
Hormonal and Biochemical Dysfunction In Men
Tired adrenal glands are usually a big part of the progression to thyroid dysfunction.
Do you work hard, play hard? Pay attention.
The most common scenarios I see in my male Hashimoto's clients is that they have
a) burned the candle at both ends
b) experienced a serious trauma or illness
c) thrive on stress
d) have endured some majorly challenging life events
or e) all of the above - which has drained their adrenals and created inflammation in their body.
This systemic inflammation leads to dysfunction of the immune system and can result in the production of antibodies to glandular tissue - the thyroid.
Because hypothyroidism can have a direct effect on the hypothalamus or pituitary gland, it often interferes with testosterone production.
Interestingly, low testosterone could be a trigger, an exacerbating factor, and even a side effect, of Hashimoto’s. Sometimes, it is difficult to understand which came first, Hashimoto’s or low testosterone.
Researchers believe that testosterone might play a protective role in the development of Hashimoto’s.
Therefore, men with low testosterone are more likely to be diagnosed with Hashimoto’s.
In some men with low testosterone, normalizing thyroid hormones (by taking prescription synthetic thyroid hormone, like Synthroid) can actually normalize testosterone levels.
Link between Genetics and Hashimoto's disease
Thyroid conditions do have a family history component.
Having a father with Hashimoto’s increases your likelihood of having it as well, even more so than having a mother with Hashimoto’s.
Additionally, some people have a genetic variation that may impair their detox abilities.
This group of single nucleotide polymorphisms, frequently called SNPs (pronounced “snips”) is known as MTHFR.
While MTHFR is a quite common variation among the general population, it seems that some people with these variant alleles, may have more severe Hashimoto’s disease.
And, conversely, severe expression of Hashimoto’s may affect how some people absorb certain B vitamins, their energy levels, and overall degree of hypothyroid symptoms.
Vitamin and Mineral Deficiencies
In both women and men, the following nutrients are likely to be out of balance if a person is suffering from thyroid symptoms or has a diagnosis of Hashimoto’s.
Vitamin D is important for strong bones, and is also important for the overall health of the immune system. An important research study also showed that a vitamin D deficiency was associated with the presence of antithyroid antibodies and abnormal thyroid function tests.
The most accurate way to measure how much vitamin D is in your body is the 25-hydroxy vitamin D blood test.
A level of 20 nanograms/milliliter to 50 ng/mL is considered adequate.
However, optimal immune system health relies on levels greater than 50 ng/ml.
Yes, sunshine really is the best source of vitamin D. I suggest 30 minutes of sun exposure per day on 30% of unprotected skin like face and arms from May to October.
But, if someone has a significant deficiency then supplementation with vitamin D3 will be necessary.
Vitamin B12 helps with energy production.
Low levels of B12 are commonly associated with Hashimoto’s. And this may lead to fatigue, depression, neurological issues, impaired digestion, brain fog, tingling extremities, nerve damage, seizures, and anemia.
Vegans and vegetarians are at greatest risk due to the fact that B12 is only found in animal foods.
Individuals with Celiac disease, pernicious anemia (a type of autoimmune condition), Helicobacter pylori (H. pylori), and small intestinal bacterial overgrowth (SIBO) may also be susceptible to deficiency of B12 due to malabsorption issues.
In Dr. Wentz’s survey of 2232 people with Hashimoto’s, 33 percent reported that they had tested as deficient in this vitamin, and 76 percent said they felt better after taking a B12 supplement.
Iron is required for the synthesis of thyroid hormone, and an iron deficiency impairs thyroid hormone synthesis by reducing activity of heme-dependent thyroid peroxidase.
While it is more common for cycling women to be deficient in iron due to menstruation, an iron deficiency can affect menopausal women as well, and sometimes men (especially endurance athletes, vegetarians and vegans).
I suggest getting serum iron and ferritin levels checked regularly, along with iron % saturation, at each of your regular thyroid check-ups.
Besides being important for the synthesis of thyroid hormone, iron of course is important for the production of red blood cells.
It is a component of hemoglobin, and as a result it plays a role in the delivery of oxygen to the tissues and cells of the body.
NOTE: Iron can interfere with the absorption of levothyroxine, and so people taking thyroid hormone should take their iron supplements approximately four hours later.
Selenium to support your thyroid health
Selenium is a very important mineral when it comes to thyroid health. Not only does it play an important role in the conversion of T4 to T3, but it also is essential for optimal health of the immune system.
In fact, some research studies have shown that taking selenium can lower thyroid antibodies.
Magnesium is necessary for more than 300 biochemical reactions in the body. It supports the immune system, maintains normal nerve and muscle function.
Magnesium also regulates the heartbeat, strengthens bones, keeps blood glucose levels steady, and plays a role in the production of energy.
Magnesium deficiency can cause migraines, headaches, insomnia, menstrual cramps, anxiety, joint pain, and a whole host of other symptoms (including an intolerance to loud noises), while supplementation can resolve them.
Studies show that long-term supplementation with magnesium can help with normalizing the appearance of the thyroid gland on ultrasound tests, and magnesium may also help for thyroid and breast nodules.
Zinc is involved as a catalyst in many different pathways in the body. It’s also very important for gut health, immune function, tissue healing, the conversion of T4 to T3, and the production of thyroid-stimulating hormone (TSH).
It can help tighten the intestinal junctions of those with intestinal permeability (which, in my experience, is all people with Hashimoto’s).
Depleted zinc levels can result in diarrhea, hair loss, impotence, loss of appetite, skin issues (acne, rashes, canker sores, foot fungus), depression, impaired vision, low sperm count, attention deficit hyperactivity disorder (ADHD), unexplained weight loss, infertility, headaches and more.
Since zinc is needed to form thyroid-stimulating hormones, those who are constantly producing TSH are more likely to develop deficiencies in zinc.
If you have Celiac disease or any other malabsorption illness that has caused intestinal damage, you may have an impaired ability to absorb zinc.
Essential fatty acids (EFAs)
Essential fatty acids (EFAs) are vitally important to our health. They are the main components of the cell membrane. EFAs are important for the production of prostaglandins.
Prostaglandins are similar to hormones, and have many important functions.
They are involved in cell growth, vasodilation (widening of blood vessels) and vasoconstriction (narrowing of blood vessels), as well as contraction of the uterus when a woman is pregnant.
They also play a very important role in regulating inflammation, which is very important with autoimmune conditions such as Hashimoto’s Thyroiditis.
Addressing nutritional deficiencies as a root cause of your Hashimoto’s is one of the surest ways to empower yourself to eat better, take the proper supplements and stay on track with your nutrition plan.
Testing & Diagnosis of Hashimoto’s in Men
Diagnosis of Hashimoto's disease is based on your signs and symptoms and the results of blood tests that measure levels of thyroid hormone and thyroid-stimulating hormone (TSH) produced in the pituitary gland.
You're likely to start by seeing your primary care doctor when symptoms present.
Your doctor may refer you to a specialist called an endocrinologist and that doctor may run a series of tests.
These may include:
- A hormone test. Blood tests can determine the amount of hormones produced by your thyroid and pituitary glands. If your thyroid is underactive, the level of thyroid hormone is low. At the same time, the level of TSH is elevated because your pituitary gland tries to stimulate your thyroid gland to produce more thyroid hormone.
- An antibody test. Because Hashimoto's disease is an autoimmune disorder, the cause involves production of abnormal antibodies. A blood test may confirm the presence of antibodies against thyroid peroxidase (TPO antibodies). This is an enzyme normally found in the thyroid gland that plays an important role in the production of thyroid hormones.
Standard Treatment For Hashimoto's Thyroiditis
Treatment for Hashimoto's disease may include observation (wait and see) and/or use of medications.
Synthetic hormones for your Hashimoto's
If Hashimoto's disease causes thyroid hormone deficiency, you may need replacement therapy with thyroid hormone. This usually involves daily use of the synthetic thyroid hormone levothyroxine (Synthroid, Tirosint, others).
Synthetic levothyroxine is identical to thyroxine, the natural version of this hormone made by your thyroid gland. The oral medication restores adequate hormone levels and sometimes - but not always - reduces symptoms of hypothyroidism.
Your doctor will tell you that treatment with levothyroxine is usually lifelong. But, because the dosage you need may change, depending on your diet, lifestyle, supplements and other wellness measures.
I encourage you to speak to your doctor about checking your thyroid levels at least every 12 months.
Please download my Hashimoto’s Checklist for a handy resource to take with you to your next doctor’s appointment.
Levothyroxine is the synthetic form of the natural T-4. T-4 is converted into T-3 in the body. While most people are treated with levothyroxine alone, some people don't feel completely normal on levothyroxine.
T-3 can be given alone as liothyronine (Cytomel) or in combination with T-4 as liotrix (Thyrolar, Armour, others).
Taking a combination T4 and T3 ends up producing higher than normal levels of T3, especially soon after the medication is taken. This can cause a fast heart rate, anxiety and trouble sleeping.
But, for those who haven't gotten enough relief from T-4 alone, adding Cytomel to standard levothyroxine treatment for a three- to six-month trial is a long enough period to see if the combination helps you.
With any medication, initially, your doctor should test your level of TSH after a few weeks of treatment.
Progressive hormone replacement (starting with a very low dose and working up as needed) allows your body to adjust to the increase in metabolism.
Spectracell Testing for Hashimoto’s
Because I offer Spectracell Micronutrient testing to my clients as part of nearly all my programs, I know how important it is to TEST, NOT GUESS when it comes to understanding the unique biochemical needs of each client.
These tests are different from the ones in your doctor’s office. Nutritional testing like with the Spectracell test is performed from a preventative and predictive stance, rather than a diagnostic one.
This means if we correct deficiencies today, health problems related to Hashimoto’s are less likely in the future.
Nutritional deficiencies have multiple implications in the body. There is no one-size-fits-all answer to the perfect combination of supplements for Hashimoto’s.
The best thing is the Spectracell Micronutrient test. This test analyzes 32 nutrients and metabolites of nutrients which are critical to your optimal health.
I love to use the Spectracell Micronutrient test to assess each person’s individual nutrient needs. This test makes clear your deficiencies, borderline nutrients, nutritional patterns and possible disease correlations.
This information can help you to understand exactly what your body needs in terms of foods and vitamins.
The nutrients we replenish thoughtfully will likely improve your Hashimoto’s, restore your health and support strong, vital energy.
Food Inflammation (FIT) test
For Hashimoto’s I also use the Food Inflammation Test (FIT test).
This test measures 132 edible compounds and determines if your body is reacting in a negative way to those foods and chemicals.
What does this have to do with Hashimoto’s? If you know your immune and digestive system’s negative reaction to specific foods, it’s easier to avoid them.
You will hear me say more than once that “all health begins in the gut.” So, starting with the gut is a great idea.
Inflammation from food reactions shows up in a variety of ways. This includes digestive, skin, sleep, mood, malnutrition and immune system disorders.
Managing inflammation is a key factor in total body healing. Lowering inflammation helps to lower anti-thyroid antibodies.
The FIT test detects both Immunoglobulin G (IgG) antibodies and complement antigens. This will determine your reactivity to 132 foods, colorings and additives.
The IgG and antigen methods yield more complete profiles of the various foods that may cause food sensitivities. The FIT test is the most sensitive food inflammation test available.
The information we glean from this test helps us assess your gut and immune health. And this can steer us in the right direction for making concrete and effective changes to your nutrition plan.
If you have a diagnosis of Hashimoto’s or another autoimmune disease but with few complaints or symptoms, you will still benefit from FIT testing.
The results gives clarity into what level of support is needed to enhance your health and vitality through foods.
Diet & Lifestyle Support For Men With Hashimoto’s
Here’s the best news: your thyroid symptoms will decrease with a clean, home-cooked food plan prepared with high-quality ingredients. By supporting your immune system, you can reverse your condition. (True!)
A plan that involves eating lots of vitamin-rich foods packed with nutrients is vital to your immune system, thyroid gland, and overall health.
If you are eating the fresh, organic plant-based foods which your thyroid needs to function optimally, your thyroid will be able to produce enough of its own natural hormones.
And, it will be better able to convert hormones into the active state, and then enter your cells for optimum metabolic activity.
Every single one of your trillions of cells needs phytonutrients.
Phytonutrients are the “magic” found in foods – think of the rainbow of colors available in plant foods!
Bright green leafy veggies, orange peppers and melon, yellow squash, purple cabbage, red radishes and berries, and so on!
If you are a meat and potatoes kind of guy, that’s OK. Just consider adding in a side dish of brightly colored veggies to at least one meal per day - and go from there.
Even if you are a meat and potatoes guy, are you consuming enough grass fed, pasture-raised animal protein? Sourcing only wild caught fatty fish? Consuming only pasture-raised eggs?
Not all protein is created equal!
There is a huge difference in the quality of meat you ought to consume for your health vs. what is readily available in grocery stores and restaurants.
You are going to have to become a CONSCIOUS Omnivore in order to get the healthiest protein possible.
Why people with thyroid disease need animal meat/protein:
Protein and essential amino acids (building blocks of protein) are needed for the recovery and repair of all of the glandular tissues in our body.
Protein is needed to transport thyroid hormones throughout the body.
Animal meat contains tyrosine which is the precursor amino acid for the thyroid gland hormone thyroxin.
Animal meat is rich in vitamin B12 and iron (as well as many other vitamins and minerals).
They are key in converting the T4 thyroid hormone (whether in its natural form or synthetic like Synthroid) to the T3 hormone.
Honestly, it can be difficult to get adequate protein intake from diet alone.
Many of my clients have aversions to animal protein, intolerances to certain animal proteins like eggs or fish or lack of accessibility to high-quality, humanely-raised and affordable protein.
For some, such as vegans with Hashimoto’s, protein shakes and amino acid supplements come into the picture.
For men, in particular, muscle loss is a primary symptom of Hashimoto’s.
Adequate protein is the one key way to restore your strength, muscle mass and even jump-start metabolism and libido.
Healthy Body/Mind/Spirit For Men
Though diet is incredibly healing, and necessary for addressing Hashimoto’s disease, it doesn’t stop there.
Guys, it’s important that you take these additional healing strategies to heart.
It can be a big challenge to start nurture and pamper yourself - especially if you are the breadwinner, a workaholic, a weekend warrior or just too hard on yourself.
How do you handle stress?
Do you have a toolbox of resources to get you through the tough times? What do you need when life throws you a curveball?
How much are you trying to juggle at one time?
Relationships and support system
Who do you lean on when you do not feel well? Do you have family and friends who can help you out at home, bring you healthy meals, take you to appointments, or just be a listening ear?
Do your personal relationships bring you joy? How often do you laugh each day?
Exercise routine for men
This one is tricky - sometimes less is more! I know lots of men killing themselves in the gym. No bueno.
Guys, each day please consider if exercise is good fit for you at that particular time.
Will it give you energy? Will it help clear your mind? Help you cope with stress? Good, then do it!
If the answer is no, please rest instead. Listen to your body!
Proper sleep is so critical for healing!
Our society makes “sleepers” feel lazy and unproductive. But, I can tell you my clients who make their sleep routine a priority feel better faster! Focus on shutting off screens, winding down (stretching, reading, etc.) and getting in to bed before 10 pm.
Keep a cool, dark room with a white-noise maker if you are having trouble with distractions or a “monkey” mind. I love the Calm app to help put me to sleep.
Attitude and outlook
When you feel like crap, it’s easy to be cranky.
The challenge now that you know there is hope, is to also know that your thoughts and emotions are empowered to help your body heal.
Accept that this is where you are right now with your health, but also that it will not last forever.
To grow a gorgeous garden, you have to first take care of the soil. There is no substitute for the process of getting well again.
Believe in nutritional healing, believe in your body. Please be patient and loving with yourself.
Address your possible adrenal fatigue - I have an entire article on that one for you to read where I talk about why men and women with Hashimoto’s both have to take care of adrenal issues.
You cannot just take care of your thyroid alone. Adrenal stuff encompasses just about everything else I just mentioned - body/mind/spirit, stress management, sleep, attitude and in general, maintaining a healthy lifestyle.
My clients who are “doing everything right” with nutrition alone for their Hashimoto’s usually have not been doing a darn thing to care for their worn out adrenals.
In other words, they have not adjusted their lifestyle.
Guys, it's possible to manage your Hashimoto's symptoms and lead a healthy life
You just read this article to the end (yay, you!) but you are wondering where to start.
Even with this blueprint of suggestions for better managing your Hashimoto’s, it can feel like a rocky, uphill road.
You are not alone. It’s hard work to embark upon a program to take care of yourself.
Most of the men in my practice come to me after they have tried just about everything on their own.
Usually, their efforts to figure out and “fix” their thyroid have been futile.
They are unassisted by their medical doctor, misunderstood by family and friends, and/or too complicated with symptoms to see any real progress.
Or, some men who come to me for help have simply tried nothing at all. Maybe they don’t have time (or the energy!) to start putting these nutrition and lifestyle into place on their own.
They need guidance.
So, listen, Guys.
You deserve to feel healthy, strong and happy!
And I am here to help.