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What Are the Signs of Thyroid Problems in Men?

cartoon man getting thyroid checked by doctor

The thyroid gland produces hormones that affect many different organ systems throughout the body. Thyroid disorders can therefore cause a wide range of symptoms. Many of the symptoms of thyroid disease are the same in men and women. However, some symptoms of thyroid disorders are unique to men. Please continue reading to find out some of the signs and symptoms of a thyroid condition in men.

What is the thyroid gland?

The thyroid gland is a small butterfly-shaped gland in the neck. It is an endocrine gland, meaning it makes and releases important hormones into the bloodstream. Thyroid function is controlled by the pituitary gland in the brain through a hormone called the thyroid-stimulating hormone (TSH).

The two thyroid hormones, triiodothyronine (T3) and thyroxine (T4), help to control many important functions in the body, including metabolism, body temperature, bone and muscle function, heart and brain function, gastrointestinal function, mood, and more. 

When the thyroid gland makes either too much thyroid hormone or too little thyroid hormone, it results in a thyroid disorder or disease. There are various types of thyroid diseases, for example, hypothyroidism, hyperthyroidism, goiter, Hashimoto’s thyroiditis, and thyroid cancer.

What causes thyroid disease in males?

Thyroid disease is up to 10 times more common in females than in males. However, men can develop thyroid disorders and experience symptoms just like women. In addition to some of the same symptoms that women experience, thyroid issues can cause symptoms that are unique to men. 

According to the American Thyroid Association, these are some common thyroid disorders and their causes and symptoms. 

Underactive Thyroid Gland

The most common cause of underactive thyroid gland (called hypothyroidism) is Hashimoto's disease. Hashimoto’s is an autoimmune condition that occurs when the immune system attacks healthy cells in the body. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDKD), this autoimmune disease tends to run in families and can affect women up to 10 times more often than men. Therefore, family history and gender are risk factors for Hashimoto’s disease and resultant hypothyroidism. 

Symptoms of untreated hypothyroidism that are common to men and women include weight gain, dry skin, hair loss, feeling cold, tiredness, constipation, joint pain, muscle aches, depression, memory problems, and an enlarged thyroid gland.

Overactive Thyroid Gland

The most common cause of overactive thyroid (called hyperthyroidism) is Graves' disease, which is also an autoimmune disorder. This thyroid issue is up to 8 times more common in women than men. 

Common symptoms of hyperthyroidism in men and women include weight loss despite an increased appetite, feeling hot, fast heartbeat, palpitations, tremor (shaking), sweating, anxiety, nervousness, tiredness, sleep problems, muscle weakness, and an enlarged thyroid gland.

Goiter and Thyroid Nodules

Chronic inflammation of the thyroid, such as in people with Hashimoto’s disease, can result in the formation of enlarged thyroid nodules. Multinodular goiter is an enlargement of the thyroid gland that occurs due to iodine deficiency. These thyroid disorders are up to 4 times more common in women than men.

Classic symptoms of goiter and thyroid nodules include a swelling in the neck and difficulty breathing or swallowing. If the nodules produce excess thyroid hormones, it can result in hyperthyroidism. If there is inflammation of the thyroid, it can be associated with symptoms of hypothyroidism.

Thyroid Cancer

Cancer of the thyroid gland occurs due to uncontrolled growth of thyroid cells. Every year, some 12,000 men and 33,000 women develop this type of cancer in the US.

Signs and symptoms of cancer of the thyroid in men and women include a lump in the neck that can be felt and/or seen, discomfort when wearing tight collars, changes in the voice, difficulty swallowing, pain in the throat, and swollen lymph nodes in the neck.

How does a man know if he has a thyroid problem?

There are some symptoms of thyroid problems that are specific to men, such as:

  • Thinning hair and hair loss
  • Reduced libido (sex drive)
  • Low sperm count
  • Low testosterone levels
  • Erectile dysfunction
  • Delayed ejaculation
  • Premature ejaculation
  • Gynecomastia (male breast enlargement)
  • Loss of muscle mass and muscle strength

It is worth noting that these are nonspecific signs and symptoms that may be due to thyroid disease or other causes. For example, a number of things can cause you to gain weight despite a healthy diet and regular exercise. If you suspect a thyroid disorder, you should make an appointment and be evaluated by your healthcare provider.

Remember that treating an underlying thyroid disease can significantly improve symptoms in men and women. 

How do doctors diagnose thyroid disorders in men?

The diagnosis of a thyroid disorder is the same in men and women. However, healthcare providers frequently do not correlate symptoms to thyroid disease in men because it is not nearly as common as in women. In addition, thyroid dysfunction usually affects men over the age of 40 and causes generalized, non-specific symptoms that can be attributed to other causes such as age and weight gain. 

If you are a man and suspect a thyroid disorder, talk to your healthcare provider. They may order certain tests to get to the bottom of things, based on your symptoms, medical history, and physical exam. These tests may include:

  • Blood tests to check thyroid hormone levels and identify a hormone deficiency or excess.
  • Imaging tests, such as ultrasound, CT scan, and MRI to look for thyroid enlargement.
  • Radioactive iodine uptake (RAI-U) test.

What is the treatment for thyroid diseases in men?

The treatment for thyroid symptoms in men and women depends on whether they are due to hypothyroidism (not enough hormones) or hyperthyroidism (excess hormones).

Hypothyroidism is usually treated with thyroid hormone replacement medication. Examples of hormone therapy include levothyroxine (Synthroid, Levothroid, Levoxyl, Unithroid, Tirosint), which is a synthetic thyroid hormone T4. You need to take this medication for the rest of your life. Other medications that may be prescribed include liothyronine (Cytomel), which is synthetic T3, and desiccated thyroid extract (DTE), which has both T3 and T4. 

Conditions resulting in hyperthyroidism (when you produce hormones in excess) are usually treated with antithyroid medications, such as propylthiouracil and methimazole (Tapazole). You may need to take antithyroid medicine long-term. However, you may be able to get off antithyroid medication if your thyroid hormone levels return to normal. Other treatment options for hyperthyroidism include radioactive iodine ablation or radiation therapy to destroy thyroid tissue and thyroidectomy (thyroid surgery to remove part of the gland). These treatments can ultimately lead to hypothyroidism, which will require treatment.

References:

  1. https://www.thyroid.org/thyroid-information/
  2. https://www.niddk.nih.gov/health-information/endocrine-diseases/hashimotos-disease
  3. https://www.niddk.nih.gov/health-information/endocrine-diseases/graves-disease#
  4. https://www.mayoclinic.org/diseases-conditions/thyroid-nodules/symptoms-causes/syc-20355262
  5. https://www.cdc.gov/cancer/thyroid/index.htm#
  6. https://academic.oup.com/bmb/article/99/1/39/298307?login=false
  7. https://www.liebertpub.com/doi/10.1089/105072504323024552
  8. https://linkinghub.elsevier.com/retrieve/pii/S0025712512000144