# Can the thyroid cause male sexual problems?



## Planter23 (May 3, 2014)

Hello everyone,

This is an embarassing issue to have. Lately, I have been having some problems with my sex drive and erections. I'm a 23 year old guy and this has been going on for several months now. I don't have much of a libido anymore. Erections are possible, but very difficult to keep. I feel almost disconnected to my genitals. Its a very strange feeling.

I recently saw a doctor and he checked my testosterone levels(no other hormones, just testosterone) and he said the test came back fine. I have been looking for more tests that I could request from my doctor. I was wondering if I should get my thyroid levels checked. I don't know if sexual problems are common in men with thyroid issues so I came here to ask. Has anyone heard of men having sexual problems caused from a thyroid issue? Should I ask to get my thyroid checked? I really don't know what to do.

Any advice would be appreciated. Thanks.


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## jenny v (May 6, 2012)

It probably wouldn't hurt to get your thyroid levels checked (Free T3, Free T4 and TSH); low sex drive can be a side effect of hypothyroidism in both men and women.


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## bigfoot (May 13, 2011)

I have a ton to add here... and I will try to get back later today. 

Short answer: Part of it includes what is considered "normal". We see that with TSH and thyroid lab numbers, same thing applies to testosterone numbers. Are you dealing with anything else besides the libido and E.D.? Anything like signs & symptoms that would make you suspect another illness or something else going on, like thyroid, for example?

----

Okay, back for the longer answer: As a fellow guy who has been dealing with this stuff for years since my 20's, I'll try to summarize as best I can:

* First off, you are too young for a doctor (any doctor) to be ignoring you, let alone signs & symptoms like this. They should not tell you things are "normal" and leave you blowing in the breeze. It is not "normal" for a 23 y.o. guy to be suffering from E.D. and low libido. Period, end of story. You are probably doing this already, but don't take "no" for an answer, and be sure to advocate for yourself. Your doctor(s) should be turning over every single stone they can find to try and get you healthy. Anything less and they don't deserve to be your doc; at that point it might be time to move to someone who will listen and think outside the box.

* Watch out for docs who want to call your libido or E.D. a "mood issue", and then throw free samples of meds at you and push you out the door. Then they are off to their all-expenses-paid drug rep trip to Hawaii. If you are dealing with any mood stuff / depression / anxiety / irritability, know that hormones have a huuuuge effect on these things. IMHO, mood problems can be a symptom of something larger in the background (such as thyroid, testosterone, etc.). If it really is a problem, a psychiatrist or psychologist is a better route.

* Get and keep copies of all your labs and test results. Very, very important.

* Thyroid testing is a great idea. You want to run the following at a minimum: TSH, Free T4, Free T3 to check thyroid function. Add Reverse T3 to that list if you can swing it. Also, check for various thyroid antibodies: Thyroglobulin Antibodies, TPO Antibodies, and Thyroid Stimulating Immunoglobulin (aka "TSI", *not* the same as TSH). A thyroid ultrasound to get a baseline for future comparison is another good idea. The TPO Ab's and Thyroglobulin Ab's will check for autoimmune Hashimoto's (can flip-flop between hypo- and hyperthyroid), while the TSI test will check for presence of Graves' (hyperthyroidism). Beware of docs who will only run a TSH test and refuse the rest. Especially if you have any signs or symptoms of thyroid problems. In that case, run, don't walk, to more knowledgeable doctor.

* The AACE recommends a TSH level of between 0.3 - 3.0. Most labs and docs are not aware of this and are going on outdated ranges. Most folks here like to see their Free T3 and Free T4 levels around 50-75% of the ranges. That's a good goal and starting point, which is sometimes easier said than done. Of course, we are all individual cases and respond differently.

* Have a CBC, CMP, liver labs, Prolactin level, Vitamin D, Vitamin B-12, and Ferritin tests run.

* Mono/EBV, Lyme disease, H. Pylori (esp. if you have GI trouble) and any other weird stuff should be ruled out, too.

* Adrenal/Cortisol testing might be a good idea. A 24-hr urine or saliva collection broken into different time periods is the best approach, instead of a one-time cortisol lab check. Especially if you don't like lab draws, as this can even spike your reading and skew the results.

* If you snore or have breathing problems at night, wake up really tired, etc... a test for sleep apnea is a thought. This can also affect libido, amongst other things.

* Testosterone testing should include the following at a minimum: Total testosterone, free testosterone, SHBG, and E2 Estradiol. Simply running a total testosterone and seeing a number in range doesn't tell the whole story. There are a couple of pretty cheap books out there; one by Dr. Shippen called "The Testosterone Syndrome" (a little dated especially with regards to treatments, but still good), and "Low Testosterone by the Numbers" by Lee Myer. For example, you could have a total testosterone of 400 which is technically "in range" but is not optimal for you. You could be someone who needs it in the 700s, 900s, 1200s, etc. Another theory is that it's not the exact number per se, but reaching whatever number is your on/off switch.

* Beware that just because a doc is a "specialist" doesn't mean that they have all the answers or are up to date on the latest info. No doc does. This can be like putting little pieces of a puzzle together. Heck, I've had a urologist tell me point blank that testosterone replacement therapy (aka TRT) is unnecessary for men. Other docs think TRT will case prostate cancer. I think the jury is still out on that one, and it is a long shot theory at best. Not having adequate testosterone can cause a mess of health issues and problems itself, one of which is a huge increase in heart attack / stroke risk.

* If it is discovered that you do have low testosterone (and really, E.D. and libido trouble), the next question to ask *before* starting treatment is "why?" Is it due to an injury, blockage, low hormones, E2 Estradiol too high, etc. You may not need TRT at all, it could be another issue. Hard to say right now. Keep in mind that TRT is generally for life, although some docs will supplement therapy with HCG to keep your testicles functioning at some level.

* Not sure what your nutrition is like, but try to stay away from processed foods, excess sugars, caffeine, junk foods, fast foods, sodas and so on. Drink plenty of water. Get exercise, fresh air, and sunshine. We could all probably do better in this area!

* So... if it comes to light that you are dealing with thyroid problems or low testosterone (which are very inter-connected), and the "why" has been answered, that probably brings you to treatment ideas. Just keep in mind there are several approaches to thyroid medications, just like there are several approaches to TRT for low testosterone. It's important to choose the right one for you, and if that doesn't work, try another. You want to optimize everything, not just be "in range" or "normal". But before crossing that bridge, the research and testing should come FIRST.


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## Andros (Aug 26, 2009)

TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin and Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/
(Copy and paste into your browser)

Absolutely. Thyroxine is a hormone and this hormone affects all the other hormones in your body.

Also, rule out diabetes.

Some suggested testing above!

And an ultra-sound of your thyroid would be a very good idea!!


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## Planter23 (May 3, 2014)

Thanks for the replies everyone.

Bigfoot your post was very thorough thank you. I go back to my doctor on May 20th and I will ask him about checking my thyroid and other testosterone hormones. Maybe my estradiol is high. Who knows. I'm also going to get my own copy of my old testosterone test when I go back too. I'm curious what my levels actually are and why he considers them normal.

My doctor, he's nice, but not entirely open to suggestions sometimes. I will try my best to convince him to get me these tests.

This may just be me being paranoid, but I had an MRI done on my neck a month ago because I was having neck pain. My MRI came back good, but my doctor (a different one than my current) mentioned something that looked like a cyst on my esophagus, but that it was nothing to worry about. Isn't the thyroid near the esophagus? What if that doctor misread my MRI and the cyst was actually on my thyroid? This doctor was very old and seemed forgetful of things. I hope that I'm just being paranoid, but I'm going to get a copy of that MRI as well and show it to my new doctor just to be safe.


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## bigfoot (May 13, 2011)

One way to be relatively sure is to get a thyroid ultrasound. Probably not a bad idea anyway to get a baseline for you to compare to in the future, especially if you suspect thyroid problems.

I totally understand about the doctor. Sometimes it takes some research and trial-and-error to wind up with a good one. If this doc isn't going to take you seriously, find one who will ASAP. It will save you a lot of time and frustration in the long run. I lost a couple of years spinning my wheels.


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