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Are Hypothyroidism and Hypogonadism Related?


ben bunting BA(Hons) PgCert Sport & Exercise Nutriton  Written by Ben Bunting: BA(Hons), PGCert. Sport & Exercise Nutrition. L2 Strength & Conditioning Coach.

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Hormones have a huge impact on our bodily functions and overall health. 

This article covers the following points:

  • Hormones
  • Hypogonadism
  • Hypothyroidism and Hypogonadism 
  • Male effects
  • Female effects
  • Summary

Hormones

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From sunrise to sunset, our bodies are constantly at work, whether it is physical or mental work. The accuracy with which humans work has a lot to do with the hormones in it.

Hormones are chemical molecules synthesized in our body that act as messengers in our body. From keeping our blood levels in check to giving us our characteristic appearances, hormones play an important role.

One of the very crucial hormones present in our body is the thyroid hormone. Since birth, or even before birth, and throughout our life it plays a vital role in the normal development of various systems of our body.

These systems include the nervous system, musculoskeletal system, and reproductive system, to name a few. Apart from development, the thyroid hormone pretty much keeps us active and healthy every day. It is required by every cell of our body to generate adequate energy and stay healthy.

Unfortunately, thyroid problems are very common throughout the world and they present as either hypo- or hyperthyroidism, referring to low or high levels of thyroid hormones, respectively. Hypothyroidism affects around 2% of the population of the UK, especially the females 1.

Hypothyroidism causes a lot of adverse effects in our body including lethargy, obesity, weakness or muscle loss, and reproductive imbalances. In this article, you are going to learn whether hypothyroidism is linked with hypogonadism. 

Hypogonadism

Gonads is a fancy of referring to the reproductive organs. The very important testes and ovaries, in males and females respectively. Hypogonadism refers to the condition in which there decrease the functioning of our reproductive organs.

It can be caused by a problem in the gonads themselves or some other underlying disease. At this point, you might be seeing where I am going with this. Yes, research has shown that hypothyroidism might be associated with hypogonadism.

If you or anyone you love is suffering from low levels of thyroid hormones, they might be at a risk of developing hypogonadism2–5.

Contrasting to the fact the hyperthyroidism is more common in women, men experience a more pronounced effect of hypothyroidism on their gonads and reproductive health6,7.

Hypothyroidism and Hypogonadism 

From the time you were a small boy your thyroid hormone is helping you to develop various parts of the body.

Your testes (gonads) are also included in this fairly long list. Having low thyroid levels can be devastating itself and also cause your gonads to work ineffectively, leading your various problems including infertility, decreased libido (reduced sexual desire), etc. 

Hypothyroidism usually presents as:

  • Increasing fatigue – your body battery cells, ATP’s, production is decreased
  • Intolerance to cold – you might feel abnormally cold i.e., shivering on a hot day
  • Unintentional weight gain – thyroid hormones increase your metabolism and when you don’t have enough thyroid your body can’t use the food, leading you to weight gain despite eating less
  • Decreased libido – your sexual drive is likely to get impaired and you might experience erectile dysfunction. This may be due to decreased testosterone levels and inefficient gonads.
  • Oligomenorrhea or amenorrhea – you might experience decreased bleeding or miss a few periods
  • Infertility
  • Excessive drowsiness and sleeping a lot

Effects in Men

Are Hypothyroidism and Hypogonadism Related?

All of these symptoms described above are clinically very important and should be addressed. However, for a lot of men having wasting muscle, gaining weight despite dieting, and having low testosterone (T) levels is absolutely alarming.

There are several reasons that could explain why hypothyroidism can be a cause of hypogonadism.

One of the most pronounced ones is the hypothalamic-pituitary-gonadal (HPG) axis imbalance. The hypothalamus and pituitary glands are the controlling glands of our body.

Most of our hormones are regulated and kept in balance by these two glands. Specifically, for the gonads, the hypothalamus releases gonadotropin-releasing hormone (GnRH) that acts on the pituitary.

The pituitary then releases luteinizing hormone (LH) and follicle-stimulating hormone (FSH) that go on and make your testes work in a proper way so you don’t lose those muscles and enjoy adequate testosterone levels.

LH has a more pronounced effect on the testes and directly induces testosterone production.

The release of GnRH or LH, and to some extent FSH, is reduced or altered it could seriously affect the gonads and testosterone levels8.

One of the factors affecting GnRH and LH, specifically decreasing their secretion, is the bodies TSH (thyroid stimulating hormone) levels. TSH acts on the thyroid to increase thyroid hormone production.

TSH increases due to hypothyroidism in an attempt to increase the thyroid levels. Elevated TSH increases prolactin secretion which inhibits the GnRH and eventually lowering the gonadal function9.

Other theories suggest that high hypothyroidism increases the levels of GnIH (gonadotropin inhibiting hormone) which functions to decrease GnRH secretions and consequently, hypogonadism10

Hypogonadism in men can affect various aspects of health. This includes a low sexual desire, moodiness or irritability, infertility, and erectile dysfunction.

Furthermore, low testosterone causes a decreased in muscle mass and increased fat deposition in the body leading to a weak and obese body3.

Effects in Women

Are Hypothyroidism and Hypogonadism Related?

Although hypothyroidism is more common in women, there is not a clear verdict whether hypothyroidism causes hypogonadism.

According to some research, having low thyroid hormones eventually leads to hypogonadism i.e., low ovarian function and decreased estrogen in the body, and it could also delay puberty in women10.

Other metanalysis has shown that hypothyroid females hit menopause (permanent cessation of menstruation) earlier than females with normal thyroid hormones11.

Conversely, some studies have shown that women with decreased thyroid function do not have lower levels of estrogen in their body, suggesting that there might not be a relationship between the two6.

Despite the need for more research about whether hypothyroidism cause hypogonadism in women, there are certain reproductive issues that come with hypothyroidism.

These include amenorrhea or oligomenorrhea and galactorrhea (flowing of milk through nipples with no pregnancy). These effects are due the increase levels of prolactin caused by the elevated TSH levels, as mentioned above.

Moreover, if not treated increased prolactin levels can also lead to infertility in women due to low GnRH, FSH, and LH 9.

Summary

While there is more room for research to develop a factual relationship between hypothyroidism and hypogonadism, especially in women, there is definitely a relationship between the two.

Men seem to have been impacted more by low thyroid levels than women. If you or anyone close to you suffer from hypothyroidism or has symptoms described above, contact your physician now and discuss the symptoms with them.

Healthy thyroid levels, healthy gonads, and a healthy every day. 

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References:

  1. Werhun A, Hamilton W. Are we overusing thyroid function tests? The British Journal of General Practice. 2013;63(613):404. doi:10.3399/BJGP13X670589
  2. Meikle AW. The interrelationships between thyroid dysfunction and hypogonadism in men and boys. Thyroid : official journal of the American Thyroid Association. 2004;14 Suppl 1(SUPPL.1). doi:10.1089/105072504323024552
  3. Vaz de CR, Maria AJ, Ferreira F, Gomes V, Wessling A, Joao BM. Hypogonadotropic hypogonadism in a patient with long-term primary hypothyroidism. Endocrine Abstracts. 2017;49. doi:10.1530/ENDOABS.49.EP1055
  4. 4 Causes of Hypogonadism | Low T Center. Accessed December 21, 2021. https://lowtcenter.com/news-article/4-causes-hypogonadism/
  5. Donnelly P, White C. Testicular dysfunction in men with primary hypothyroidism; reversal of hypogonadotrophic hypogonadism with replacement thyroxine. Clinical endocrinology. 2000;52(2):197-201. doi:10.1046/J.1365-2265.2000.00918.X
  6. Pirgon O, Sivrice C, Demirtas H, Dundar B. Assessment of ovarian reserve in euthyroid adolescents with Hashimoto thyroiditis. Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology. 2016;32(4):306-310. doi:10.3109/09513590.2015.1116510
  7. Fadlalla MB, Wei Q, Fedail JS, Mehfooz A, Mao D, Shi F. Effects of hyper- and hypothyroidism on the development and proliferation of testicular cells in prepubertal rats. Animal science journal = Nihon chikusan Gakkaiho. 2017;88(12):1943-1954. doi:10.1111/ASJ.12883
  8. Nedresky D, Singh G. Physiology, Luteinizing Hormone. StatPearls. Published online September 28, 2021. Accessed December 21, 2021. https://www.ncbi.nlm.nih.gov/books/NBK539692/
  9. Bahar A, Akha O, Kashi Z, Vesgari Z. Hyperprolactinemia in association with subclinical hypothyroidism. Caspian Journal of Internal Medicine. 2011;2(2):229. Accessed December 21, 2021. /pmc/articles/PMC3766941/ Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3766941/
  10. Kiyohara M, Son YL, Tsutsui K. Involvement of gonadotropin-inhibitory hormone in pubertal disorders induced by thyroid status. Scientific Reports. 2017;7(1). doi:10.1038/S41598-017-01183-8
  11. Handisurya A, Rumpold T, Caucig-Lütgendorf C, et al. Are hypothyroidism and hypogonadism clinically relevant in patients with malignant gliomas? A longitudinal trial in patients with glioma. Radiotherapy and Oncology. 2019;130:139-148. doi:10.1016/J.RADONC.2018.10.014