Hyperthyroidism, which happens when the thyroid gland in your neck produces too much thyroid hormone, affects multiple areas of your health. Recent research indicates that hyperthyroidism and male fertility are also linked. Read on to learn about the symptoms and causes of hyperthyroidism, how hyperthyroidism affects male fertility, and ways you can treat hyperthyroidism and improve your sperm health.
Key takeaways
- You have hyperthyroidism when your thyroid gland produces too much thyroid hormone.
- Symptoms can include fatigue, hair loss, and muscle weakness. The condition may cause complications, like osteoporosis and fertility issues.
- In people with sperm, hyperthyroidism may be linked to low semen volume, low sperm density, and other issues.
- Hyperthyroidism treatments focus on bringing your thyroid hormones back to normal levels, which may help resolve infertility caused by a thyroid disorder.
What is hyperthyroidism?
Hyperthyroidism, also known as overactive thyroid, occurs when the thyroid gland in your neck makes too much thyroid hormone. Since thyroid hormone affects your metabolism, or how your body uses energy, too much of the hormone can speed up your body’s processes.
The condition affects around 1% of Americans aged 12 and above.
Hyperthyroidism vs. hypothyroidism
Hypothyroidism is the opposite of hyperthyroidism. Also referred to as underactive thyroid, this condition happens when your thyroid gland makes too little thyroid hormone. This can slow down your body’s functions and cause fatigue, joint pain, muscle gain, fertility issues, and other symptoms. However, signs of hypothyroidism may develop slowly over months or years.
Hypothyroidism is more common than hyperthyroidism, affecting almost 5% of Americans aged 12 and older. It occurs most frequently in women and people over age 60.
Symptoms of hyperthyroidism
Hyperthyroidism symptoms may include:
- tiredness
- trouble concentrating
- anxiety
- enlarged thyroid gland, called a goiter
- frequent bowel movements
- frequent sweating
- loss of hair
- shaky hands
- muscle weakness
- increased appetite
- fast or irregular heart rate
- difficulty sleeping
- weight loss
- irregular menstrual periods
Hyperthyroidism symptoms in males may also include:
- low sex drive
- erectile dysfunction
- gynecomastia (enlarged breasts)
- premature ejaculation
Older adults may experience slightly different symptoms of hyperthyroidism, like loss of appetite.
Hyperthyroidism can cause additional health problems if it’s left untreated. These may include:
- blood clots or heart failure from an irregular heartbeat
- osteoporosis
- Graves’ ophthalmopathy, an eye condition that may cause vision loss
- fertility issues
- pregnancy complications, including premature birth and miscarriage
What causes hyperthyroidism?
Causes of hyperthyroidism include:
- Graves’ disease, an autoimmune disorder where the immune system attacks your thyroid gland
- thyroid gland inflammation
- taking too much thyroid hormone medication for hypothyroidism
- overactive nodules, or lumps, in your thyroid that may make too much thyroid hormone
- a noncancerous tumor in the pituitary gland in your brain (an uncommon cause)
- eating too much iodine, which is present in seaweed and some cough and heart medications
Graves’ disease is the most frequent cause of hyperthyroidism. You also have a higher risk of developing hyperthyroidism if you:
- are female
- are over age 60
- have family members with thyroid disease
- have type 1 diabetes
- were pregnant in the last six months
- previously had thyroid surgery
- consume too much iodine
How is hyperthyroidism diagnosed?
To diagnose hyperthyroidism, your doctor will start with a physical exam and ask about your medical history. They may find you have an enlarged thyroid gland, faster heart rate, and high blood pressure.
Symptoms of hyperthyroidism can also indicate other diseases, so your doctor may use blood and imaging tests to diagnose hyperthyroidism. These tests may include:
- Thyroid stimulating hormone (TSH) test: This checks for the amount of TSH present in your blood. Usually, the pituitary gland makes TSH, which in turn prompts the thyroid to make thyroid hormone. If you have hyperthyroidism, the thyroid makes too much thyroid hormone and causes the pituitary gland to stop making TSH, resulting in the test finding a low level of TSH.
- T4 test: This test measures the level of the thyroid hormone T4, or thyroxine, in your blood. A high level generally indicates hyperthyroidism.
- T3 test: You may have hyperthyroidism even with normal T4 levels, so your doctor may order a T3 test if they still suspect hyperthyroidism. T3, or triiodothyronine, is the second type of thyroid hormone produced by your thyroid.
- Thyroid antibody tests: These tests can help determine the cause of hyperthyroidism if it was a result of an autoimmune disease, such as Graves’ disease. The test measures the number of thyroid antibodies in your blood.
- Ultrasound: Ultrasounds use sound waves to create pictures of structures inside your body. This test may be used to examine thyroid nodules to check for cancer.
- Thyroid scan: A thyroid scan begins with you taking a pill containing a small amount of radioactive iodine. Four to six hours after swallowing the pill, you’ll have your thyroid scanned for the position of the iodine and the intensity of the rays it emits. The thyroid gland collecting too much iodine is one sign of hyperthyroidism. People who are pregnant should not take this test, because of the risks associated with radiation.
- Radioactive iodine uptake test: This test may be done alongside a thyroid scan. It involves taking a pill containing radioactive iodine, then using a probe four to six hours later to check for the radioactive material in your thyroid. The percentage of iodine taken up by the thyroid gland reveals whether the gland is functioning normally. If the gland has a higher uptake than normal, it may suggest hyperthyroidism, with a common cause being Graves’ disease.
Treatment for hyperthyroidism
Hyperthyroidism treatment involves returning your thyroid hormone levels to normal. This should improve your symptoms and reduce the likelihood of long-term health issues associated with hyperthyroidism.
The cause of your hyperthyroidism will determine your treatment. Treatment options include:
- Medications: Antithyroid medicines like methimazole lower the production of thyroid hormone, while beta-blockers can help relieve symptoms.
- Radioiodine therapy: Taking radioactive iodine damages the parts of the thyroid gland that make thyroid hormone, decreasing its production. While this treatment doesn’t harm other parts of your body, it will likely cause you to develop hypothyroidism in the future.
- Thyroid surgery: This less-common treatment can be used to take out part of your thyroid gland to lower your thyroid hormone levels. You might develop hypothyroidism after the procedure.
It may also help to avoid iodine supplements and limit foods like kelp that contain a lot of iodine, since your body uses iodine to produce thyroid hormone.
How hyperthyroidism affects male fertility
Thyroid issues are known to cause female infertility, but recent research suggests hyperthyroidism and male fertility are also linked. Hyperthyroidism may be associated with:
- issues with spermatogenesis (sperm production)
- high levels of testosterone, luteinizing hormone (LH), and follicle stimulating hormone (FSH), which affect reproduction
- low semen volume
- low sperm density and motility
- abnormal sperm morphology
- erectile dysfunction
- premature ejaculation
- low sex drive
More studies in people are needed to explain why thyroid hormone impacts semen quality, but some research indicates that the hormone may directly affect sperm cells. As a result, the study’s authors recommended that thyroid function should be checked in infertile men.
What can hyperthyroidism patients do to improve their fertility?
The first step to improve fertility in people with hyperthyroidism is to treat the thyroid issue to return thyroid hormone levels to normal.
Lifestyle changes may also lead to general improvements in sperm and fertility. These changes include:
- exercising regularly
- following a healthy diet
- quitting smoking
- limiting your alcohol intake
- maintaining a healthy weight
- getting sufficient sleep
- taking fertility supplements
During and after your hyperthyroidism treatment, you can easily assess your sperm health and understand areas that could use improvement with Legacy’s at-home semen analysis.