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Avatar universal

Low T in Women

I had posted this in the "woman's health" forum area and got no comments back at all. That area doesn't seem as active of a community as this one.  So I will re-post what I posted there related to my wife's hormone levels.

As far as thyroid she is being treated with Armour and just got bumped up to 180 mg (from 165).  her FT4 are BELOW range, her FT3 are about 25% to 50% of the range but the range is also wider than most ranges we see here.  We have been in discussion with the Dr to add in T4 medication but her symptoms are coming back and thus he raised the Armour again.  We will see how this settles out and then determine to again raise Armour or to start adding back in some T4 in about 4 to 6 weeks.

Here is the discusssion on the other sex hormone results.

------------------
My wife has low thyroid which she is being treated for. But over the last year, she has had her sex hormones tested.

Here are the test results.  All the tests were taken day 3 for the 1st two test and day 5 on the last test following the start of her period.

7/21/14
• Testosterone total was ZERO percent of range. (20 with a range of 20-73)
• Estradiol was 22% BELOW range (23 with range 56 - 204)
• Progesterone was 58.6% of range (0.42 with range 0.25 -0.54)

11/10/14
• Testosterone was essentially immeasurable (<20 with a range of 20-73) and therefore BELOW range.
• Estradiol Total was 27.2% of range (53 with range 19 –144)
• Progesterone was 24.1% of range (0.32 with range 0.25 -0.54)

8/28/15
• Testosterone was AGAIN essentially immeasurable (<20 with a range of 20-73) and therefore BELOW range.
• Estrogen Total was 25.8% of range (219 with a range 90 – 590)
• Progesterone was immeasurable (<0.25 with range 0.25 - 0.54)and therefore BELOW range

The estrogen it is a bit hard to tell what is going on as the actual hormone tested and the reference ranges changed a little bit. But seem to hover around 25% of the range.

Progesterone has decreased over time from 58% down to the most recent test where she is BELOW range.

I understand that early in the follicular phase the estrogen and Progesterone are at the lowest levels.  But that does not explain the consistent decrease of Progeesterone.  My wife if currently 45 years old so this could be a natural decline as she approaches menopause or is evidence she is in preimenopaus.

It is the testosterone that is of most concern. It remains at rock bottom or not even measurable BELOW range.  I have done some research of the top 10 symptoms of low T in women and she has about 7 or 8 of the ten symptoms.  THat being said, many of these symptoms are also parallel low Thyroid which we know she has and is being treated for.

However have any other women out there been diagnosed ith Low T?

If so have you been treated?  what worked?  How did you find a Dr to treat you?  And how do you feel now?

In my research I was shocked to learn that women have 10 times more testosterone in their blood than estrogen!  This would seem to indicate the critical and important nature and need for sufficient testosterone in women.

So far my wifes Dr. has been resistant to even consider doing anything about her low T condition.  Despite it being repeatedly tested low and her having symptoms consistent with low T.

This is VERY frustrating and any advice for help or where to go or who to call to find a good Dr would be much appreciated.

My wife is also a bit apprehensive or taking a "man's hormone" and since her Dr is not conmcerned about it she is not very motivated to do anything about it.  Even though it can help or may help her overall health.

Help!
30 Responses
1756321 tn?1547098925
Here is some info from Dr. Yakelin Sosa's article on female hormones...

"Low Estrogen: Low estrogen levels are often addressed by supplementing with estrogen cream or patches; however some nutritional supplements may also help improve symptoms

Low Progesterone: Treatment often includes natural progesterone supplementation, which is generally very safe and effective. The herb chasteberry may also help normalize progesterone levels. Sometimes low progesterone indicates low thyroid hormone levels, therefore lab tests for thyroid function may be recommended.

Low Testosterone: Sometimes adding progesterone or correcting adrenal issues can improve low testosterone symptoms. However, in some cases it may be necessary to supplement with testosterone."
Avatar universal
She has had low thyroid for a LONG time,  yet her Progesterone was OK and so too for the most part her estrogen seems OK.  

It only seems like Testosterone is a chronic problem.

I also wonder about how DHEA pays into this. As DHEA is a pre-cursor and used to build up the sex hormones. She has never been tested for DHEA and I suppose it is possible that if she is low in DHEA that may explain the inability to create testosterone and other sex hormones.  So this will be something we can ask for her to be tested for.

I'm really interested in finding some women who have had low T and have been treated for it.  I am interested to note what other positive health benefits and symptom relief other than low libido that was associated with getting their testosterone levels to a reasonable level.
1756321 tn?1547098925
I wrote indepth about DHEA on another answer if you are interested...

http://www.medhelp.org/posts/Thyroid-Disorders/New-Labs--dumb-food-allergy-test/show/1911263
Avatar universal
Thanks,

Seems like the common symptoms of Low T, Low DHEA and Hypothyroid are almost identical.  And of course my wife has almost all of the symptoms and known low T and hypo.  So now what?

Knowing that she is hypo, and now tests show low T, it only makes sense that since DHEA is related to all of them, that she should be tested for DHEA.  

Maybe the final peice to the puzzle to my wife getting optimized COULD be the DHEA connection.

Worth a look at the very least, what do we have to lose other than a few dollars for the test???
Avatar universal
Hi, I'm probably the only woman in the same mess . Here is my story and hope you find some information helpful. So, since March 2015 diagnosed with Hypothyroidism and premature ovarian failure. At this moment still not finding right dose for thyroid meds.  I was tested for most things and DHEA was low, along with E, P, T.  I was suppose to take 5mg DHEA every day, but can't tolerate.(chin hair/acne) I'm taking it 3 times a week now and retested hasn't gone up much. I started with 1mg Estrogen, 50 mg Progesterone and at one point 6mg Testosterone, all creams( yes that high). I'm doing tests for FSH and complete testosterone tests every 3 weeks.  My doctor told me that as long as my thyroid is not optimal the other hormones that I'm taking will not stabilize. At first I didn't believe that I have a Thyroid hormone resistance, but now I'm at my wits end. I'm on 3 grain NT, and no improvement. I'm feeling sleepy most of the time. Now I'm on 1.5 mg Estrogen , 100 progesterone and 3mg Testosterone. I'm also taking nettle root powder to help with lowering SHBG, which seems to get higher. My doctor said if at 4 grains still no improvement, will go with Synthroid/Cytomel, clearly NT is not getting to the cells. So,  my story feels like a two steps forward, one step back.  He wants my FSH to be around 5 (not 17) and seems it stayed there for 2 months , then went back up. He said if a woman's FSH is at 20 is considered menopause regardless of cycle.(well he treats it as menopause)  If this new higher doses are not working at keeping the numbers where it needs to stay at , pellets are the next step. While I feel libido coming to life a little here and there, also able t to enjoy sex again, it has only been a week. Will see how long the miracle lasts. My doctor is really knowledgeable and knows the doses really well for thyroid and  sex hormones. He said I'm the most complicated case he had in his whole career, with thyroid and sex hormones. He said that for most of his patients, the thyroid meds dose he gets it right within a month.  It is important to have DHEA in the right range to help with testosterone, also pregnenolone, zinc, selenium etc.  I've ordered my nettle root powder from a website "supermanherbs.com"  you should look into some of the herbs and formulas they have for women, find pine pollen interesting as well, tonkat ali. I don't want to mess with too many things, at this point because I want to get a real response from my testosterone therapy. My main priority is to get thyroid in order since that is impeding my progress with everything. My total T was  about 39, 3 weeks ago,  and the free was really low and SHBG 185, which is really high.  When I was doing 6mg T, my total T was 194 but the free% lower than optimum, and SHBG  158 , and no libido, no nothing. Is important to keep SHBG on the low side and get the free % higher. Hope to accomplish that with nettle root powder. My post may not seem very hopeful, but there is progress since I started the whole process. I'm so fed up with the thyroid mess.
1756321 tn?1547098925
I did up a simplified version of the steroid hormone pathways but this may not post well as I'm using certain symbols medhelp doesn't like. :) The three types of estrogen are estrone, estradiol, estriol. If you are under stress and you need more cortisol (stress hormone) the body will convert more pregnenolone to cortisol at the expense of the other hormones except progesterone (which is on the pathway to cortisol). The lowering of the testosterone and estrogen is called the pregnenolone steal.

vitamin B5 > acetyl CoA  cholesterol > circulating LDL's > pregnenolone

pregnenolone > progesterone > cortisol / progesterone > aldosterone

pregnenolone > DHEA > estrone > estradiol > estriol /

DHEA > testosterone
1756321 tn?1547098925
Hmmm lol. Why am I not surprised.  It should be vitamin B5 and dietary fat make acetyl CoA. I'll post it again but with -- symbol.

vitamin B5 -- acetyl CoA -- dietary fat

acetyl CoA -- cholesterol -- circulating LDL's -- pregnenolone

pregnenolone -- progesterone -- cortisol / progesterone -- aldosterone

pregnenolone -- DHEA -- estrone -- estradiol -- estriol

DHEA -- testosterone

1756321 tn?1547098925
I was taking 3 grains of Armour and having major breathing issues and was back onto synthetic T4 (50mcg) quick smart! I actually have cellular thyroid issues but that is at the very least related to inflammatory cytokines. The issue with poor absorption of Armour however looks to be problems with absorption due to not enough proteolytic enzyme production (in my case I believe this was due to being hyperthyroid for a year).

Excerpts from the book: Thyroid Diseases: Clinical Fundamentals and Therapy by Fabrizio Monaco, Maria A. Satta, Brahm Shapiro, Luigi Troncone...

"There is some differences in the rate of absorption between animal and synthetic preparations. After a single oral dose of synthetic L-T4, the absorption is approximately 70 - 80%, 20 - 30% being recovered in the stool.  It is absorbed rapidly, mainly in the distal small bowel, reaching maximum plasma levels in 2 to 4 hours."

"Variability of absorption also occurs with desiccated thyroid, dependent on proteolytic enzymes of the gastrointestinal tract. Since desiccated thyroid and thyroglobulin preparations contains T4 and T3 incorporated into thyroglobulin, to release thyroid hormone the crude preparations must be hydrolyzed by gastrointestinal proteolytic enzymes, which indirectly influence the absorption of T4 and T3."
Avatar universal
Thanks for the info on proteolytic enzymes, so if I would take the said enzyme it might help?  If at 4 grains I don't have improvement I'll be switched to Synthroid/Cytomel.  When I get an increase I get sometime sleepier than before, after a week evens out to my usual sleepy routine. I don't have any sense of energy, mental alertness or anything to resemble being alive. My pulse is around 64 lucky if 70. I didn't mean to highjack flyingfool's post.  
1756321 tn?1547098925
You could try a proteolytic enzyme supplement to see if that helps first.  Plenty of hickjacked threads on medhelp lol.
Avatar universal
My wife is on Armour. She at the above sex hormone tests she was taking 165 mg which is 2.75 grains.

She has since been bumped up to 180mg = 3 grains.

Her FT4 is BELOW range and her FT3 is low in the range.  And the last blood test they did NOT test for FT3 which we are VERY upset about!  But her feet have been colder and she has been complaining about being cool in the car when the rest of us are hot, so a bump was definately needed.  She has brought up the idea of adding back in T4 medication to get the chronically below range FT4 levels up.  Maybe with the next dose change.

I'm not sure what type of interaction thyroid has with the other sex hormones.  I can't really find articles that really talks about this interaction, so it leads me to believe that the interaction is not all that great. And the bioidentical hormone therapy articles it would seem would all mention that thyroid imbalance should be taken care of FIRST if there was a great interconnection between thyroid and sex hormones.  So the silence is deafening if you know what I mean.

My wife has recently started taking some on-line college classes and is taking over some additional work at her job due to a co-worker out on maturnity leave. She is stressed out!  So I have little doubt that the last 2 weeks maybe 3 weeks her cortisol levels have shot up.

But the most recent blood labs were taken BEFORE this stress really set in.

I am leaning towards DHEA as first thing.  If it is low then holding off on Testosterone treatment would make sense to see what adding DHEA would do.

My wife has tried taking some over the counter (GNC) libido enhancers in the past. And she could not tolerate them.  Usually got the "shakes" and also almost immediately started breaking out in acne.  Tried it I think two or three times separated by weeks or months and had the same reaction each time and at least two different products.  I can't remember the name of them now.  But ended up throwing both of them away.  So I'm a bit dubious of over the counter herbal remedies.  I'm also concerned that likely these had DHEA in them.  Thus she like you may be way to sensitive to take DHEA even if she is low.

She has tried "Maca root" which is reported to help libido and other things and it did absolutelyl NOTHING.  So she stopped taking that.

My wife has been battling thyroid optimization for more than 10 years I think.  Many Dr's were hired and fired throughout this journey of misery.  All to start over and try to train them only to find they are a brick wall, On to the next Dr and on and on.  At oine point had a "good" endo, and he retired.  His replacement was a complete "ditz" and changed everything and my wife "crashed", and woudl not listen to my wife. So we fired her too!

This most recent Dr will at least listen to her and was the first to easily allow Armour.  And is willing to do the increases based upon what she is feeling. But even this has been over a year I think and she is still being bumped up and still has FT4 levels in the basement!  TSH is NOT suppressed at the moment (2.2) but has been suppressed on and off again.  But I take like zero credibility in TSH, especially at now 3 grains or Armour.  Yes she takes the Armour in two doses during the day and away from food and supplements.

She takes or did take a LOT of supplements including Vit D, and Selenium.  I think at least a common daily multivitamin.  But I'm not sure how much like Zinc and copper is in there per say.

It is only her/our proding to get the sex hormones tested that the Dr has agreed to test them.  The Dr seems to be resistant to want to do any sex hormone treatment.  Every time we mention it he seems to find an "excuse" as a reason to ignore it.  

He is, or seems to be a good Dr.  I think it is simply a matter that he is not experienced in sex hormone theapy and especially testosterone treatment in women.  So he is simply not comfortable with it so we are getting the "run around".  It is reminisant of what we have seen in the past with Dr's who know nothing about thyroid but keep giving excuses over how everything is "normal" while my wife feels like crap.

My wife is dealing with other issues as well and the testosterone thing is not very high up on her list.  She is pretty content at just getting and working on increasing her Thyroid at this point.  She doesn't think that a libido is anything much to care about.  But obviously I do, and the fact that testosterone plays a MUCH bigger health aspect in woman's health than I think she and most even realize.

The fact that normal levels of testosterone in woman's blood is TEN times more than the amount of estrogen.  Even with that long process Red_Star points out that it takes to make testosterone should indicate I think two things.

1) That testosterone is VERY important to woman's health
2) That Estrogen is amazingly powerful at extremely small amounts!

I am just trying to learn and see what other women have had for experience.  In particular I'm hopefully looking for a bunch of women who have been successfully treated and they can testify as to what the effects were in addition to libido.  As my wife will probably be more interested in those "other" benefits more so than her husband "pushing" for her to get testosterone treatment in order for her to obtain a libido.  That sales job is a bridge too far if you know what I mean!  She thinks I'm only out for THAT one reason, and that is not the case. Well not entirely the case anyhow ;)
Avatar universal
Thanks for your comment! I find it very disappointing when doctors don't test or suggest what to test for. In my case my husband doesn't care, but I want to feel the same like I used to be. I'll be 40 next month, I don't want to feel like my life is over. Many women don't pursue testosterone because don't know, and if the doctors don't mention testosterone as a test, that's the end of it. When I was looking for a doctor for my problems, I has asked all the women I knew. Only one mentioned him and the fact that he does  all the tests and knows how to treat with all hormones. All other women never mentioned testosterone as part of the equation.( 35 women all menopausal)  I completely trust my doctor on regards to the thyroid affecting the sex hormones. He's been practicing for over 26 years. A lot of the information he tells me is not available on line, no surprise!  If he doesn't figure it out for me I am completely doomed, he's one of the few in a 200 mile area. Looking back at my symptoms the thyroid ones were progressing for 16 years until the ovarian failure started 6 years ago. Also Adrenal Fatigue is one that interferes with thyroid meds and sex hormones not getting better, if you read on Dr. Lam website. I had the 4 times a day saliva test done in the beginning and was fine.  Funny thing is that when I get a thyroid increase things get better with sex hormones, lasts a week and back to square one again, because that's how long I feel ok with the thyroid meds. I'm taking a 5mg micronized DHEA.  I get it at his office very inexpensive. You can get it from  Pure Encapsulations. I don't tolerate it every day. I could never get used to maca powder, would make me dizzy. My labs on the thyroid are very low keeping in mind I've been taking the meds for 7 months. In the past month had the most increase, every week, or 2 depending how much of increase. I'm calling in every week, which is so wired, don't feel any different anymore.  I am very intrigued myself to see if more women reply. When I first discovered MH, I was curious if other women had the testosterone deficiency as well, while estrogen was really low for me, testosterone was almost non existent, and believe me I was testosterone "queen" in my day. There few posts from men asking the correlation between  hypothyroid and low T.  Good luck in finding more answers. One thing is for sure, I miss my testosterone driven life.
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649848 tn?1534637300
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