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hypothyroid and low testosterone linked?

After many years of symptoms(low pulse, sensitivity to cold-raynauds, weight gain, thinning hair, dry skin,  FATIGUE), doctors finally noticed TSH was high around 5. After these doctors visits, I have been taking simivastin for cholesterol, 50mcg levothyroxine, and 1mg finasteride for about a year. I asked for finasteride as 42 year old male, didn't know if thinning hair might be genetic or thyroid. also diagnosed with fatty liver with high liver enzymes . Since , my TSH is now at 2.95, and liver enzymes better, and hair seems to have stopped thinning, chol.very good. My fatique is restored to about 80%. I had to push but primary physician  did hashimotos ab test, and it seemed to not be in range of hashimotos. I also have had low ceruloplasmin for some unexplained reason, but they ruled out wilsons disease as copper is normal.

After consulting a endocrinologist outside of the US while visiting, she recommened shooting for 2.5 TSH and doctor back home agreed to up to 75mcg daily to try and help fatigue. However, this doctor also tested testosterone and it is very low, 132 when range is 280-and up.  I guess I'm trying to understand the link. My google searches say TSH lowering should generally increase metabolism and testosterone production, and finasteride if anything should raise testosterone a little.

I'm just trying to ask how much I should push my HMO to search for a pituitary tumor with an MRI or at least escalate me to a specialist. Could that kind of thing cause hypothyroid AND low testosterone?

*I don't think any doctor sees a link, but many of my symptoms started after having a moderate to severe case of exercise associated hyponatremia about  5 years ago in the desert, I mention it because it really screwed with my system for awhile, but salts test since have always been fine) I am in good shape, do lots of cardio, but  have persistent fatigue, maybe slightly lower libido, but perf ok.
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Avatar universal
Thyroids can slow - so you may just have to treat them.
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Avatar universal
well, I am in Philippines and I just chose to pay $200 out of pocket and get a high contrast brain MRI just to settle the matter at least in the Pituitary sense. The cost is cheap here and wanted to know before I'm back in US where I might not ever know.

Radiologist here said Pituitary is completely fine, not enlarged, no cysts, no lesions, nothing on pituitary stalk, hypothalmus normal.

They did however find "The atrial of both lateral ventricles appear symmetrically distended, filled by nodular lesions characterized by intermediate T1 and increased T2 signals with incomplete suppression of the flair images. Diffusion weight images reveal increased signals and and there is no evidence of abnormal enhancement after contrast...

The bilateral symmetric non-enhancing nodular lesions within the atrial of the lateral ventricles are consistent with imaging characteristics of choroid plexus xanthogranulomas and most likely incidental find.

I guess these are some sort of common benign cyst like structure found in other parts of brain but probably completely unrelated to any symptoms.

Anyway, back to the blood tests I guess to see what might link TSH/hypo and low testosterone. Since I don't seem to have Hashimoto, still no clue what went wrong with thyroid.
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Avatar universal
One test cannot rule a cortisol issue in, or out.

Having had Cushing's myself, I had low, normal and high tests. Sometimes it was me, sometimes it was test timing, or lab handling (ACTH was most often botched) that interfered with accurate testing and/or an total view of what was really going on. I used to be low or normal in the morning, but was whiz bang high at night.

So yes, a pituitary issue can cause both issues but your TSH is not low enough to pinpoint pituitary. I would also say your testing as also not been complete enough to really pinpoint a source IMHO - at least from what you have posted.



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Avatar universal
thanks. I hope you sort your issues out.  Yes, it is hard using google, but also hard sometimes to get answers from Doctor at HMO. I don't think I have any cushings related issues.

Doctor abroad did just check Cortisol and that seems within range, perhaps on the low end, but within limits
8.75 ug/dl  in range of 6.2 to 19.4
241.38 nmol/L in range of 171 to 536  
in 8am fasting extraction

i'm still trying to make sure a benign pituitaray cyst isn't making my pituitary less functional and causing my hypothyroidism and low testosterone , home doctor just wants to give me meds and no MRI as he does not think my symptoms are likely pituitary caused
Helpful - 0
Avatar universal
In general, TSH for central hypo means it will show up as .000 something - mine is .0004 or .0007 or the like.

The problem with doctor google is that he cannot take a history, run tests and really look at the overall patient - so it is hard to really get a good complete answer.

With weight gain fatigue low TSH low T, fatty liver - that can be an elevated cortisol issue potentially - aka Cushing's syndrome?
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