Endocrine Abstracts

Introduction: The prevalence of hypothyroidism overtly ranges from 5% to 11%. Though Hypothyroidism is less common in males as compared to females but deficiency of thyroid hormone affects almost all metabolic organs of the body, which includes changes in growth hormone, steroid metabolism, sexual function, antioxidative function.

Aim: − The aim of our study was to assess the levels of total testosterone LH, FSH levels in males with overt hypothyroidism pre and post levothyroxine therapy. In our study we included 51 patients with overt hypothyroidism, with mean age 40.2 years(32-56 years). 50% of patients had low testosterone level at baseline, low testosterone level associated with hypothyroidism has not been well documented in several studies with varying prevalances. In our study only 5 patients had low LH level at baseline while FSH level of all the patients was normal at baseline, semen analysis could not be done due to non consent of patients. In our study after attainment of euthyroidism or after 4 months of replacement of levothyroxine therapy 70% of hypogonadic patients had their testosterone level normal, more than 80% of patients with low ADAMS score showed improvement in their parameters.

Conclusion: Thyroid hormone deficiency affects all tissues of the body, including multiple endocrine changes that alter growth hormone, corticotrophin, glucocorticoids, and gonadal function. Primary hypothyroidism is associated with hypogonadotropic hypogonadism, which is reversible with thyroid hormone replacement therapy. The same has been seen in our study also that after levothyroxine replacement there was significant improvement in free testosterone level, significant improvement in ADAMS score, although predominance of hypogondotropic hypogonadism was not that significant but still some degree of relevance was observed. So according to the results we concluded that overt hypothyroidism can induce hypogonadism or low testosterone levels in men that is reversible with thyroxine replacement therapy. Importantly, some of the clinical manifestations of primary hypothyroidism in men may be due in part to a reduction in free testosterone. Further evaluation of this potential clinical interaction would require a controlled trial of androgen replacement in the hypothyroid state. However, hypogonadotrophic hypogonadism with thyroxine replacement is reversible with full restoration of normal thyroid function.