T Nation

Help with Thyroid Tests

Hey guys,

Anyone on here know what the ideal TSH level should be in a 24 year old guy? I thought my problem was low testosterone (levels constantly hanging around 15mnol-17mnol), but I have symptoms that could equally be caused by hypothyroidism.

What should an optimal TSH level be,and can a thyroid problem impact the efficacy of Testo Gel?


0.4 milliunits per liter (mU/L) to 4.0 mU/L though my doc likes to see mine under 2.0.

I don’t know the relationship between T and TSH though I have both hypothyroidism and hypogonadism. Treating my hypothyroidism made a much more dramatic improvement in my QoL than did the administration of test.

<---- not a Dr.


Thank you for your post. Most of my TSH levels come back at 4.79mu/L, so is this too high? I have a range of symptoms; low libido, ED, mild depression, hot flushes, mild fatigue etc, which could be caused by either low testosterone or low thyroid. My GP tested my testosterone and it is 15mnol-17mnol, so low for a healthy guy my age. However, he has also suggested that if my TSH is high, that could affect my testosterone levels?

Would you say the figure I quote for TSH is too high, and that it might be worthwhile discussing the possibility of either adding thyroid replacement into my treatment, or else trying it in conjunction with the TRT gel he has put me on?


I can’t say if it’s too high for you, however, when I first sought treatment ~6 years ago my TSH was just over 5.0 and I felt awful. I was falling asleep in the middle of the day and couldn’t shake a sense of overwhelming fatigue. The fatigue led to low libido, depression, etc because who the hell wants to have sex or pursue interests when they can’t even get off the couch?

Treatment for hypothyroidism is easy, cheap, effective, and reversible. I knew within 9 days of first starting treatment that something positive was happening though it takes 6 weeks for blood levels of the drug to stabilize. If it doesn’t work for you, you can cease treatment with little to minor side effects. I seem to remember a story of a woman who had been taking medicine for hypothyroidism for decades, went off, and her thyroid starting right up producing on it’s own.


Thank you for your reply. TSH is definitely higher end of the reference range, which usually could indicate hypothyroidism rather than hyperthyroidism. I shall ask my endo to check all thyroid function thoroughly during our appointment. Prolactin is also very high, so I am hoping he’s willing to do MRI scan to determine whether I have a prolactinoma, as I am led to understand this too can cause ED, low libido etc etc.

Can I ask how old you are and how old you were when you began thyroid replacement therapy? What drug do you take, and did taking it improve your libido, energy levels and overall physical and mental well-being? I accept my testosterone levels are at the lower end of normal, but, given my TSH readings and what you have described, I wonder if perhaps we are overlooking the importance of thyroid issues.

Look forward to hearing from you and Happy New Year!

I’m currently in my mid-40s but was in my late 30s when I was diagnosed. I started on 25 mcg of levothyroxine (Synthroid) and the amount was increased by 25 mcg every 3 months until my TSH stabilized around 1.0. My current dose is 125 mcg.

The levothyroxine made a noticeable and dramatic change in my QoL. It’s hard to describe the fatigue I was experiencing but even the thought of something simple like taking out the garbage would make me tired.

Put it this way, if I had to choose between testosterone and levothyroxine for the rest of my life I would choose the levothyroxine without thinking twice.


Thank you for your message. So when you were diagnosed, can you recall what your TSH levels were? Now you are on treatment, are your levels at the lower end of the range? Am I correct in thinking that the lower the TSH the healthier you are or have I got that the wrong way around?!

If you don’t mind my asking, did you have low libido, ED or similar symptoms before you started on Levothyroxine? My symptoms, to be fair,do suggest a testosterone/ oestrogen problem more than a thyroid one, as I also have acne, bloating, can’t build muscle bulk and have mild man boobs. However, when you began your medication, did your libido and ED and mood problems improve substantially?

Can I also ask, does a stabilising of thyroid levels often improve erectile function and quality?

Sorry to bombard you with so many questions!

Per my earlier posts, my starting TSH was > 5.0 and is currently ~ 1.0. The lower the number the better (unless you veer into hyperthyroidism).

I had relatively low libido (interest but no energy) but no ED issues. I had no acne but did have bloating and IBS-like symptoms. It’s very difficult for me to build muscle but that has more to do with my general build (skinny, distance runner) than thyroid issues.

After a week and a half the first thing I noticed was that my digestion improved dramatically and I became more regular. My IBS-like symptoms disappeared over the course of 12 months and my mood dramatically increased. Libido was back mostly because I wasn’t falling asleep at 8:15 and had the energy to chase the old lady around the kitchen table once again.


So ideally for optimal thyroid health, I should be looking for a TSH under 5.0 for sure? Again, in the UK healthcare system, we seem to have doctors who behave almost like robots in a very prescriptive fashion. You can have ALL the symptoms of a given condition, like for example hypothyroidism or low testosterone, but if your blood test numbers fall within this arbitrary “normal range”, then symptomatic or not, they will often refuse to even countenance treatment. Everything in the world seems to be about money money money and keeping costs down, even f the patient’s quality of life is diminished.

I have ED, low libido, mild Gynaecomastia, acne, tummy bloating, low mood and quite bad muscle aches and fatigue. Do you think pressing my endo further to consider a trial period of Levothyroxine, either alone or in conjunction with TRT might be an avenue worth exploring further?

Nobody should have to live with symptoms like these, especially men our sort of age! I remain hopeful that in the end common sense and skill will win the day, and I will finally get the diagnosis and treatment I need!

I hesitate to tell you what you should be doing, but I felt much, much better with my TSH hovering around 1.0 rather than above 5. Based on my experience, the fatigue, bloating, low libido, and low mood may improve once your hypothyroidism is treated.

I don’t know what the cost for levothyroxine is where you are but it’s cheap in the States. I pay $6/mo with insurance and was paying $11/mo without.

Of course, I was just curious as to whether some of your symptoms had resolved once on the Levothyroxine. I hope that the other tests they run will establish the underlying reason for the ED, as I am not aware of thyroid disorders actually causing ED, although I have heard that many men who have low thyroid levels do sometimes suffer ED also.

I think TSH levels likely vary from person to person in terms of how a given number translates to a persons’ sense of well-being. However, my TSH numbers have been at the higher end of the reference chart on every occasion, and I am suffering symptoms which may suggest low thyroid hormones.

Will see the endo and ask him to test me for every thyroid problem known to man! Hopefully, with thorough and rigorous testing, he can diagnose the root cause of my symptoms and prescribe appropriate medication as needed.