December 17, 2014

Dr. David Clark, DC – Raleigh-Durham-Chapel Hill thyroid expert, explains how high Testosterone causes Low Thyroid symptoms.

Hidden Cause #18 Why you STILL have low thyroid symptoms, even though you may be taking thyroid medication and even though your lab tests are normal is…

Elevated Testosterone causing Over-conversion of T4 into T3 leading to Resistance. 

Okay, that’s a mouthful.  There’s a couple of different concepts we have to understand so let’s first talk about “Over-conversion.

A lot of times you’ll hear me talk about “under-conversion”…under-conversion of T4 to T3 that leads to low levels of T3.

Well, now we’re talking about something being too high.  If you remember the thyroid story…

…97% of what your thyroid gland makes is T4.  T4 is basically inactive. It must be converted into T3.  T3 is the active form of your thyroid hormones.

Conversion primarily happens in the liver, primarily through an enzyme called 5-deiodinase.  

Here, we’re talking about Over-conversion–something is speeding up the conversion of T4 to T3 leading to something called “resistance.” 

Think of Resistance like this… you’re growing a plant. The plant likes to have a little bit of water, but it doesn’t like to have a floord of water because you’ll drown it.  You’ll kill it. 

Well, thyroid hormone receptors (for T3) are like that.  They like to have enough T3 in order to dock and make them work. 

But if you bombard them with lots of T3, they shut down and become resistant…

….which means you can have all the T3 in the world floating around,  trying to get onto this receptor, but it can’t. 

Or… alternately, the hormone can dock on the receptor, but the response to the docking is blunted.

For comparison, another example of “resistance” is women who take Cytomel® T3 and then become more hypothyroid. You’re bombarding the receptors.  There’s too much there and they shut down.

Here’s what high testosterone causing over-conversion leading to resistance looks like….

A women has totally normal thyroid lab numbers but, has these low thyroid symptoms:

  • hair loss
  • weight gain
  • constipation
  • brain fog
  • fatigue
  • needing to sleep an excessive amount of hours just to function
  • infertility
  • miscarriage. 
  • high cholesterol

Those are all low thyroid symptoms that can be caused by resistance–thyroid hormone resistance.

I’ll  back up and explain it again (there’s a lot of moving parts). 

T4 has got to get converted to T3.  When you over-convert, you get lots of T3…and T3 can bombard the receptor and shut it down…making you have more low thyroid symptoms.

Now, I said “testosterone causing overconversion leading to resistance.”  Where does this testosterone come from?

In a woman, the #1 cause for abnormally elevated testosterone is blood sugar instability–insulin resistance. 

These are women who have chronically high blood sugar.  The classic symptom of “insulin receptor resistance” is getting sleepy/drowsy within 15 to 30 minutes after you eat. (Not 2 hours later). Other symptoms of insulin receptor resistance include:

  • Crave sweets after you eat. 
  • Hard time going to sleep 
  • Wake up in the morning feeling completely beat up as if you didn’t sleep at all. 

Those are all pretty good signs of insulin resistance.

In insulin resistance you get surges of insulin when you eat…this surge up-regulates an enzyme that makes women make more testosterone. 

Testosterone can cause this Over-conversion that bombards the receptor that leads to resistance and low thyroid symptoms. 

…I know that’s kind of a long story, but that’s what happens.

Women with insulin resistance are often diagnosed with Polycystic Ovarian Syndrome.  The insulin resistance leads to elevated testosterone. 

So, blood sugar instability is often the underlying cause of this high testosterone that we’ve been talking about.  What you eat, when you eat and inflammation are ALL factors that can cause insulin resistance.

We’ve got a lot of pieces on the chessboard…pieces that a good, effective doctor must looking at and thinking about all at one time.

Now, another way that you can develop elevated testosterone is simply if you are using it…or if your husband or your boyfriend is using topical testosterone.  Testosterone gel easily rubs off on you and will can cause this Over-conversion. 

Your doctor’s got to be able to evaluate all of those different possibilities.

Treatment depends on what the actual mechanism is for each individual patient.  If it’s insulin resistance, chances are you’ll have to change your what you’re eating and when.  You have to look for food sensitivities…inflammation (from all possible sources). 

For successful treatment, you’ve got to do ALL the above simultaneously. 

I see a ton of PCOS and Insulin resistance caused by diet and inflammation.

Now, back to the thyroid to wrap it up….

The reason high testosterone causing Over-conversion leading to resistance and more low thyroid symptoms is a hidden cause is because there’s so many links in the chain.

Your doctor needs to have the skills, experience and determination to find these links.

© 2014 David Clark. All Rights Reserved.

Disclaimer: The contents of this site are for educational purposes only. Nothing here should be construed as medical advice. Nothing here is a substitute for actual medical care. Consult a qualified healthcare professional.

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