Thyroid, DHEA & Cortisol: Keys to Men’s Energy | Total Health Pros WV

The Overlooked Roles of Thyroid, DHEA and Cortisol in Men’s Energy

Introduction

When men feel exhausted, they often assume their testosterone is low. While testosterone plays a key role in energy, other hormones may be equally important. Thyroid hormones (T3 and T4) control the speed of metabolism and energy conversion, DHEA serves as a precursor to testosterone and opposes the stress hormone cortisol, and cortisol orchestrates the fight‑or‑flight response. Understanding how these hormones interact helps identify hidden causes of fatigue and guides effective treatment.

Thyroid: the metabolic thermostat

Your thyroid gland produces thyroxine (T4) and triiodothyronine (T3). These hormones control your body’s metabolic rate—the process of transforming food into energy. When thyroid hormone levels are optimal, your cells produce adequate energy, your heart rate and body temperature stay in a healthy range, and your mood remains stable. If levels are off, everything slows down or speeds up.

• Hypothyroidism (underactive thyroid): Symptoms include fatigue, weight gain, cold intolerance, constipation, dry skin, depression and brain fog. It often results from autoimmune Hashimoto’s disease or iodine deficiency. TSH, free T4, free T3 and thyroid antibodies should be tested.
  

• Hyperthyroidism (overactive thyroid): Symptoms include weight loss, heat intolerance, palpitations, anxiety, tremors and insomnia. Causes include Graves’ disease and toxic nodular goiter. Lab tests will show suppressed TSH and high free T4 or T3.

Even mild hypothyroidism can cause fatigue and weight gain. Because thyroid hormones affect every cell, small deviations can have big effects. Treatment may involve thyroid hormone replacement (levothyroxine) or functional approaches like iodine optimisation, selenium supplementation and addressing autoimmune triggers.

DHEA: the unsung hero

Dehydroepiandrosterone (DHEA) is the most abundant steroid hormone in the body. Produced by the adrenal glands from cholesterol, it acts as a precursor to testosterone and estrogen. It also counteracts some of cortisol’s effects. According to Everlywell, DHEA and cortisol together orchestrate the stress response, with DHEA helping to “set things right” after cortisol surges. High DHEA‑to‑cortisol ratios may reduce the negative impacts of stress, while low ratios are linked to cognitive impairment, depression and metabolic syndrome.

DHEA levels peak in your 20s and decline with age. Low DHEA can cause fatigue, decreased muscle mass, low libido and poor concentration. Testing involves measuring DHEA‑sulfate (DHEA‑S) levels. Some men take DHEA supplements to increase testosterone; however, evidence for effectiveness is mixed, and excess DHEA can lead to acne, hair loss or hormonal imbalance. At Total Health Pros, we recommend testing before supplementing and consider functional interventions like stress management and nutrient support.

Cortisol: the stress conductor

Cortisol is produced by the adrenal glands in response to stress. It elevates blood sugar, blood pressure and heart rate to help you respond to danger. However, chronic stress keeps cortisol levels high, suppressing the immune system, impairing digestion and reducing testosterone production. Elevated cortisol can cause fatigue, weight gain (especially around the abdomen), insomnia, anxiety and weakened bones. Conversely, extremely low cortisol (as seen in adrenal insufficiency) leads to extreme fatigue, weight loss, salt cravings and low blood pressure.

Balancing cortisol involves addressing stress sources, improving sleep and supporting adrenal health with proper nutrition and relaxation techniques. Everlywell suggests that maintaining a healthy DHEA‑to‑cortisol ratio is key to reducing stress impacts.

Testing and interpreting hormone levels

• Thyroid: Test TSH, free T4, free T3, thyroid antibodies (TPOAb, TgAb) and reverse T3 (in some cases). Optimal free T3 levels typically fall in the upper half of the reference range.
  

• DHEA‑S: Provides a stable measure of adrenal production. Low levels may warrant supplementation or investigation of adrenal function.
  

• Cortisol: Salivary or urinary cortisol assessments measure diurnal patterns. High morning cortisol and low evening cortisol are normal; flattened curves or elevated levels across the day indicate dysregulation.
  

Work with a knowledgeable provider to interpret results in the context of your symptoms.

Balancing thyroid, DHEA and cortisol naturally

• Nutrition: Adequate iodine, selenium and zinc support thyroid hormone production. Foods rich in omega‑3 fats, antioxidants and protein support adrenal function and hormone synthesis.
  

• Stress management: Meditation, yoga, deep breathing and time in nature reduce cortisol levels. Exercise also helps, but avoid overtraining as it can raise cortisol excessively.
  

• Sleep: Prioritise seven to nine hours of quality sleep—most hormone regulation occurs during sleep.
  

• Adaptogens: Herbs like ashwagandha, rhodiola and holy basil may support adrenal balance and improve energy. Consult a healthcare provider before use.
  

• Functional testing: At Total Health Pros we offer DUTCH testing, which provides a comprehensive view of estrogen, testosterone, cortisol and DHEA metabolites, helping tailor interventions.

Integrated hormone evaluation at Total Health Pros

Our clinic doesn’t stop at testosterone. We assess thyroid function, adrenal health and DHEA levels to understand the full hormonal picture. If thyroid hormones are low, we can prescribe bioidentical thyroid medication or work on nutrient support. For high cortisol, we develop stress‑management plans and may recommend targeted supplements or adaptogens. For low DHEA, we evaluate adrenal function and consider supplementation only after careful testing. Our functional medicine perspective ensures that we address root causes, not just symptoms.

Conclusion

Energy in men depends on more than testosterone. Thyroid hormones set the metabolic pace, DHEA supports testosterone and counters cortisol, and cortisol governs the stress response. Imbalances in any of these can leave you feeling drained. Instead of guessing, test and address each hormone thoughtfully. Total Health Pros offers comprehensive hormonal evaluations and personalised plans to restore energy and well‑being. Contact us to learn more about our integrated approach.