Overview Of Thyroid Hormone Metabolism In The Brain
The hypothalamic-pituitary-thyroid axis is a complex interplay between several factors: thyroid hormones, deiodinase enzymes, transporter proteins, and receptors. An understanding of the interactions of these factors may contribute to better elucidate the pathophysiology of psychiatric disorders as well as the response to psychiatric treatment.
Thus, the HPT axis includes complex pathways and impairment in its components has been linked in some studies to behavioral changes as will be further pointed out.
Subjects On Thyroid Hormone Replacement
The situation is different in subjects on thyroid hormone replacement. It has been clearly documented that these subjects have poorer well-being compared to the general population . It also appears that the association between thyroid function and depression is more clearly seen in this population.
An association between thyroid function and depression in subjects on thyroxine was first shown by Saravanan et al. who found a clear association between higher TSH and lower free T4 and poorer psychological well-being in 697 subjects on thyroxine from the UK. This persisted when only subjects with a TSH within the reference range were included. Findings were similar in the HUNT 2 study from Norway and a study from the Netherlands .
As there appeared to be a clear difference in the associations between thyroid function and depression in subjects who were and were not on thyroxine, we used the large sample size of the HUNT 2 study to determine if we could show a statistical difference in these relationships. We looked for an interaction of being on thyroxine on the relationship between TSH and HADS depression and found that this was the case in females indicating significantly different associations in the two populations . This is best shown in figure figure11.
Causes Of Anxiety In Thyroid Disease
The causes of anxiety symptoms in thyroid disease depends on whether a person has hyperthyroidism or hypothyroidism.
Hyperthyroidism essentially speeds up your bodys metabolism. This causes your entire sympathetic nervous system to become more active, leading to feelings of anxiety. In fact, your whole body could feel like its shaking and going into overdrive.
In contrast, hypothyroidism leads to an imbalance of neurotransmitters, such as serotonin. Although this imbalance often leads to feelings of depression, anxiety is also a common symptom.
Thyroid dysfunction both overactive and underactive can lead to various mental health symptoms ranging from mild depression to anxiety to psychosis.
Depression is particularly common in people with thyroid conditions. has shown that many people with depression have significantly abnormal levels of T3, T4, and thyroid-stimulating hormone .
Research suggests that about of individuals with hypothyroidism have depression. People with underactive thyroid also frequently exhibit symptoms of cognitive dysfunction, apathy, and psychomotor slowing. In severe forms of hypothyroidism, clinical symptoms may look like melancholic depression and even dementia.
Depending on the research, prevalence of depressive disorders in hyperthyroidism may range anywhere from
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Tip : Consider A Selenium Supplement
Selenium is a trace mineral your body requires to activate thyroid hormone. Studies have linked low selenium levels with increased risks for chronic autoimmune thyroiditis, Graves disease, and goiter.
You can increase your selenium levels by increasing your intake of meat, seafood, or whole grains. But some people may require a supplement to enhance selenium levels. Talk with your doctor about what may help.
Consider scheduling an appointment with your doctor if you experience the following symptoms as they could be related to your thyroid:
- feeling a nodule or lump on either side of your larynx
- experiencing weight loss or gain that you cant explain by changes in diet or activity level
- constantly feeling very hot or very cold
- experiencing mood changes, such as depression, anxiety, or nervousness
- feeling a sense of significant fatigue
These symptoms can all indicate a potential thyroid concern and warrant a trip to your doctor.
There are two thyroid-related conditions that can be medical emergencies: myxedema coma and thyroid storm. You should seek emergency medical attention for either.
When Good Glands Go Wrong
Sometimes, your thyroid produces too much or too little hormone. Or it enlarges and forms lumps. Common thyroid problems include:
- Hyperthyroidism. When your thyroid becomes overactive, your heart races and you may feel weak or irritable.
- Hypothyroidism. If your thyroid fails to create sufficient hormones, your metabolism slows down. You begin to feel depressed and sluggish. It may be hard to lose weight.
- Goiter. A lack of iodine in your diet or excessive inflammation from a thyroid-related autoimmune disease can cause your thyroid to enlarge, producing a goiter in your neck.
- Nodules. Your thyroid gland may make too much hormone, which can produce tiny lumps in your neck. These may be cancerous or benign.
- Autoimmune disease. An autoimmune disease triggers the body to wage war upon its own healthy cells. Graves and Hashimotos diseases specifically target the thyroid gland. Graves disease produces an overactive thyroid, while Hashimotos disease, the most common cause of hypothyroidism in the United States, creates chronic inflammation as antibodies attack healthy thyroid cells. These occur most frequently in middle-aged women, but they can affect anyone.
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Linking Hypothyroidism With Depression
To help your doctor figure out if your depression is because of hypothyroidism, they should test you for thyroid disorders. Blood tests can confirm them if they show low levels of a thyroid hormone called thyroxine and a high level of one called thyroid-stimulating hormone .
Studies show that if you have both hypothyroidism and depression, thyroid-replacement medications may work better than antidepressants. They boost levels of two major thyroid hormones: triiodothyronine and thyroxin . When thyroid pills lower TSH levels, you may start feeling better.
What Are Some Types Of Thyroid Conditions
Thyroid gland hormones can affect food metabolism, mood, and sexual function. When the thyroid produces too much hormone, the body uses energy faster than it should. This condition, overactive thyroid, is called hyperthyroidism. Symptoms that may indicate hyperthyroidism include:
- enlarged thyroid gland
- enlargement of the thyroid gland
Some of these symptoms — fatigue, irritability, weight changes, and sleep problems — are symptoms that may also mimic depression.
Your doctor may order blood tests to determine levels of certain hormones, including:
- thyroid stimulating hormone
- triiodothyronine
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What Are Mood Disorders
- Depression: Losing interest in daily activities along with feelings of sadness and a loss of hope. If these feelings last for two weeks or longer, this could indicate the onset of depression.
- Dysthymia: This is a low-grade depressed state or irritable mood that lasts for two years at least.
- Bipolar disorder: People living with bipolar disorder usually have periods of highs and lows. They often exhibit phases of depression and then extreme highs typified by signs of mania.
- Mood disorders associated with illness: Cancer, injury, arthritis, infections, and many chronic diseases can often cause depression.
- Substance-induced mood disorder: Medicines, toxins, illegal drugs, and alcohol can all cause symptoms of depression.
- Mood disorders related to significant events: Significant life events can cause depression, such as PTSD , divorce, career setbacks, or witnessing tragic events.
Low Cortisol Can Be An Additional Problem
In addition to low T3 levels causing psychiatric and psychological disorders, low cortisol levels can be an additional culpriteven when you feel you are adequately treated for your thyroid problem.
Low cortisol results in cell receptors failing to adequately receive thyroid hormones from the blood, and can explain certain emotional and behavioral symptoms even when a patient is on thyroid meds. Those emotional and behavioral symptoms include..
- the need to avoid leaving ones house
- seeking peace and quiet no matter what
- unable to tolerate stress
- low tolerance to loud noises
- tending to rage about things
- emotional ups and downs similar to bi-polar
- hyper-sensitive to the comments of others
- being argumentative/raging/overly defensive in patient groups
- suicidal ideation.and more.
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Ie Its Not All In Your Head
Believe it or not, many mental health issues are outright due to being hypothyroid , or having a cortisol problem, especially low cortisol.
No, this doesnt take away that there can be other causes of any mental health challenges. But its a common scenario for undiagnosed hypothyroid patients, no matter the cause of their hypothyroidism. Its also common for those on T4-only. And its especially common when there are issues with ones adrenals, such as now having low cortisol.
For hypothyroid patients, no matter the cause, mental health issues can be directly due to having a low free T3, the active thyroid hormone. And this is also common for patients treated with Synthroid, Levoxyl, Eltoxine, Levothyroxine, Tirosint, and other T4-only medications by themselves.
Mental health issues are also strongly connected to having low cortisol, especially as proven by a saliva cortisol test. You can order and do the latter test, its not about falling in any range. Its about where those cortisol results fall, as revealed here.
What Causes Anxiety In Hypothyroidism
Why are people with hypothyroidism more likely to develop anxiety? “One theory is that simply having a physical problem like hypothyroidism can increase anxiety,” says Cheryl R. Rosenfeld, DO, a spokesperson for the American Association of Clinical Endocrinologists , partner at North Jersey Endocrine Consultants, and adjunct clinical associate professor of medicine at the Touro College of Osteopathic Medicine in New York City. “Symptoms of hypothyroidism include poor concentration, decreased memory, and difficulty performing daily activities all of which can be anxiety-producing.”
Not getting proper treatment for hypothyroidism can contribute to anxiety, as well. Levothyroxine is a common treatment for hypothyroidism, but if your dose is too high, it can directly lead to anxiety and cause symptoms like rapid heartbeat and shakiness, which can make anxiety worse, says Rosenfeld. And if hypothyroidism is not treated, symptoms like dry skin, sensitivity to cold, hoarse voice, and mood swings will persist. Over time, untreated hypothyroidism can cause heart issues like a weak pulse or heart failure, which may provoke further anxiety.
Anxiety can also make it harder to stick to your hypothyroidism treatment if it causes you to forget to take medications or causes problems going to the doctor or sticking to a healthy lifestyle.
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The Thyroid And Depression
Researchers have long recognized that there is a link between thyroid function and depression, although the exact mechanisms of how they interact are not fully understood. Not only are people with thyroid disorders more likely to develop depression, but evidence also suggests that taking thyroid hormone treatments can enhance the effectiveness of antidepressants.
The metabolism of the thyroid hormones in the brain is a complex process that often involves many steps and pathways. If any of these components become impaired, it may have an impact on the thyroid’s ability to signal the brain.
Studies suggest that TSH levels are correlated to the severity of depressive symptoms. TSH, or thyroid-stimulating hormone, is a hormone secreted by the pituitary gland that acts to stimulate the production of more thyroid hormone.
So If Your Physician Therapist Or Psychiatrist
a) failed to check your thyroid function with the correct lab tests
b) failedto understand that those thyroid-related lab results are about WHERE they fall in any range, not just falling anywhere.
c) failed to correctly check your adrenal function with a 24 hour adrenal saliva test, NOT BLOOD
d) failedto understand that those saliva cortisol results are about WHERE they fall in any range, not just falling anywhere.
e) and instead prescribed his or her favorite band-aid psychotrophic medicationthen you are left with medications that can include unneeded fluoride, that can clash with your other meds, that can make your hypothyroid worse, or can leave you with classic side effectsbesides the cost.
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From Janie Bowthorpe: My mother is a classic example of the tragedy of poor assessment or treatment of thyroid function. After she battled clinical depression and anxiety for years while on Synthroid, she relinquished all control of her health to a doctor who gave her electric shock therapya treatment which only slightly lessened her chronic depression and dulled her memory and especially her intelligence for the rest of her life.
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How Do You Calm Hashimoto’s
Eating a thyroid-friendly diet can help reduce inflammation and decrease the severity of flare-ups. Try to eat meals that mostly consist of lean meat, fish high in omega-3’s, and vegetables. Some studies suggest that eating a gluten-free diet may also help people with autoimmune thyroid conditions like Hashimoto’s.
Treating Your Thyroid Conditions
Thyroid disease can affect your mood, causing such psychological disorders as anxiety or depression. Dr. Baker and his compassionate team treat your thyroid disease, which may also provide relief from any related emotional symptoms. Depending upon your particular thyroid issues, Dr. Baker and his colleagues can help manage your health through:
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Can Hashimoto’s Turn Into Lupus
Automimmune disorders that occur with increased frequency in patients with Hashimoto’s thyroiditis include insulin-dependent diabetes mellitus, myasthenia gravis, celiac disease, pernicious anemia, vitiligo, rheumatoid arthritis, systemic lupus erythematosus, scleroderma, primary biliary cirrhosis, dermatitis …
Treatment Of Thyroid Problems And Depression
After testing your thyroid levels and detecting an imbalance, your doctor will review the results with you and the impacts on your mental health. If you feel you are experiencing depression directly related to an improperly functioning thyroid, your doctor will be able to determine the best course of treatment moving forward. Thyroid medication is the usual course for those with some type of thyroid disease, such as hypothyroidism or hyperthyroidism.
If you have hypothyroidism, thyroid medication can either boost the hormones produced or replace those hormones entirely. The intention of prescribing thyroid medication is to regulate these hormones and get them back to a normal level to restore healthy bodily functions. If you are struggling with depression then it may also reduce or completely stop your depression by regulating thyroid hormones that can cause depression. However, if thyroid medicine alone is not enough and your symptoms of depression do not go away then your doctor may consider antidepressants, such as SSRIs. SSRIs or selective serotonin reuptake inhibitors are the typical class of antidepressants that are used to treat depression. Talk therapy may also be added into the course of treatment for the maximum benefits.
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Can Thyroid Medicine Cause Depression
The short and simple answer is no, there is no research that supports thyroid medicine causing thyroid depression. Those who are being treated for hypothyroidism with thyroid medicine can develop depression, but this stems from the hypothyroidism and not the medication itself. However, research does suggest that medication that treats depression can lower the hormone levels that the thyroid produces and trigger symptoms of hypothyroidism.
When To See Your Healthcare Provider
If you have thyroid symptoms, visit your healthcare provider. To find out what’s going on, they may:
- Give you a physical exam
- Ask questions about your medical history
- Ask for details about your symptoms
- Give you a blood test to check your thyroid levels
- Order imaging tests, such as a thyroid scan or ultrasound
In most cases, thyroid conditions can be effectively treated.
Thyroid Disease Doctor Discussion Guide
Get our printable guide for your next doctor’s appointment to help you ask the right questions.
- Loss of consciousness
Hypothyroidism can lead to another medical emergency. It’s called myxedema coma.
Myxedema coma is rare. It’s triggered by trauma, infection, cold, and some medications. It causes body temperatures and blood pressure to drop. You may lose consciousness. This condition can cause death.
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What Exactly Does The Thyroid Do
The two-inch-long thyroid gland is part of the endocrine system that controls your metabolism. It affects your breathing, energy, even how quickly your heart beats. It also regulates body temperature and monthly menstrual cycles, and it helps create energy from the food you eat. The parathyroid glands produce a hormone that regulates calcium in your body.
The Thyroid And Depression Connection
Experts arent exactly sure why, but thyroid issues can bring about symptoms of depression. In fact, a 2021 study published in Clinical Endocrinology found that people with hyperthyroidism at the start of the study were more likely to develop depression 4 years later than those with normal thyroid hormone levels.
Depression is more commonly seen with hypothyroidism but can also be seen with hyperthyroidism, along with anxiety and agitation, says Dr. Lester. And thats especially true in older adults. For example, younger people with an overactive thyroid may show signs of anxiety. This includes restlessness and chronic worry. But older adults may appear more apathetic.
What that looks like to an outside person, says Dr. Lester, is someone who sits quietly and doesnt engage much in conversation, has slowed body movements or doesnt move much. Or they sit with an inexpressive facial expression, something she says is often dubbed a masked face or flat effect.
So do depression and thyroid conditions always go hand in hand? Certainly not. In fact, its thought that most people with depression have normal thyroid function, a review published in the Journal of Thyroid Research found.
Depression can be caused by many different factors, says the National Institute of Mental Health. A family history of depression, trauma, stress and a wide range of health conditions or medications can all play a role. We answer your top questions about treating depression here.
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