Depressed or Anxious? Maybe It’s Your Thyroid

Thyroid Scan

Melissa England, 19th Medical Support Squadron ultrasound technician, scans the thyroid of a simulated patient Dec. 5, 2017, at Little Rock Air Force Base, Ark. Gel is used to allow the ultrasound machine to scan more efficiently in the desired area. (U.S. Air Force photo by Airman 1st Class Rhett Isbell)

Thyroid Conditions Can Mimic Mental Health Problems

Have you been diagnosed with depression or anxiety by a health professional? Are you taking prescription medication to ease symptoms and still not feeling great? If you haven’t had your thyroid checked recently, you may want to ask your medical professional to run blood tests to measure your thyroid levels.

Your thyroid gland, located in the area surrounding the Adam’s apple, is part of your endocrine system. It is responsible for a whole host of systems and functions in the body. It produces hormones that control heart rate, body temperature, and metabolism. Sometime the thyroid gland produces too few hormones (hypo-thyroidism) and sometimes too many (hyper-thyroidism). Each of these conditions present with a set of symptoms that can mimic some mental health conditions, such as anxiety and depression.

There are astonishing numbers that link hypothyroidism and depression and anxiety disorders. Between 30-45% of people who have been diagnosed with anxiety and depression also have some form of thyroid disease. Over roughly 60% of patients with hypothyroidism experience anxiety or depression. That’s some interesting math, but the takeaway is that if you have one condition, you may have the other as well.

Symptoms of Hypothyroidism

For people who have a diagnosis of depression, the symptoms of hypothyroidism will sound awfully familiar. Fatigue, trouble focusing, lack of energy, and weight gain are all symptoms of hypothyroidism as well as being symptoms of depression. Having body aches in muscles or joints can also be manifested in both conditions.

Conversely, symptoms of anxiety correlate closely with hyperthyroidism. People with anxiety often feel that they can’t slow down—their thoughts race, they be shallowly, their bodies can’t relax. All of these can be symptoms of hyperthyroidism. Other symptoms include unexplained weight loss, hand tremors, and an enlarged thyroid gland.

Diagnosing Thyroid Disease

For patients who exhibit symptoms of thyroid disease, some primary care physicians will order an initial blood test. This first blood test checks for TSH, or thyroid-stimulating hormone, levels. TSH is produced by the pituitary gland which tells the thyroid what level of hormones it should be pumping into your system. If the pituitary gland senses that thyroid hormone levels, such as T3 and T4, are low, it will produce more thyroid-stimulating hormone (TSH) to tell the thyroid gland to get busy. Therefore, if TSH levels are high, the thyroid gland is underactive; if the TSH levels are low, the thyroid gland is overactive.

The test for TSH levels doesn’t always paint a complete picture of what’s going on with a person’s endocrine system. If TSH levels come back with a normal range, but a patient is symptomatic, the next test would be for the levels of T3 and T4, which are the two main hormones produced by the thyroid gland. A final test, one that endocrine specialists are more likely to test for than primary care doctors, is a blood test to check for thyroid antibodies. Many people with thyroid disease actually have antibodies that indicate an autoimmune disorder, such as Hashimoto’s or Grave’s disease as the underlying cause of the disease. Treatment plans don’t tend to change regardless of whether antibodies are present, but it can reduce worry to know what’s happening in your own body.

Treatment Options for Thyroid Conditions

When we are diagnosed with anxiety or depression, sometimes we wonder whether the diagnosis is accurate. After all, there are no blood tests; the diagnosis is based on observation and self-reported questionnaires. With an underlying thyroid issue, however, blood tests can indicate clearly whether there is an issue. If you think your thyroid may be affecting your overall health, talk to your doctor. Don’t be afraid to advocate for yourself and get the proper blood tests.

Treatment for hypothyroidism involves taking synthetic hormones that mimic your natural ones. Doctors usually prescribe a low dose to start and continue to monitor hormone levels. Dosage is increased as needed, based on symptoms and blood tests. The treatment for hyperthyroidism varies and can include medication, radiation therapy to shrink the gland, or surgery to remove part of the gland. If you have an undiagnosed, untreated thyroid condition, one thing is for sure. Finding answers and getting the proper treatment can help you feel a whole lot better.

References
Martin, Laura, J., reviewed by “Hypothyroidism (Underactive Thyroid),” WebMD, August 13, 2017
Siegmann, Eva-Maria, et al, “Association of Depression and Anxiety Disorders With Autoimmune Thyroiditis,” JAMA Psychiatry, May 2, 2018
Biggers, Alana MD, reviewed by, “What’s the Link Between Thyroid Conditions and Depression?” Healthline, January 14, 2018

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