Below is a growing list of links you can read about your thyroid health and behavioral disorders. I welcome any additional links, or if a link has changed, just use the Contact Me form at the bottom of the page to let me know.

(Be aware that many of the articles below still call a patient “normal” based on a fallible and erroneous TSH test or being on thyroxine, which can still leave your free T3 in the lower half of the range.)

MENTAL ILLNESS AND THYROID ARTICLES

Schizophrenia Daily News Blog
This article reveals that “patients diagnosed with mental illnesses (especially those with a mood component) are more likely to have involvement of a thyroid hormone imbalance than the general population.”

ANXIETY

Anxiety disorders linked to thyroid disease, respiratory disease, arthritis and migraine headaches
This article talks about the co-occurrence of anxiety disorders with thyroid disease and other conditions.

Anxiety and Endocrine Disease
Article “Anxiety and Endocrine Disease” by Richard D. Hall, M.D. and Ryan C.W. Hall which includes sections “Anxiety Disorders in Patients with Thyroid Hormone Disturbance” and “Panic disorder/agoraphobia and thyroid disease”.

HYPOTHYROID AND IRON DEFICIENCY WITH PSYCHIATRIC ISSUES

Hypothyroid and Iron Deficiency misdiagnosed as psychiatric disorder
Father’s story of his daughter’s encounter with psychiatric medicine and misdiagnosis.

HASHIMOTOS AND PSYCHIATRIC/MOOD DISORDER ISSUES

Psychiatric Manifestations
“Psychiatric Manifestations of Hashimoto’s Thyroiditis” by Richard C.W. Hall

The link between Thyroid Autoimmunity and Mood disorders
Study “The link between thyroid autoimmunity (antithyroid peroxidase autoantibodies) with anxiety and mood disorders in the community: a field of interest for public health in the future.”

A case of ‘hallucination of solioquy’ with hypothyroidism induced Hashimoto disease.
“Hallucination of soliloquy”, the autoimatic flow of meaningless words inside the patients’s mind.  Symptoms disappeared soon after starting thyroid hormone treatment.

HYPOTHYROIDISM and PSYCHIATRIC ISSUES

Hypothyroidism Presenting as Psychosis
“Hypothyroidism Presenting as Psychosis: Myxedema Madness Revisited” by Thomas W. Heinrich, M.D. and Garth Grahm, M.D.

DEPRESSION WITH HYPOTHYROIDISM or HASHIMOTOS

Thyroid hormone and depression
Thyroid hormone and depression

The Thyroid and the Mind
The Thyroid and the Mind and Emotions/Thyroid Dysfunction and Mental Disorders.

Depression Explored
Depression Explored, With Dr. Barry Durrant-Peatfield

Antithyroid antibodies and depression
Antithyroid antibodies may signal difficult-to-treat depression

Antithyroid antibodies in depressed patients.
Findings support the hypothesis of subtle thyroid dysfunction in a sizable sample of psychiatric inpatients with prominent depressive symptoms.

Thyroid and Depression
Thyroid condition may slow depression recovery.

Teen with depression found with hypothyroidism
Teen with depression found to have hypothyroidism

Depressive and Anxiety Disorders in Hashimoto’s
Study seems to confirm that risk for depressive disorders in subjects with thyroiditis is independent of the thyroid function detected by routine tests and indicates that not only mood but also anxiety disorders may be associated with Hashimoto disease.

“Symptomless” autoimmune thyroiditis in depression
While patients with SAT are clinically euthyroid, what might be “symptomless” for the endocrinologist might be a syndrome presenting with psychiatric symptoms to the psychiatrist.

Thyroid antibodies in depressive disorders.
Hashimoto’s/hypothyroidism is a risk factor for depression.

Hypothyroidism and depression: a therapeutic challenge.
Depressed patients should be screened for hypothyroidism. In hypothyroid patients, depression may be more responsive to a replacement regimen that includes T3 rather than T4 alone.

Thyroid function in clinical subtypes of major depression: an exploratory study.
There is evidence suggesting the presence of an autoimmune process affecting the thyroid gland in depressive patients.

Studies on thyroid therapy and thyroid function in depression patients.
A number of cases of depressed patients have latent hypothyroidism, possibly due to hypothalamus-pituitary dysfunction.

BIPOLAR AND HYPOTHYROIDISM

Thyroid hormone and bipolar patients
A world-renowned expert on bipolar disorder discusses the latest research demonstrating that thyroid hormone can have a positive and profound effect on mood in bipolar patients.

Bipolar Link with Thyroid Condition in older folks
Research zeros in on bipolar link with thyroid condition

Thyroid and bipolar disorder
Thyroid and bipolar disorder

T3/T4 Combination
This clinician’s patient was bipolar and had not had any success with any anti-depressants or mood stabilizers but responded favorably to a T3/T4 combination.

PSYCHOSIS and HYPOTHYROIDISM

Psychotic states associated with disorders of thyroid function.
Highlights the need to consider the possibility of thyroid disorder in all patients presenting with acute psychotic mental disorder.

Psychotic manifestations of hypothyroidism.
The case of a young woman who was treated one and one half years with psychopharmacologic agents and psychotherapy until hypothyroidism was diagnosed. Under administration of thyroid hormone the patient was free of psychiatric and somatic symptoms within 3 months.

ANTI-DEPRESSANTS AND T3

Efficacy of T3
This meta-analysis supports the efficacy of T3 in accelerating clinical response to tricyclic antidepressants in patients with nonrefractory depression. Furthermore, women may be more likely than men to benefit from this intervention.

SUICIDE AND HYPOTHYROIDISM

Hypothyroidism and suicide
Woman admitted to psychiatric hospital after suicide attempt and found to have hypothyroidism.

MISCELLANEOUS

Hypothyroidism and blood tests
1/3 of borderlines have symptoms of hypothyroidism, with “low normal” blood tests.

Thyroid hormone in brain and behavior
Role of thyroid hormone in brain and behavior.

Prevalence of Psychiatric Disorders in Thyroid Diseased Patients
Abstract “Prevalence of Psychiatric Disorders in Thyroid Diseased Patients”.

False Lab Results–Psychiatric or Thyroid?
Article “Psychiatric illness or thyroid disease? Don’t be misled by false lab results” by Richard A. Mermudes, MD.

The following is a sampling of related PubMed medical abstracts which can be searched at www.pubmed.com:

Psychiatric presentations of hypothyroidism.

Hypothyroidism often misdiagnosed as psychiatric illness.
Thyroid screening recommended for patients presenting with depression, psychosis or organic mental disorder.

Masked “myxedema madness”
Hypothyroidism can present a wide range of psychiatric manifestations, including personality disturbance, neurotic traits and psychotic features. Failure to recognize the endocrinopathy may not only produce recovery difficulties but also psychiatric and endocrine repercussions if psychotrophic medications are given in such masked cases.

Psychiatric symptoms in endocrine diseases.
Psychiatric symptoms secondary to endocrine disturbance generally reverse, albeit slowly, with treatment of the primary hormonal abnormality.
Treatment with pychotrophic agents for symptomatic relief of psychiatric complaints should be undertaken with great caution in patients with endocrine disorders.

Psychiatric and cognitive aspects of hypothyroidism.
All symptoms improved with thyroxine treatment, although patients did not necessarily reach premorbid functioning in 6-12 months.
In the literature, depression in hypothyroidism is hypothesized to be at least partly caused by relative hypothyroidism in the central nervous system, and local brain triiodothyronine deficiency may be a possible explanation for affective and cognitive symptoms in subclinical hypothyroidism.

Psychiatric manifestations as the only clinical sign of hypothyroidism.
The presence of potentially irreversible cognitive deterioration, as well as the inocuity and sensibility of thyroid hormones examination justify the systematic thyroid evaluation for all new psychiatric patients.

Myxedematous madness without myxedema.
A young woman, whose psychiatric history covered 16 years, has been treated several times as in-patient for psychotic depression, which was finally cured with thyroid replacement therapy.

The diagnostic dilemma of myxedema and madness, axis I and II.
A patient with presumed chronic paranoid schizophrenia had chronic thyroiditis and Grade I hypothyroidism. Psychosis cleared following treatment with thyroid replacement.

Experiences of fatigue and depression before and after low-dose 1-thyroxine supplementation in essentially euthyroid individuals.
Individuals may experience thyroid-related symptoms such as fatigue and depression before thyroid indices become abnormal.

The presence of antithyroid antibodies in patients with affective and nonaffective psychiatric disorders.
Thyroid disorders may be particularly common in patients with bipolar affective disorder.

Brain perfusion abnormalities in patients with euthyroid autoimmune thyroiditis.
Findings suggest a higher than expected involvement of central nervous system in thyroid autoimmune disease.

Brain metabolism in hypothyroidism studied with 31P magnetic-resonance spectroscopy.
First direct evidence of cerebral metabolic effects of hypothyroidism on an adult brain.

Sub-laboratory hypothyroidism and the empiral use of Armour Thyroid.
In some cases, treatment with desiccated thyroid has produced better clinical results than levothyroxine.

Psychoneuroendocinology of mood disorders. The hypothalamic-pituitary-thyroid axis.
Abnormal thyroid functioning can affect mood and influence the course of unipolar and bipolar disorder.

Regional cerebral blood flow in patients with mild hypothyroidism.
Decreased cerebral blood flow in mild hypothyroidism found in regions mediating attention, motor speed, memory, and visuospatial processing.

Myxedema psychosis – insanity defense in homicide.
Man commits murder in course of hypothyroid psychosis. Later judged to be not guilty by reason of insanity.

Another excellent resource is the book, “The Thyroid Axis in Psychiatric Disorder” by Russell T. Joffe, M.D. and Anthony J. Levitt, M.D. A couple of quotes from this book:

A rich and diverse literature now exists on the relationship between thyroid function and a variety of psychiatric disorders.

…animal studies also suggest that brain utilization of thyroid hormones differs from that of peripheral organs. These advances create exciting possibilities for further studies examining the role of thyroid hormones in psychiatric illness.

…recurrent exacerbations of chronic or relapsing thyroiditis may lead to sporadic changes in thyroid hormone availability or cyclicity without necessarily grossly altering thyroid function tests.

Hashimoto’s disease is often occult and, therefore, frequently remains undiagnosed. It appears that, in some phases, dysregulation of hormone production may be subtle but associated changes in brain function may be unexpectedly prominent.

Because the diagnosis of autoimmune thyroid disease is so complex and sometimes so elusive, its identification as the cause of thyroid-related disorders of mental function is often delayed or even overlooked entirely.

Long-standing changes in thyroid function lead to considerable changes in dynamics of the cerebral circulation and these, rather than direct effects of the hormone in the brain, may be responsible for symptoms of brain dysfunction.

It can be speculated that the role of thyroid hormone in the brain may be different from that in peripheral tissues.

In summary, it is important for those having behavioral and/or psychiatric symptoms to know that T3 is found in large quantities in the limbic system of the brain, the area that is important for emotions such as joy, panic, anger, and fear…and that if you don’t have enough T3, or if its action is blocked, an entire cascade of neurotransmitter abnormalities may ensue and can lead to mood and energy changes.