Thyroid and mental health articles

Below is a gro­wing list of links you can read about your thy­roid health and beha­vio­ral disor­ders. I wel­come any addi­tio­nal links – just use the Con­tact Me form. 

(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.)

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

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

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

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.

The link bet­ween Thy­roid Autoim­mu­nity
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.”

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. 

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.

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

Bipo­lar Link with Thy­roid Con­di­tion
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.

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

Thy­roid and Depres­sion
Thy­roid con­di­tion may slow depres­sion recovery.

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

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.

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.

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. 

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.

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. 

“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.

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.

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.

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.

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.

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.

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.

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

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.

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

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.