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Hypothyroidism and Anxiety: Understanding the Link Between the Two

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The link between hypothyroidism and anxiety shows that thyroid disorders do not only affect the human body’s metabolism but can also affect mental health. However, before diving into the case subject, the central player must first be introduced – the thyroid.

The thyroid is a butterfly-shaped gland that plays a vital role in our body by releasing the thyroid hormones T3 and T4 in right amounts. These hormones then signal other glands like the pituitary gland to produce other hormones needed by the body.

Without the thyroid gland, the hormones needed for metabolism, growth, and energy won’t be produced, and the body won’t develop or function properly. Unfortunately, a large number of people still face complications whenever the thyroid gland produces either too much or too few hormones.

Hyperthyroidism is a condition where the thyroid produces too much of the thyroxine hormone that causes energy metabolism to speed up. Hypothyroidism, on the other hand, is when the thyroid gland doesn’t produce enough thyroid hormones.

Common causes of hypothyroidism include thyroid gland failure caused by inflammation, Hashimoto’s thyroiditis, or certain medical treatments. Hashimoto’s thyroiditis is an example of a thyroid autoimmune condition.

Thyroid autoimmunity is a condition wherein the body considers the thyroid tissue to be a threat and makes the immune system attack the gland. Medical treatments, on the other hand, cause hypothyroidism when procedures such as a surgery remove too many thyroid cells leading to less hormone production.

Since hypothyroidism causes the thyroid gland to produce not enough hormones, body functions slow down, causing the sufferer to experience slowed metabolism, weight problems, muscle weakness, and tiredness.

Hypothyroidism may also cause depression and anxiety since thyroid hormones work together with neurotransmitters, which are chemical signals that affect feelings like mood and hunger. With too little thyroid hormones produced, mood disorders arise from the imbalance of neurotransmitters.

The physical symptoms hypothyroidism causes also add more stress and anxiety to the individual with the condition.

Several studies have been performed to find out the link between hypothyroidism and anxiety. A study in 2017 assessed anxiety, along with depression and self-care management, in 65 patients with hypothyroidism in India.

The team of researchers used a structured questionnaire and the Hamilton rating scale, which determines a patient’s level of depression, to assess anxiety and depression. Their results showed that 46.1% of the patients had severe anxiety while 4.6% had depression. They also suggested that proper self-care is valuable to lessen the anxiety patients experience as a result of hypothyroidism.

A previous study conducted in Belgium had a similar conclusion with Nila and colleagues’ research about the connection between hypothyroidism and anxiety. The study compared the performance of 23 participants in a hypothyroid state in a cognitive battery test with 26 other people without hypothyroidism. The study showed that the 23 participants were more anxious and depressed than their counterparts with normal-functioning thyroids. It also showed that the anxiety symptoms of the participants also interfered with their cognitive performance.

It should be noted, however, that hypothyroidism and anxiety aren’t usually associated together. Depression is more common as a symptom and effect of hypothyroidism, while anxiety is more associated with hyperthyroidism.

Anxiety is not always related to hypothyroidism itself but may be caused by stress in having the disorder rather than by the hormone imbalance caused by the condition. But even though hypothyroidism and anxiety may not always be linked together, it’s important to know that the condition may still cause anxiety in different ways.

A study from 2005 in Norway, which combined psychiatry and neuroscience, showed results with no associations between thyroid autoimmunity and anxiety. As stated earlier, an autoimmune thyroid condition may cause hypothyroidism. The 30,175 individuals involved in the study aged 40 to 84 years old were also a mix of people with and without thyroid disorders.

The study tried to determine the relationship of thyroid autoimmunity with anxiety and depression by measuring the thyroid-stimulating hormone (TSH) and anti-thyroid antibodies of participants. The rationale behind this is that TSH levels and anti-thyroid antibody levels of people with hypothyroidism are high.

Anxiety and depression experienced by the participants were also screened using the Hospital Anxiety and Depression Scale. The results of the study showed that more women are affected by thyroid autoimmunity. It also concluded that there was no association between anti-thyroid antibodies and anxiety or depression.

The best way to confirm if hypothyroidism and anxiety are a cause and direct effect pair is by having a doctor verify. Diagnosis can be performed using iodine tests, TSH tests, and T4 hormone tests, and doctors will also check for other symptoms related to thyroid dysfunction.

It’s never advisable for people to diagnose their anxiety themselves when they have a condition such as hypothyroidism. They may end up believing that the illness is causing their anxiety rather than something else.

Treating both hypothyroidism and anxiety isn’t impossible, whether the anxiety is caused by hypothyroidism or by another medical condition.

As for anxiety, it’s best to know the underlying problem that causes it so that it’ll be easier to manage.

When studying cause and effect concerning mental health, knowing more about the disease helps us understand the root of the problem.

References:

https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072572/

https://www.health.harvard.edu/diseases-and-conditions/thyroid-deficiency-and-mental-health/

https://www.ncbi.nlm.nih.gov/pubmed/16212680/

https://www.mdedge.com/psychiatry/article/62439/identifying-hypothyroidisms-psychiatric-presentations/

https://www.ncbi.nlm.nih.gov/pubmed/16253615/

http://www.jpsychores.com/article/S0022-3999(05)00087-5/abstract/

https://innovareacademics.in/journals/index.php/ajpcr/article/view/21074/

https://www.cambridge.org/core/journals/journal-of-the-international-neuropsychological-society/article/anxiety-and-depression-attention-and-executive-functions-in-hypothyroidism/AF9CE1E366191C17B9071F02F3A247D8/

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