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Accompanying Disorders to Thyroid Problems

Wednesday 13 January 2021
Thyroid Disorders
4 minute(s) read
Dr..Jubil Tom

Medically reviewed by

Dr. Jubil Tom, MD

on 9 February 2021

Table of Contents

I. Thyroid Issues and Mental Disorders

II. Hypothyroidism and Psychosis

III. Thyroid Disorder and Depression

IV. Bipolar Affective Disorder

V. Thyroid Disease and the Heart

VI. Treatment for Thyroid Problems

Thyroid Issues and Mental Disorders 

Several factors contribute to mental health disorders. For example, depression may be caused by stressful life events, medications, medical problems, or even genetic vulnerability. [1] Finding the exact cause of a mental health disorder is difficult because many conditions are extremely complex. However, one thing is certain: chemical reactions in your brain directly affect your mood and perception of reality. [1]

So, where does the thyroid come into play? Your thyroid gland is responsible for producing thyroid hormones that regulate energy levels, mood, and weight. Naturally, a faulty thyroid gland can cause hormone imbalances that lead to mood swings.  Severe thyroid issues are associated with bipolar disorder, depression, and psychosis. Your doctor will often evaluate your thyroid health when diagnosing a mental health condition to identify any links. If your mental health disorder results from a thyroid problem, your doctor may prescribe Synthroid (levothyroxine), desiccated thyroid, or Tapazole (methimazole) to address the underlying issue. [2]

Hypothyroidism and Psychosis

Psychosis is a mental state of delusion and confusion. Psychosis can occur in people with mental health disorders when they enter a trance or experience hallucinations. Hallucinations can occur in many forms. For example, an auditory hallucination can cause you to hear voices when nobody is speaking. [3]

a motion-blurred image of a man’s face

When an underactive thyroid (hypothyroidism) becomes too severe, doctors refer to it as myxedema. Studies show that myxedema can lead to psychosis. When this occurs, treatment tailored to the psychiatric disorder will be ineffective. Instead, the only treatment for the myxedema will relieve symptoms. [4]

Thyroid Disorder and Depression 

Your underactive thyroid does not have to become myxedema to disturb the mood. Even mild cases of hypothyroidism have been known to cause depression. In one study, researchers found that 40 percent of their hypothyroid patients showed significant symptoms of refractory depression (treatment-resistant depression). 

The reverse relationship is also true, where 50 percent of patients with refractory depression showed symptoms of hypothyroidism. Evidently, there is a strong link between the two disorders. Whichever disease comes first, hypothyroidism and depression often coexist. [4]

Bipolar Affective Disorder

Although the link is strong between thyroid hormone production and depressive disorders, more research is required to better understand the exact connection between thyroid health and bipolar disorder. [5] People with bipolar disorder swing between periods of intense highs (mania) and periods of extreme lows. [6]

an extremely happy man

Like depression, patients with bipolar disorder have been found with hypothyroidism. The difference is that bipolar patients can sometimes have an overactive thyroid. While hypothyroidism causes fatigue, hyperthyroidism can be responsible for manic episodes. [5]

Thyroid Disease and the Heart

Your thyroid affects much more than your mood. By analyzing the effect of thyroid hormone on the cardiovascular system, researchers have been able to tell how thyroid dysfunction affects rhythm disturbances, vascular resistance, cardiac output, cardiac contractility, and blood pressure. [7] Hypothyroidism may slow your heart rate, constrict your blood vessels, and increase your blood pressure. In severe cases of hypothyroidism, heart failure and death can occur. Additionally, under-treating and over-treating hypothyroidism can increase your risk of developing heart problems. [8] 

Treatment for Thyroid Problems 

Usually, the accompanying condition is caused by the thyroid disorder itself. Accordingly, treating the thyroid disorder with Synthroid (levothyroxine), desiccated thyroid, or Tapazole (methimazole) may introduce improvements in both conditions. Thyroid replacement therapy typically entails daily doses of synthetic thyroid hormone and may be prescribed as hypothyroidism treatment. [4]

pills on a purple background

For hyperthyroidism, antithyroid medications like methimazole may be prescribed, although a surgical thyroidectomy or radioactive iodine ablation (removal of body tissue) are available options as well. [9] The former is a surgery that removes all or part of your thyroid gland, while the latter is a pill that gradually shrinks your thyroid. [10] [11]

Some cases do not stem from either thyroid problems or the accompanying disorder. In this scenario, your doctor may need to expand your treatment plan to address both diseases. Cognitive dysfunctions, affective disorders, and psychosis will likely require psychiatric treatment. [4] It is important to test for thyroid problems if you are experiencing symptoms of any mental health disorders. A proper diagnosis will ensure there is no delay in treating the offending condition and help avoid unnecessary side effects that are caused by an inappropriate treatment plan.

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