Thyroids and Depression: How Thyroid Hormones Impact Mental Health

Thyroids and Depression: How Thyroid Hormones Impact Mental Health

Depression, anxiety, and other mental illnesses can be treated in a variety of ways. The success of these various forms of treatment often depend upon a combination of unique factors affecting the individual being treated, like family history, brain chemistry, and other environmental and health-related factors. 

At Mid City TMS, we specialize in transcranial magnetic stimulation, or TMS, a non-invasive, electromagnetic treatment aimed at individuals struggling with depression who have not responded well to typical antidepressants or psychotherapy. However, it is encouraged that you take the steps to safely improve your mental health in a way that works for you. There are many experimental and alternative treatments for depression that are studied every day. One possible treatment for depression is the use of thyroid hormones.

What Is the Thyroid?

The thyroid gland is a small, butterfly-shaped organ located in the front of your neck. The thyroid releases important hormones to help regulate your body’s metabolism, which helps your body process food into energy and use that energy to help your body function. When a thyroid gland produces too many hormones, a disease called hyperthyroidism can develop. When a thyroid gland produces too few hormones, a disease called hypothyroidism can develop. Both should be taken seriously and treated by a doctor.

Your thyroid controls your metabolism with two different hormones, triiodothyronine, or T3, and thyroxine, or T4. These hormones communicate with your cells to use your body’s energy properly. Thyroid activity is monitored by the hypothalamus and the pituitary gland in your brain. When the pituitary gland senses an imbalance of hormones in your body, it will adjust the amounts with its own hormone. This hormone is called thyroid stimulating hormone, or TSH.

How Does the Thyroid Impact Mental Health?

Thyroid disease and dysfunction can affect an individual’s mood and mental health, in general. Usually, the more severe the hyperthyroidism, the more severe the changes in mood. When suffering from hyperthyroidism, one may experience paranoia, anxiety, or irritability. If suffering from an underactive thyroid, or hypothyroidism, one commonly experiences fatigue or depression.

Many studies from around the world have shown links between hypothyroidism and depression. However, other studies have come back inconclusive, have produced mixed results in larger pools of people, or have shown no relationship between TSH and depression.

Recent efforts have been made to determine whether there is a direct correlation between thyroid dysfunction and depression. In 2019, a comprehensive meta-analysis and systematic review was published in the journal Frontiers in Endocrinology. Researchers reviewed data from 21 different studies on subclinical hypothyroidism and depression, with 103,375 subjects across 7 of these studies being pooled to examine the risk of depression. The analysis showed a positive link between subclinical hypothyroidism and a risk of depression, especially in patients 50 years and older. These results indicate that physicians should take notice of depressive symptoms in patients with thyroid disease or dysfunction. 

While mood changes are a common symptom of thyroid disease, it can also result in weight loss or weight gain, abnormal sensitivity to cold or hot temperatures, changes in the bowel movement, or menstrual irregularities.

The Use of Thyroid Hormones in the Treatment of Depression

Mood disorders like major depressive disorder and anxiety affect millions of individuals across the world. The World Health Organization predicts that by 2030, major depressive disorder will be the leading cause of disease burden. Disease burden is the measure of quality of life based on the financial cost, morbidity, and mortality of a disease. 

In some cases, traditional antidepressant treatment of major depressive disorder does not significantly improve the lives of those suffering. In efforts to find or create more effective responses to mood disorders, scientists and mental health professionals have studied the effects of targeting certain thyroid hormones in the treatment of depression. The manipulation of hypothalamic-pituitary thyroids, or HPT, has been evaluated as monotherapies or adjuncts to the treatment of depression. It has been successful as a therapeutic response to CNS, or central nervous systems, symptoms of major depressive disorder. CNS symptoms include things like mood swing, insomnia or drowsiness, paranoia, and confusion. 

One specific thyroid hormone called triiodothyronine, or T3 , has shown promising results in the treatment of depression. The majority of evidence concludes that T3 can accelerate the response of tricyclic antidepressants, which affect norepinephrine levels rather than serotonin levels. T3 has also worked as an augmentation agent for individuals that do not respond well to antidepressant monotherapy. 

Trials using T3 as an accelerant for tricyclic antidepressants, or TCAs, resulted in lasting wellness in participants, even after discontinuing T3 dosages two to four weeks into the study. Some evidence suggests that women are more responsive to T3 hormone treatment than men. Overall, trials indicate that T3  functions efficiently as an accelerant for TCAs but not as well with SSRIs, the most popular form of antidepressants.

In other trials, patients who were previously unresponsive to TCAs became twice as likely to respond when receiving T3 augmentation. However, these trials were less conclusive, calling into question the efficacy of T3 augmentation. Some patients reported large improvements in overall depression symptoms while others reported no significant change or worsened symptoms. T3 augmentation may be an efficient method for treating depression, however more trails should be done with a larger sample size to assure efficacy.

Some studies have also found promising results in thyroxine, or T4  treatments. An Italian study of 36 women suffering from poor mental and psychological health found significant improvement in mood and verbal communication after six months of standard thyroxine hormone treatment. Another German study concluded that thyroxine treatment improved the moods of individuals who had not responded to standard antidepressant treatments.

Contact Mid City TMS for Depression Treatment

With over three decades of clinical research, TMS therapy has shown positive results amongst patients with depression. Mid City TMS is a New York TMS center that provides transcranial magnetic stimulation as a part of our comprehensive depression treatments. Mid City TMS offers expert and compassionate care from a dedicated team, extended hours, state-of-the-art technology, and comprehensive, individualized care in collaboration with your treatment providers. Learn more about what TMS treatment feels like here, and please contact us with any questions. If you’re interested in starting treatment, make an appointment today.

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