III. Low Thyroid and Depression

Thyroid: Mood and Cognitive Symptoms

Thyroid imbalances, particularly hypothyroid (low thyroid), pervade the depressed population.
Conversely, depression (and low energy) is a major symptom for almost all hypothyroid patients, even if only mildly low thyroid. (Fardella 2000, Pies 1998, Placidi 1998, Prange 1996, Musselman 1996)

Typical mental symptoms also include: apathy, loss of interest or pleasure, cognitive slowing, difficulty concentrating, suicidal ideas, memory problems, weakness, pervasive fatigue (may literally sleep one's life away), emotional instability, anxiety, perhaps panic, delusions and fears, suspiciousness and resentment.

Greater Severity and Myxedematous Madness 

Progressive hypothyroidism (myxedemia) steadily slows mental and physical functioning, compromising memory, concentration, comprehension, energy, and reflexes.
Before hormone treatment developed, up to 50% developed a psychosis, termed, myxedematous madness.
Symptoms could include melancholia, mania, and psychosis. Also,  slowed thinking, dementia, morbid dreams, obsessions, frightening hallucinations, persecutory delusions, paranoia, suicidal ruminations, along with physical symptoms of low metabolism.   (Gull 1873,  Clinical Society of London 1888,  Asher 1949)

Missed Thyroid Diagnoses

Psychiatric hypothyroid symptoms frequently precede physical, often leading to misdiagnosis as depression, and incorrect treatment. (Asher 1949, Reed 1977, Boillet 1998)
Low thyroid decreases cerebral glucose metabolism and blood flow (Marangell 1997), suppresses catecholamine activity and receptor sensitivity (Mano 1998), and is associated with more lengthy, frequent and severe depressions. Subclinical or clinical hypothyroidism is especially common in antidepressant-resistant affectives. (Frye 1999)

Note: Physical Symptoms

Weight gain, increased fat, difficult to reverse unless thyroid activity improves. Appetite changes.
Dry, puffy, rough skin; flaky acne. Pallor, yellow tinge (due to difficulty metabolizing carotene).
Water-logged tissue, e.g., ankles, face, especially under the eyes. 
Missing outer third of eyebrows. Eyebrows may be permanently raised to keep lids open.
Brittle, easily broken nails. Thinning, dry, brittle, hair. 
Vision problems, night blindness. Hearing problems.
Hoarseness, slurred speech, tongue thick and swollen, difficulty swallowing.
Anemia, poor circulation, cold sensitivity; perhaps also intolerant to heat.
Joint pain or stiffness, arthritis. Fatigue after minor exertion. Muscle weakness, aches, cramps.
Headaches, migraines.
Indigestion, gas, chronic constipation. Sensitive to drugs and toxins.
Prone to allergies, Candida, hypoglycemia, diabetes.
Low libido, PMS, fertility problems. Menses tend to be irregular, profuse, painful.
Shortness of breath, chest pain, slow pulse. Low blood pressure; but eventually too high, elevated cholesterol, atherosclerosis, heart disease. Prone to lung disorders.

To get a comprehensive view, you may want to look through my book, Natural Healing for Bipolar Disorder
                available here.

To contact me, click here.


Reminder: This information is presented for educational purposes only, and is not intended as diagnosis or treatment recommendations for the individual. Each person's biochemical requirements tend to be unique. So if you need treatment for bipolar, thyroid disorder or any other medical condition, please consult a knowledgeable physician.

I. Thyroid and Bipolar Disorder

The thyroid gland is crucial to metabolism, growth and immunity, as well as supporting heart and kidney function, bone development, and maturation of the nervous system. Thyroid is also critical to cognition and mood.

In fact, thyroid hormones have been used to augment antidepressants and convert nonresponders, and to treat certain rapid cycling and hypomanic patients unresponsive to other treatments (though careful medical evaluation is essential, as thyroid hormone may promote mania).

Thyroid status in bipolars

Bipolars frequently exhibit thyroid underactivity or sometimes other thyroid conditions.* (Lasser 1997, Pies 1998)  Moreover, two of the major mood stabilizers (lithium and carbamazepine) may suppress the thyroid further. (Lazarus 1998)

In some bipolars, thyroid activity cycles with affective state.  Bipolars may be particularly sensitive to such fluctuations, even when within the normal range. (Cole 2002)  Cognitive function, for instance seems to be significantly linked to thyroid status, rather than lithium levels. (Tremont 1997)

Barnes (1976) warned that many patients medicated for depression, anxiety, and so forth, have undetected thyroid dysfunction, causing mood symptoms. Unfortunately, effective thyroid  status is often obscured by distorted interactions of the hypothalamus/pituitary/thyroid axis, and by difficulty determining peripheral sensitivity to thyroid.**(Pies 1998)

* Even as compared to the general psychiatric populations, in which thyroid problems are common. (Gloger, 1997, Fardella 2000, Placidi 1998)
** For example, you can get high thyroxine, with an elevated pituitary TSH nonresponsive to regulatory feedback, so continuing to stimulate the thyroid further. Along with high thyroid symptoms of, for example, weight loss, rapid heart beat, etc., the patient may manifest selective insensitivity to T4 in mood-modulating neural pathways, fostering the low thyroid symptom of depression. Labs also will be contradictory: with high T4, suggesting hyperthyroid; high TSH, hypothyroid. Thus neither effective thyroid status nor appropriate treatment will be readily apparent.

Affective symptoms in thyroid disorder patients

Thyroid dysfunction alters mood (as well as cognition and behavior), (Lasser 1997, Loosen 1987, Prange, Whybrow 1987, Tremont 1997)  typically creates affective symptoms, (Gibson 1962, Graves 1843) and is associated with increased incidence of depression, dysthymia, bipolar disorder, cyclothymia, panic disorder, phobia, and obsessive compulsive disorder. (Placidi 1998)

Hypothyroidism characteristically creates a depressive syndrome; even subclinical hypothyroidism may be associated with mood cycling, depression, and poor or slow response to affective treatment. Autoimmune thyroiditis is often associated with depression (especially postpartum), and with rapid cycling. Hyperthyroidism creates symptoms of, and contributes to, mania. (Pies 1998)

Nonetheless, the precise impact of thyroid activity can vary from one individual to another. (Loosen 1987)

I have excerpted the above post from the first page of a 32-page section on thyroid in my book, Natural Healing for Bipolar Disorder (copyright 2009).

To get a comprehensive view, you may want to look through my book, on bipolar disorder
                available here.

To contact me, click here.


Reminder: This information is presented for educational purposes only, and is not intended as diagnosis or treatment recommendations for the individual. Each person's biochemical requirements tend to be unique. So if you need treatment for bipolar, thyroid disorder or any other medical condition, please consult a knowledgeable physician.