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THYROID HORMONES AND MENTAL HEALTH: ANXIETY, DEPRESSION, AND WHAT YOU NEED TO KNOW
The thyroid gland, a small butterfly-shaped gland in the neck, produces the hormones T3 (triiodothyronine) and T4 (thyroxine) – the "conductors" that regulate the body's rhythm from metabolism, energy, heart rate, to mood and emotions. When the thyroid gland functions abnormally, these changes not only affect physical health but also profoundly impact mental health, including anxiety and depression.
Signs of thyroid disorder related to mood
Hypothyroidism (low hormones)
Prolonged fatigue, lethargy
Unexplained weight gain
Dry skin, hair loss, brittle nails
Sadness, depression, loss of interest
Difficulty concentrating, poor memory
Sensitivity to cold
Changes in menstrual cycle, decreased libido.
Hyperthyroidism (high hormones)
Anxiety, nervousness, trembling hands
Rapid heartbeat, irregular heartbeat
Difficulty sleeping, fatigue but does not alleviate stress
Unexplained weight loss
Increased sensitivity to temperature
May cause excessive nervous stimulation, affecting mood.
Mechanism affecting the brain
Thyroid hormones influence neurotransmitters such as serotonin, dopamine, and norepinephrine, while also affecting crucial brain regions like the hippocampus and prefrontal cortex – areas that control emotions, mood, and cognitive abilities.
Therefore, thyroid hormone imbalance can directly cause mental disorders, or exacerbate pre-existing conditions.
Diagnosis
Clinical evaluation
The doctor will examine and ask about symptoms: fatigue, weight changes, mood disorders (depression, anxiety), changes in heart rate, skin, and hair.
Observe external signs of the thyroid gland, such as an enlarged thyroid, swollen lymph nodes, or goiter.
Blood testing
TSH (Thyroid Stimulating Hormone):
Elevated → commonly seen in hypothyroidism.
Decreased → commonly seen in hyperthyroidism.
T3 and T4: determine actual thyroid hormone levels.
Thyroid antibodies (Anti-TPO, Anti-Tg): help detect autoimmune causes, e.g., Hashimoto's thyroiditis.
Additional tests (if necessary)
Thyroid ultrasound: checks structure, detects tumors or abnormalities.
Other imaging tests: such as radioactive iodine uptake scans to assess thyroid activity.
Psychological evaluation
If the patient has prolonged depression or anxiety, the doctor may use mood and anxiety scales to determine the level of impact and coordinate treatment.
The combination of medical diagnosis and psychological evaluation helps ensure that psychiatric symptoms are not confused with primary depression or anxiety.
Treatment
Hypothyroidism
Supplement with replacement hormones (levothyroxine) to bring T3/T4 levels back to normal
Regularly monitor TSH, T3, T4
Adjust lifestyle: balanced diet, exercise, adequate sleep.
Hyperthyroidism
Antithyroid drugs or radioactive iodine
- In some cases, partial thyroidectomy
Management of anxiety and nervousness.
Psychological support
Psychological counseling or cognitive behavioral therapy (CBT)
Treatment for depression, anxiety with medication if necessary.
When should you get your thyroid checked?
You should have your thyroid function checked if you experience the following symptoms:
Prolonged fatigue, decreased energy
Unexplained weight changes
Sadness, anxiety, or depression
Difficulty sleeping, palpitations, hand tremors
Menstrual cycle changes or decreased libido
Basic tests, including TSH, T3, and T4, help doctors determine the cause and provide an appropriate treatment plan, which may include thyroid hormone supplementation or treating the cause of hyperthyroidism.
Balance hormones, improve mood
Treating hypothyroidism with levothyroxine helps restore normal hormone levels, improving depression and anxiety.
Controlling hyperthyroidism helps reduce heart palpitations, hand tremors, and anxiety.
Combining a healthy lifestyle: balanced diet, regular exercise, adequate sleep, helps stabilize hormones and improve mental health.
Preventing thyroid disorders and psychological problems
Balanced nutrition
Eat enough iodine, selenium, and zinc to help the thyroid gland function effectively.
Limit processed foods, high sugar, and saturated fats, as they can affect hormone metabolism.
Regular health check-ups
Perform regular TSH, T3, T4 tests, especially if there is a family history of thyroid disorders or unexplained symptoms of depression, anxiety.
Maintain a healthy lifestyle
Regular exercise, at least 150 minutes per week.
Get enough sleep, reduce stress and psychological pressure.
Limit alcohol, tobacco, and stimulants.
Early symptom detection
Monitor mood, energy, weight, menstrual cycle, and sleep.
When abnormal signs appear, see a doctor immediately for timely diagnosis and treatment.
Timely treatment if a disorder is detected
Hypothyroidism: hormone replacement therapy as directed by a doctor.
Hyperthyroidism: use antithyroid drugs, radioactive iodine, or surgery if necessary.
Maintaining normal hormone levels helps reduce the risk of depression, anxiety, and other psychological problems.
Thyroid hormones not only control bodily functions but also play a crucial role in mental health. Early recognition of abnormal signs, such as persistent fatigue, weight changes, unexplained depression or anxiety, and timely diagnosis and treatment are extremely important. This not only helps prevent depression and anxiety but also maintains overall physical and mental balance, avoiding long-term health consequences.
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