Can You Develop Anxiety When You Have Hashimoto’s Disease
Hashimoto’s disease is a slowly progressing condition, often with no noticeable signs or symptoms in the earlier stages. Still, as the disease progresses, the decline in thyroid hormone production can result in overt hypothyroidism, with more prominent manifestations.
Studies show a higher prevalence of anxiety and depression among patients with hypothyroidism.
Thyroid diseases, including Hashimoto’s disease, can affect your mood and mental health, often causing anxiety or depression. It is possible that the more severe your thyroid disease, and the further it progresses, the more extreme the mood changes.
Research has found that a person with hypothyroidism is over twice as likely to develop an anxiety disorder as healthy individuals.
Data also found that symptoms of depression were 3.5 times higher among patients with hypothyroidism compared with healthy people.¹
Theres A Quick Diagnostic Test
If youre not sure whats causing your symptoms, your doctor might be able to help you with that fairly quickly. Prevention.com explains although not fun for needle-phobes, theres a simple blood test to confirm the condition.
The test checks for your blood levels of two thyroid hormones called thyroid stimulating hormone and T4. To confirm Hashimotos, theyll also look at whether you have antithyroid antibodies, which are produced when your immune system attacks the gland, according to the source.
Depression And Thyroid Hormones
Although many studies inspected the relationship between depression and thyroid hormones, this subject is still poorly elucidated. The involvement of hypothalamic-pituitary-thyroid axis in the pathogenesis of depression is supported by various studies. While some research shows the normal range of thyroid hormone levels during a depressive episode, the great deal of evidence confirms the diverse changes in different hormones linked with this axis.
Regarding TSH some studies report increase while others claim its levels decrease during a depressive episode. Concerning T3 the evidence is more conclusive and it shows the levels of this hormone tend to reduce in the presence of depression. In fact, the degree of T3 reduction is associated with severity of depression.
Dont forget that hypothyroidism is a condition indicated by lower or insufficient production of thyroid hormones. When it comes to T4, results are still contradictory due to a diversity of factors such as differences in phenotypes of depressive patients, severity and duration of disease, and many others.
It is also important to mention that thyroid hormones influence noradrenergic and serotonergic neurotransmission which are crucial in the pathogenesis of depression and they also pose as targets for treatment of this condition. Studies show that administration of T3 leads to an increase in serotonin levels in the cerebral cortex. At the same time, hypothyroidism is linked with lower levels of serotonin.
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Symptoms Of Inflammation In Hashimoto’s Patients
#1. Fluctuating thyroid levels.
The most common symptom of inflammation in Hashimoto’s is that of fluctuating thyroid hormone levels.
What do I mean?
I’m talking about changes to your hormone FUNCTION.
Inflammation is associated with either a DOWNWARD trend in thyroid function or an UPWARD trend in thyroid function.
Most people will experience this as LOW thyroid function, meaning the symptoms of hypothyroidism or low thyroid.
This is why Hashimoto’s is often referred to as Hashimoto’s hypothyroidism.
Because it causes hypothyroidism!
BUT, it can also cause hyperthyroidism.
Inflammation can damage the thyroid and result in TOO much thyroid hormone production which leads to hyperthyroid symptoms.
Acute damage tends to cause this problem while chronic long-term inflammation tends to cause LOW thyroid function.
One of the reasons that Hashimoto’s patients struggle to identify how they feel is because this process can go up and down like a roller coaster.
One week you can feel hyperthyroid and the next you can feel hypothyroid which can seem confusing.
But if you understand what inflammation is doing then it doesn’t have to be.
The goal is obviously to cool down this inflammation to stabilize your thyroid function.
#2. Feeling run down
Do you ever feel like you just don’t have the energy that you used to?
Like it’s difficult to get out of bed and do your day to day activities?
Or how about just not having the drive or motivation to do the things that you know you HAVE to do?
How Common Is Depression
Depression is more prevalent than we think. According to the National Institute of Mental Health, about 16.2 million American adults or 6.7% of this population had at least one major depressive episode in 2016. Figures also show that depression is more prevalent in adult women than men with ratio 8.5% vs. 4.8% respectively.
In October 2017, GoodwinR. et al published a study which revealed that depression appears to be increasing among Americans, especially among youth. Findings demonstrate that depression increased significantly among people in the US from 2005 to 2015 from 6.6% to 7.3%.
Rates of depression could be even higher than estimates show. Official statistics only take into account diagnosed cases of depression, but there are many people who dont seek medical assistance for symptoms they experience and hence receive no diagnosis.
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There May Be A Cancer Link
The California-based non-profit PLOS notes on its website that, in recent years, there have been reports that thyroid cancers are associated with Hashimotos disease. It focuses on a study that looked at the prevalence of thyroiditis among patients with papillary thyroid cancer.
The study analysis involved 5,378 Korean patients with papillary thyroid cancer aged 20 to 79-years. The prevalence of chronic lymphocytic thyroiditis among these patients was 4-percent for men and 12.8-percent for women in 1999 numbers that dramatically jumped to 10.7-percent for men and 27.6-percent for women by 2008. Korea has the highest incidence of thyroid cancer in the world, adds the source.
The Link Between Depression And Hashimotos Thyroid Disease
The relationship between Hashimotos disease and depression in Australia has long been recognised, with people with thyroid disorders being more prone to develop depressive symptoms. Women are more likely than men to have thyroid disease. One in eight women throughout Australia will develop thyroid problems during her lifetime.
Often General Practitioners will attribute the most common symptoms of hypothyroidism, such as weight gain, depression, anxiety, brain fog, sleep problems and fatigue, to general depression or just stress. Many women are then offered anti-depressants to combat their depression.
Strong Link Between Depression And Anxiety Disorders With Chronic Thyroid Disease
- University of Erlangen-Nuremberg
- There is a strong link between depression and anxiety disorders and autoimmune thyroiditis , a chronic thyroid condition affecting approximately 10 percent of the population. Scientists have now demonstrated that special treatment could help many sufferers, especially women.
There is a strong link between depression and anxiety disorders and autoimmune thyroiditis , a chronic thyroid condition affecting approximately 10 percent of the population. Scientists at Friedrich-Alexander-Universität Erlangen-Nürnberg have now proven that special treatment could help many sufferers, especially women.
Depression and anxiety are among the most common psychiatric disorders across the globe. In 2016 more than 260,000 patients were admitted to hospital for treatment in Germany alone, according to statistics from the Federal Statistics Office.
Initial diagnosis of autoimmune thyroiditis
The fact is that calculations have shown that patients with AIT are 3.5 times more likely to suffer from depression, or 2.3 times more likely to suffer from anxiety. This doesn’t sound like much at first, but as all three disorders are very common it means that patients with AIT account for more than 40 percent of all cases of depression and 30 percent of all cases of anxiety. Dr. Grömer gives a detailed description of the disease in his article.
Blunted Tsh Response And Abnormal Diurnal Rhythm
Depression has been linked to various endogenous circadian rhythms abnormalities such as diurnal mood variation, abnormalities in core body temperature, cortisol secretion, and sleep-wake cycle . In addition to these circadian dysfunctions, depression has been linked to an abnormal diurnal TSH rhythm as well. An absent TSH nocturnal surge has been noted in depression and a lower basal TSH has been reported in major depression as opposed to nonmajor depression . Furthermore, a blunted TSH response to TRH was reported in about 2530% of depressed subjects compared to healthy ones . One preeminent hypothesis to explain the above finding is that chronic TRH hypersecretion associated with depression leads to downregulation of pituitary TRH receptors . In support to this hypothesis are reports of elevated CSF concentrations of TRH in depressed patients .
The prolonged release of TRH in depression may be seen as a compensatory response to the decreased 5HT activity in an attempt to normalize 5HT function and maintain normal levels of thyroid hormones . An alternative explanation is that the blunted TSH response may be induced by the hypercortisolism associated with depression or the elevated thyroid hormone levels mediated by adrenergic mechanisms .
In addition, TRH has been postulated in early studies to have an antidepressant effect.
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It May Affect Ability To Conceive
MedicineNet.com says that although hypothyroidism resulting from Hashimotos disease is not a reason for women to avoid trying to get pregnant, but in some cases, it may lead to trouble conceiving. In addition to careful obstetric care, management of thyroid hormone replacement by an endocrinologist is helpful, adds the source.
It says thyroid hormone levels should be checked before and during pregnancy, so the medication doses can be adjusted if necessary. The target goal is usually within the range for non-pregnant women but at the higher end of the normal range, it adds.
What Can You Do
Remember to eliminate, and then reintroduce and then consume to your tolerance. Some people need to be very strict, other people have some leeway and its important to understand that. Also, to understand that a thyroid condition is not a death sentence, its actually a very manageable condition that should respond well to these therapies, plus or minus medication if you need it. You can live a very healthy, happy, productive life, which is important for people with thyroid problems to hear, because you may have a tendency to be more anxious and depressed. So we dont want to fuel that fire.
The truth actually is that you can be very happy, very healthy and very functional. So hopefully this is a lifeline that will pull you out of any despair you can fall into if youre reading the wrong information on the Internet. So, this is Dr Ruscio with some thoughts on this study Looking at the connection between thyroid autoimmunity, anxiety, depression.
I hope this information helps you get healthy and get back to your life. Thanks.
Need help or would like to learn more?View Dr. Ruscios additional resources
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About Dr Josh Redd Chiropractic Physician Utah Arizona New Mexico Functional Medicine
Dr. Joshua J. Redd, DC, MS, DABFM, DAAIM, author of The Truth About Low Thyroid: Stories of Hope and Healing for Those Suffering With Hashimotos Low Thyroid Disease, is a chiropractic physician and the founder of RedRiver Health and Wellness Center with practices in Utah, Arizona, and New Mexico. He sees patients from around the world who suffer from challenging thyroid disorders, Hashimotos disease, and other autoimmune conditions. In addition to his chiropractic degree, Dr. Redd has a BS in Health and Wellness, a BS in Anatomy, and a MS in Human Nutrition and Functional Medicine. He speaks across the nation, teaching physicians about functional blood chemistry, low thyroid, Hashimotos, and autoimmunity. You can join his Facebook page here.
Why Are So Many Women Experiencing Thyroid Problems
Many factors can interfere with thyroid function, which requires healthy thyroid tissue, the ability to produce adequate amounts of thyroid hormone, conversion of the inactive form of thyroid hormone to its active form , and the effective binding of thyroid hormone to your cellular receptors a key and lock type of effect that activates all of the thyroids activities in your body.
Here are some of the top factors that can interfere with these processes:
Environmental Toxin Exposure and Detoxification Overload: We are living in a veritable sea of environmental toxins about 80,000, in fact, from hormones to heavy metals that can interfere with thyroid function. This toxic burden, which affects us from a very young age, even before we are born, can cause both direct damage and also overloads our ability to detoxify fast enough to keep up. The daily and cumulative impact of these are often overlooked, but they are taking a toll on our thyroid health. Pesticides on non-organic foods, lawn chemicals, personal care products with perfumes, household cleaners, plastics, makeup, water and air pollution all add up in a big way.
Immune System Confusion: Environmental toxins, chronic stress, nutritional insufficiencies, leaky gut, food intolerances, being overweight, and having chronic inflammation are all factors that can lead the immune system to become confused and eventually start to attack our own tissue which is exactly what is happening in Hashimotos.
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Symptoms Of A Thyroid Imbalance
If you suspect you might have some type of thyroid condition, it is important to watch for symptoms. Talk to your doctor if you think that an underlying thyroid condition might be contributing to symptoms of depression, anxiety, or another mental health condition.
Symptoms of hypothyroidism include:
- Weight loss
The Connection Between Hashimotos Disease And Anxiety
Anxiety is extremely common for those woman who have Hashimotos disease. Do you experience bouts of inward trembling, shakes, heart palpitations, Insomnia or an overwhelming sensation of fear that just comes over you?
Suffering from anxiety and Panic Attacks can make you feel like you are being held captive in a place where worry and fear consume your every thought.
Anti-anxiety medicines are often prescribed by traditional medical doctors but science is now discovering that there are many things that can be done naturally to overcome anxiety and panic attacks.
Unfortunately, for too many woman, traditional doctors dont check for Hashimotos and when they do, the treatment only includes the addition of an anti anxiety medication. While this may help get you through a crutch, it doesnt address the Root cause of the anxiety.
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They Share Some Symptoms
As demonstrated above, depression and hypothyroidism are connected in many ways, but it is a little-known fact that they have some other things in common. Did you know that symptoms of depression and hypothyroidism are similar too? Lets check it out.
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The table above shows that not only hypothyroidism and depression have some symptoms in common, but depression is also a symptom of an underactive thyroid gland.
Do Thyroid Hormones Improve Response To Antidepressant Therapy
As mentioned above animal studies have shown that thyroid hormone levels in the brain can influence neurotransmitter concentrations furthermore, antidepressants can influence deiodinase action potentially leading to altered local thyroid hormone concentrations. Therefore, it seems reasonable that thyroid hormones could be used to augment treatment for depression, and this practice has been used for some years. There have been many studies in this area, unfortunately mostly small and with methodological problems. The two main areas of study are: does augmentation of antidepressants with thyroid hormones speed the time to response, and does the addition of thyroid hormones to patients with resistant depression already on antidepressants increase response?
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What Is Hashimoto’s Disease
Hashimoto’s disease is an autoimmune disease where the immune system attacks healthy tissues and cells. In the case of Hashimoto’s disease, your immune system makes antibodies that attack your thyroid gland.
The thyroid gland is vital because it produces hormones that control how your body uses energy. Thyroid hormones help regulate your body’s metabolic functions and keep it functioning normally.
Your thyroid and the hormones it makes affect nearly every organ and cell in your body and control many of your body’s most critical functions.
Hashimoto’s disease, also known as Hashimoto’s thyroiditis,² causes swelling and inflammation of the thyroid gland. White blood cells are a part of the immune system, and Hashimoto’s thyroiditis causes large amounts of white blood cells to build up in the thyroid.
The build-up of white blood cells damages the thyroid and affects thyroid hormone production.
Hashimotos disease and hypothyroidism
Hashimoto’s thyroiditis can lead to an underactive thyroid, known as hypothyroidism.
When your thyroid gland reduces the production of hormones below the normal level, your metabolism and many of your body’s functions slow down. The decrease in levels of thyroid hormones affects nearly every organ in your body and can affect many body functions, including breathing, heart rate, weight, digestion, and mood.
What Happens If I Have Hypothyroidism During Pregnancy
For pregnant women, there is a different thyroid stimulating hormone goal. If your TSH level is not at goal, your provider will likely offer you treatment with synthetic thyroid hormone to protect the safety of your pregnancy and your baby.
Untreated hypothyroidism during pregnancy can increase the risk of miscarriage, premature birth and stillbirth. Or it may cause a dangerous rise in blood pressure in late pregnancy . Untreated hypothyroidism can also affect your babys growth and brain development. Your providers will work with you to make sure your hypothyroidism is under control during your pregnancy.
Hypothyroidism during pregnancy is not common. But sometimes symptoms of hypothyroidism can be overlooked during pregnancy, with its fatigue and weight gain. Let your providers know right away if you notice any hypothyroidism symptoms, or feel like youre developing a goiter.
A note from Cleveland Clinic
In most cases, hypothyroidism can remain well controlled as long as you take your daily medication and get blood tests to adjust the dosage as instructed by your healthcare provider. Eating healthy and getting enough exercise can help you live a long, healthy life with the condition. Your healthcare providers can tell you what steps to take to feel better along the way.
Last reviewed by a Cleveland Clinic medical professional on 06/11/2020.
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