HEALTH NEWS

Is Sluggish Thyroid Function Stressing Your Mood?

By Dr. Linda J. Dobberstein, DC, Board Certified in Clinical Nutrition

January 20, 2020

Depression or anxiety - how many times have you been told “it’s all in your head”? Or that your poor mood is a result of “stinking thinking” or a bad attitude? The reality is that mood changes happen for numerous reasons other than attitude. One factor that significantly affects your mood and well-being is your thyroid. Studies show a strong inter-relationship exists between autoimmune thyroid disorders, subclinical hypothyroidism, and primary hypothyroidism and mood disorders of depression and anxiety. Understanding this concept can help you make more informed choices for a healthier mood and well-being.

Thyroid Dysfunction or Stressed Mood?

Diminished thyroid function consists of a constellation of symptoms that affect the whole body. Symptoms of low thyroid function include fatigue, weight gain, poor concentration, depression, muscle pain, menstrual irregularities and constipation. As things deteriorate further, there may be hair loss, dry skin, loss of libido, and weakness. Sometimes, though, there may not be a lot of symptoms. It may just be depression, anxiety and fatigue.

At a quick glance, your provider might think that you have a mood disorder. Without further evaluation, you get a prescription for the latest antidepressant or anti-anxiety medication and/or a referral to the psychiatrist. However, your post-holiday or winter blues, or more chronic complaints of depression, listlessness, poor motivation, and/or anxiety, may be related to a thyroid system that is under duress and not working well.

Thyroid Dysfunction Linked with Depression and Anxiety

Thyroid dysfunction is a recognized cause of depression and anxiety, but may be missed with only thyroid stimulation hormone (TSH) testing. Individuals who have a diagnosis of depression or anxiety may actually have unrecognized autoimmune thyroid concerns or subclinical hypothyroidism. Persistent depression and anxiety may also occur if one is on inadequate support for thyroid failure or primary hypothyroidism. Several studies show the interrelationship between mood and thyroid disorders indicating a need to look beyond the TSH lab score.

Look at the Whole Picture – More Than Just TSH

A 2015 study showed thyroid antibodies were significantly elevated in women with major depression. The study evaluated 47 women with depression. Several thyroid markers were tested include TSH, free T3, free T4, and antibody levels with thyroid peroxidase antibodies, thyroglobulin antibodies, and thyroid stimulating hormone (TSH) receptor antibodies along with an immune inflammatory marker IL-17.

Results showed that of all the markers tested, everything was normal – except TSH receptor antibodies were significantly higher. This indicated that these individuals experienced autoimmune thyroid inflammation, which interfered with healthy thyroid function. The study concluded that “TSH receptor antibodies might be a biomarker of immune dysfunction in depression”.

A JAMA Psychiatry 2018 systematic review and meta-analysis study evaluated 19 studies with 36,174 participants with depression and/or anxiety. Individuals who had autoimmune thyroiditis, Hashimoto’s thyroiditis, or subclinical hypothyroidism had much higher prevalence and risk of depression and anxiety compared to individuals with healthy thyroid function. It was concluded that it was better to focus on thyroid health and not just psychotherapeutic treatment with symptoms of depression and anxiety.

Even in the most severe states of depression in which there is attempted suicide, thyroid concerns exist. Elevated levels of TSH, antithyroglobulin (TgAb) and thyroid peroxidase antibody (TPOAb) were found in individuals with severe major depression and suicide attempt. This December 2019 study suggested that these thyroid markers should be evaluated in anyone with depression and may be biomarkers for assessing suicide risk.

The Link between T3 Thyroid Hormone and Mood Neurotransmitters

A close relationship exists between thyroid hormone levels and the neurotransmitters serotonin and noradrenaline – which is affected by dopamine. T3 thyroid hormone controls the amount and action of serotonin and noradrenaline. Decreased T3 levels can cause reduced levels of serotonin and noradrenaline, which can lead to depression and anxiety. As T3 circulates throughout your body, it is thought to act like a neurotransmitter, affecting serotonin and noradrenaline levels and function.

Serotonin lack may lead to loss of pleasure and enjoyment in hobbies, interests, foods, friends and relationship, sadness with dark, gloomy weather, inability to fall into a deep restful sleep, sensitivity to pain, and even unprovoked anger and paranoia.

Dopamine (noradrenaline) lack may cause isolation, lack of concern for others, inability to finish tasks, irritation and anger, inability to handle stress, feelings of worthless, hopelessness, and thoughts of self-harm. Decreased levels of serotonin and noradrenaline/dopamine may affect body temperature and cold weather tolerance.

Concerns Impact Millions

Thyroid disorders affect women 8 – 9 times more than men. Women between 30-50 years are more likely to experience thyroid concerns but an estimated 4 percent of women age 18-24 and 21 percent over the age of 74 are likely to have a thyroid that no longer functions or have been diagnosed with primary hypothyroidism. Centers for Disease Control states that an estimated 50 percent of all Americans will have concerns with mental health at some point in their lifetime. Depression is the third most common cause of hospitalization in young and middle age adults.

Different Types of Thyroid Disorders

Primary hypothyroidism is failure of the thyroid gland and requires lifelong thyroid hormone replacement therapy. Autoimmune thyroid disorders and/or iodine deficiency are considered the most common causes of hypothyroidism.

Subclinical hypothyroidism is an early sign that thyroid function is failing. The thyroid gland is still able to produce thyroid hormone but is exhausted and falling behind with its job. In subclinical hypothyroidism, TSH levels are slightly above reference range with normal levels of free T4 or thyroxine.

Autoimmune thyroid disorders reflect the immune system attacking the thyroid gland, hormone, or receptor sites. Elevated antibody levels may occur several years before the thyroid gland fails or develops hypothyroidism that requires lifelong medication.

Other concerns strongly coexist with thyroid and mood changes. These include sleep apnea, metabolic syndrome, and acute stress.

Nutrition Needed for Healthy Thyroid Function

Your brain sends signals to the thyroid gland via a hormone called TSH – thyroid stimulating hormone to make thyroid hormone. T4 thyroid hormone is the primary hormone. T4 is then converted into T3 primarily by your liver, gut, and muscles. Activated (free) T3 then travels throughout the body and is received by receptor sites by all cells for metabolism. Your muscles and physical activity play a critical role in T3 activation.

In addition, you need several nutrients for thyroid hormone activation and its cascade of effects with mood and physiology.

Adrenal and Mitochondrial Nourishment Essential for Thyroid

Adrenal gland function and mitochondria need adequate nutritional nourishment as their function interplays with thyroid physiology. A diet rich in a wide variety of nutrient dense foods from organic, complex carbohydrates, quality fats, and proteins and other nutrients provide vital nourishment and complement thyroid support. These same nutrients are also used to support a healthy mood.

Your thyroid also needs support against excess oxidative stress and free radicals that triggers immune dysregulation and tissues destruction. Oxidative stress may come from infections, gut problems, toxins in the environment like BPA and other bisphenols, other plastics and plasticizers, heavy metals, EMF and wireless technology, leptin resistance, gluten intolerance, soy intake, other illness and more. Consider super foods rich in fiber, blue, green, red, and orange colors, and cruciferous veggies.

Your mind and body needs nourishment along with rest and exercise to be able to work at its best. If you struggle with mood, make sure your thyroid gets its due share of support.

Here are some additional resources concerning thyroid and mood.