Thyroid Disorders and Mental Health

Thyroid is a small butterfly shaped gland situated in the anterior region of neck. It is one of the most important glands in the body for physical and mental health. It has a direct impact on emotions, cognitions, mental processing, sleep, metabolism, weight, reproduction, and general wellbeing of an individual.  Its function is determined by values of three hormones in the blood namely FT3, FT4 and TSH. Suboptimal thyroid function is called hypothyroidism and excessive thyroid function is known as hyperthyroidism. Both are disorders and need treatment. About 2 to 11 percent of general population suffer from either of the two thyroid disorders during their lifetime. The risk is more in females and increases with growing age.

Thyroid disorders and mental health are closely related to each other. The associations are multi-fold.

1. High prevalence of thyroid disorders in patients with mental illnesses.
2. High presence of mental illnesses in patients of thyroid disorders.
3. Few of the medication used for mental illnesses may lead to thyroid dysfunction in longer run.
4. Both are comorbid in people having chronic stress.
5. Both disorders run in families; both have high genetic inheritance.
6. Both are chronic and disabling, if not treated properly.
7. Both can remain undetected, especially if mild, for many years leading to complications later.
8. Both have remarkably similar clinical presentation; both have overlapping symptoms.

Percentages from global data to substantiate the above statements –

1. Hypothyroidism is detected in 20 percent of depressed patients.
2. Prevalence of depression and anxiety is as high as 50 percent and 40 percent in hypothyroid patients, respectively.
3. In a study, 30 percent of patients having schizophrenia had abnormal thyroid function.
4. In the same study, about 25 percent individuals with Mood Disorders were found to have some thyroid dysfunction.
5. Anxiety is found in 60 percent of patients with hyperthyroidism.
6. Depression is as high as 60 percent in hyperthyroid patients.

Some of the common features present in both thyroid disorders and mental illnesses are –

Depressed mood	Aggression
Irritability	Hallucinations
Fatigue	Sleep disturbances
Poor memory	Appetite changes
Poor attention and concentration	Constipation
Unspecific nervousness	Weight gain or weight loss
Headaches & Bodyaches	Menstrual irregularities
Ghabrahat	Premenstrual tension
Palpitations	Reduced sexual desire

Dos and Don’ts for patients who have both Thyroid Disorder and Mental Illness –

1. See a doctor, get yourself tested and start your thyroid pill at the earliest. Your doctor is the best judge of the starting dose for you. Please remember to follow up with your doctor regularly and to get your thyroid hormones tested at least 4 times in a year (once a quarter). The strength of the pill may need modification as the time passes, which is best decided by looking at the patient’s clinical response and the most recent blood report.
2. Take your thyroid pill daily without fail. Taking it daily helps in replenishing the hormone in the body for those 24 hours only. Keep taking it regularly till your doctor suggests that it is now ok to stop it.
3. Do not increase or decrease the dose by yourself without consulting your doctor.
4. It is important to take the pill at the same time every day for most effective treatment. Besides, taking the same brand also helps in maintaining the hormone levels at a steady state.
5. If there are chances, that you may forget if you took the dose today or not, you may want to keep your pills in a pill box marked for each day of the week. Keep the pill box away from children in a place where you can see it often.
6. Seeking help for psychiatric problems along with thyroid issues makes the treatment response quicker and better. Most of the times, combining both the medicines is the best way to lead a healthy happy life.
7. Speak to your doctor openly and honestly, have faith in the treatment and move on! All patients benefit from the medicines, but some may have unintended side effects at some time during the treatment. It is the responsibility of both the patient and the doctor to be mindful of the side effects so that the benefits of the medicines outweigh their side effects.

Wishing you the best of mental health today and always!

Dr Apala

Please note that starting, stopping, or changing the treatment without consulting a doctor is not at all recommended. This post is for information purpose only.  Consult a doctor for medical advice, diagnosis, and treatment.