The Connection Between Hypothyroidism and Depression in Women

October 11, 2023

Approximately 12 million women in the United States experience clinical depression each year.

Depression occurs most frequently in women aged 25 to 44.

Women experience depression at roughly twice the rate of men.

In a world where women often wear many hats – juggling careers, families, and personal aspirations – it’s not uncommon to feel overwhelmed, stressed, or even down from time to time. You’ve all experienced those days when the weight of the world seems to rest heavily on your shoulders, and a cloud of sadness engulfs you. But what if there’s more to it than just life’s ups and downs? What if the source of your depressed moods is due to a connection that affects countless women around the world: the link between hypothyroidism and depression?

Research shows a definite connection between hypothyroidism and depression, and it has been well established that depression is a symptom of low thyroid function. People with depression, anxiety and psychiatric problems often have low levels of thyroid hormone.

Hypothyroidism is a condition in which your thyroid gland doesn’t produce enough thyroid hormone for your body’s needs, or when thyroid hormone isn’t being used efficiently at the cellular level. Subclinical hypothyroidism is defined as low thyroid function that goes undiagnosed because it is below the surface of clinical detection, or has no recognizable clinical findings. Subclinical hypothyroidism is defined as a condition without typical symptoms of hypothyroidism, elevated TSH, and normal circulating thyroid hormone.

Thyroid hormone governs your body’s metabolism and energy production. Without adequate levels of thyroid hormone and its proper utilization, symptoms such as depression, anxiety, mood swings, brain fog and poor concentration become increasingly prevalent.

Symptoms of Hypothyroidism

• Loss of energy (malaise/fatigue)
• Difficulty losing weight
• Weight gain
• Fluid retention
• Enlarged tongue with teeth indentations
• Cold extremities and cold sensitivity
• Cold intolerance
• Difficulty concentrating and short term memory loss
• Muscle pain and cramps
• Joint pain
• Tiredness after a full night’s sleep
• Recurrent and chronic infections
• Decreased mental sharpness, “brain fog”
• Hair loss
• Dry skin
• Brittle fingernails with ridging
• Low basal body temperature
• Elevated cholesterol and triglycerides
• Depression or mood swings
• Constipation
• Menstrual irregularities
• Headaches
• Enlarged thyroid gland

The Relationship Between Hypothyroidism and Depression

Patients with thyroid disorders are more prone to develop depressive symptoms. Today, it is well recognized that disturbances in thyroid function may significantly affect mental status including emotion and cognition. Both excess and insufficient thyroid hormones can cause mood abnormalities, including depression, that is generally reversible with adequate thyroid treatment. Furthermore, thyroid hormones are reported by many to be effective when addressing depression. Primary thyroid disorders, including both hypothyroidism and hyperthyroidism, may be accompanied by various neuropsychiatric manifestations ranging from mild depression and anxiety to overt psychosis. (1)

According to the American Association of Clinical Endocrinologists, “The diagnosis of subclinical or clinical hypothyroidism must be considered in every patient with depression.” Among the various neuropsychiatric manifestations of thyroid disorders, depression remains the most common. (1)

Researchers studied the lifetime history of major depression in 16 people with subclinical hypothyroidism and 15 people whose thyroid function was completely normal. The lifetime frequency of depression was significantly higher in the people who met the criteria for subclinical hypothyroidism (56%) than in those who did not (20%), suggesting that subclinical hypothyroidism may lower the threshold for the occurrence of depression. (2)

The prevalence of depressive symptoms based on Beck’s Scale among subclinical hypothyroidism patients was about 2.3 times higher than those with normal thyroid function. Results showed a significant association of subclinical hypothyroidism with psychiatric disorders and an increased frequency of depression and anxiety symptoms in subclinical hypothyroidism in relation to the group without hypothyroidism. (3)

Findings suggest that suboptimal thyroid function increases vulnerability to the occurrence of depression and represents a risk factor for depression in females. (4) An elevated level of thyroid peroxidase antibodies, as found in autoimmune thyroiditis, was significantly associated with depression. It was concluded that women with autoimmune thyroiditis are especially vulnerable to depression. (7)

“You aren’t depressed because you have low levels of Prozac in your blood.”
-Dr. Steven Hotze

Dangers of Antidepressants

It is common for people with hypothyroidism to be given a misdiagnosis of a psychiatric illness such as depression. People with hypothyroidism may experience any or all of the symptoms of low thyroid function, but will often be misdiagnosed because of a single blood test, the TSH or thyroid stimulating hormone test. Often a person’s TSH blood work is “within the normal range,” so their physician will determine that they are not hypothyroid strictly based on this one lab value. This TSH lab range is so wide that it includes the majority of people. You could be very low in the range, needing treatment, yet conventional doctors will only see you as being in the so-called normal range and dismiss a diagnosis of hypothyroidism.

Unfortunately, this scenario often leads to the prescription of antidepressants. We strongly caution against the use of antidepressants. These drugs are dangerous because they are addictive and have many negative side effects, including more depression, and homicidal and suicidal tendencies.

In 2004, the Food and Drug Administration (FDA) issued a black-box warning on antidepressants indicating that they were associated with an increased risk of suicidal thinking, feeling, and behavior in young people. (5) The FDA conducted a series of meta-analyses of 372 randomized clinical trials of antidepressants involving nearly 100,000 participants, which showed that the rate of suicidal thinking or suicidal behavior was 4% among patients assigned to receive an antidepressant, as compared with 2% among those assigned to receive placebo. (6)

If you are currently taking an antidepressant, please do not stop it abruptly – you must work with your doctor to wean off of it slowly and safely. A great resource is “The Antidepressant Solution: A Step-by-Step Guide to Safely Overcoming Antidepressant Withdrawal, Dependence, and ‘Addiction” by Dr. Joseph Glenmullen.

Effective Treatment of Depression Caused by Hypothyroidism with Compounded Thyroid (T3 and T4)

In our practice, our providers have had great success in treating the symptoms of hypothyroidism with compounded thyroid, both T3 and T4, the active and inactive thyroid hormones. We find that most patients on Synthroid (T4 only) don’t get a resolution of their symptoms.

In patients treated with T4, psychological symptoms may persist even when they achieve a normal thyroid lab value. This study is the first evidence to indicate that patients on thyroxine (T4 only) replacement with a normal TSH display significant impairment in psychological well-being compared to people of similar age and sex. (1, 8) It is important to note in one study that therapy with levothyroxine (T4) alone was not sufficient to induce a total remission of depressive symptoms. (1)

One research study compared the effects of thyroxine (T4) alone with those of thyroxine (T4) plus triiodothyronine (T3) in 33 patients with hypothyroidism. Among 17 scores on tests of cognitive performance and assessments of mood, 6 were better or closer to normal after treatment with thyroxine plus triiodothyronine. Similarly, among 15 visual-analogue scales used to indicate mood and physical status, the results for 10 were significantly better after treatment with thyroxine plus triiodothyronine. In patients with hypothyroidism, partial substitution of triiodothyronine (T3) for thyroxine (T4) may improve mood and neuropsychological function. (9)

Remember, the root cause of depression does not lie in an antidepressant deficiency. Treating depression lies in treating the underlying cause, which can often occur with a decline in your thyroid function.

Symptom Checker

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At the Hotze Health & Wellness Center, we are here to partner with you and help you get on a path of health and wellness naturally, so that you can live your best life! Contact our Wellness Consultants at 281-698-8698 for a complimentary consultation. It will be our privilege to serve you!

Related Content
How to Beat Depression After a Hysterectomy: Rose’s Story
4 Ways to Diagnose Hypothyroidism: What Your Doctor Doesn’t Know

Research

1. The Link Between Thyroid Function and Depression

2. Subclinical Hypothyroidism: A Modifiable Risk Factor for Depression?

3. Subclinical Hypothyroidism: Psychiatric Disorders and Symptoms

4. Relationship Between Thyroid-Stimulating Hormone Levels and Risk of Depression Among the General Population with Normal Free T4 Levels

5. Antidepressants’ Black-Box Warning – 10 Years Later

6. Review and Evaluation of Clinical Data: Relationship Between Psychotropic Drugs and Pediatric Suicidality

7. Are Autoimmune Thyroid Dysfunction and Depression Related?

8. Psychological Well-Being in Patients on ‘Adequate’ Doses of L-Thyroxine: Results of a Large, Controlled Community-Based Questionnaire Study

9. Effects of Thyroxine as Compared with Thyroxine Plus Triiodothyronine in Patients with Hypothyroidism

Categories: Antidepressants, Blog, Blog English, Depression, Hypothyroidism

Tags: depression, Hypothyroidism, Hypothyroidism - Depression, hypothyroidism causes depression

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