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Can Thyroid Dysfunction Be the Cause of Depression? (July 11, 2012)

When the thyroid gland doesn’t produce enough of its essential hormones, it can cause serious depression. This condition is known as hypothyroidism and is tied in with a wide range of health and metabolic problems. It can make a person feel tired and slow, produce coldness or tingling in the hands and feet, and severely depress the mood. There’s even evidence that patients who have already been diagnosed with depression are much more likely to also have hypothyroidism than people with normal moods.

Problems with Testing

In a study produced in 2004, almost 40 percent of older patients who had been diagnosed with hypothyroidism also dealt with depression symptoms. Despite the known association between the two conditions, however, many people don’t get treatment. This is in part because patients with hypothyroidism often don’t receive a timely diagnosis. They may not be tested for thyroid problems. If they do get a blood test, fluctuations in thyroid hormone levels may cause tests to read as normal. A normal test result doesn’t always mean normal thyroid function. Even the smallest deviation from correct function could cause serious problems. People with minor under-activity of the thyroid gland are considered to have sub-clinical hypothyroidism, a problem that can be hard to diagnose but which can cause significant cognitive function and mood problems. Many of the symptoms of this problem are similar to those of full-blown hypothyroidism, but the condition itself is hard to diagnose.

Who Gets Hypothyroidism?

In general, women are more likely to develop both ordinary hypothyroidism and sub-clinical conditions. Estimates vary across a wide range, due to the fact that different doctors use different normal ranges for thyroid hormone. Anywhere from 2 to 7.5 percent of women may suffer from an under-active thyroid gland. Even mild versions of this problem can get worse over time. Somewhere between five and 15 percent of people who have been diagnosed with sub-clinical thyroid problems will later develop clinical hypothyroidism. Some scientists believe that this percentage is even higher, and that true hypothyroidism is under-diagnosed People with the sub-clinical condition are also more likely to suffer from symptoms of depression than those who have normal thyroid hormone levels.

Getting Tested

Doctors recommend that all people who suffer from depression should be tested for proper thyroid function, since treating the depression itself won’t remove the underlying problem in patients with hypothyroidism. Thorough testing can help doctors to identify people who could receive more benefit from thyroid treatment than from conventional depression medications. Any time a patient’s test shows even a slight underproduction of thyroid hormone, some kind of treatment should be included in the overall program targeting the depression. This allows patients to get the most out of their medical and psychiatric care. Thorough testing involves identifying the major symptoms of low thyroid levels. These can include sensitivity to cold, tiredness or dizziness, and puffiness in the face. The hands and feet may tingle or feel numb. Many people with under-active thyroid glands also have dry skin, loss of hair, and weight gain. They may suffer from breathing problems and a slow pulse. Patients also often have a low body temperature and low blood pressure. They may be infertile or suffer from multiple miscarriages. Not everyone suffers from the full list of symptoms, so people with even a few of these problems should request a test.

Thyroid Tests

The first test can be performed at home; patients should monitor their morning temperature for at least five days in a row. Blood tests for proper thyroid function include Thyroid Profile, TSH, Free T3, Free T4, and Thyroid Peroxidase (TPO) Antibodies.  In cases where additional confirmation is required, doctors may request a round of tests to measure other hormone function and to rule out other problems that might produce the same symptoms. If the results come back normal, but a patient still feels as though thyroid function is the problem, it may be necessary to get a second opinion. Patients should also request the specific test numbers whenever possible rather than relying on the doctor’s opinion, since the “normal” thyroid hormone range can be a controversial subject.