The HYPOthyroid and anxiety connection...

I think that most everyone knows about the connection between being HYPERthyroid and having anxiety. What seems to be not as well known, in the medical community especially, is the connection between having anxiety and being hypothyroid. I have been interested in this from a personal stand point, I will admit. I have had thyroid issues for years. For a long time, I went undiagnosed and untreated for thyroid disease, specifically, Hashimotos thyroiditis, which is an autoimmune condition. In Hashimotos , the thyroid gland is slowly attacked by the immune system, resulting in hypothyroid disease. What I did not know at the time of onset of my Hashimotos, was that my body was most likely experiencing surges of thyroid hormones that could cause a temporary hyperthyroid state. These surges of thyroid hormones can produce anxiety and depression. A patient can have one or both of these mood disorders. To be honest, I have never had true depression ( depression lasting days or not caused by a traumatic life event) but I have really struggled with anxiety issues.

Many doctors are pretty quick to prescribe antidepressants, and other medications for anxiety and/or depression. I am not going to discuss depression, except to say that if one has depression, it would be prudent to have a physician check TSH, T3, T4 and reverse T3 at least, in order to rule out thyroid disease that may be causing the depression. It may be that thyroid hormone supplementation could be enough to treat the depression. Or perhaps, treating the thyroid disorder with thyroid hormone could enable the prescriber to use a smaller dose of an antidepressant. There should be no stigma with having mental health issues, but if these disorders are caused by a thyroid function problem, it makes perfect sense to treat that first. Then if other medications are needed, those can be discussed a little later. I will mention that other therapies- talk therapy, exercise, meditation,etc. have been shown to improve depression and anxiety, so I think these are valuable options that should be explored before prescribing medications.

Back to anxiety. My endocrinologist, whom I really like, by the way, does not buy into the hypothyroid and anxiety connection. I have searched for medical articles on this subject, as well as talking to others who are hypothyroid and are having to deal with anxiety. The best article that I have found so far, is an article in the Indian Journal of Endocrinology and Metabolism, 2016, Jul-Aug; 468-474. This was a very small study, and the authors freely admit that because of the size of the study( 100 patients), their results could not be considered conclusive. Still, this study has given me some insight and I think some hope. This study also cited that females who were hypothyroid experienced anxiety more than males in the study. One thing is certain: thyroid hormone and thyroid  function affects the central nervous system throughout a patient's entire life. I will not get too technical here, but thyroid hormone affects the development and action of neurons, the release of serotonin,as well as activity in the brain. Exactly how  thyroid hormone affects brain activity is not yet understood. The fact that thyroid hormone does indeed affect brain activity seems to explain the problems in mood in hypo and hyper thyroid patients. One finding of this study hit a nerve with me. And it reads as follows: " Moreover, an early recognition of an endocrine condition will help minimize psychiatric morbidity and hence improve health ." The important words in this sentence, to me anyway, are EARLY RECOGNITION.

In my opinion, or if you watch public television, IN MY HUMBLE OPINION( IMHO), now that the connection between anxiety and being hypothyroid has been established, how is anxiety treated? Well, there are several medications that can be used. Remember, we are talking about anxiety here, not depression. For those people who have both, using an antidepressant medication along with proper thyroid replacement therapy and hopefully more holistic methods( as mentioned above) may be the answer. If a patient is having anxiety only, there are medications that may offer some help, but they come with several side effects. These are the benzodiazepines ( Valium, Xanax, Ativan,etc), and  beta blockers, to name a few. Holistic treatments mentioned above  may also help with anxiety. I think that knowing what may trigger an anxiety attack and taking action quickly to resolve the feeling of anxiety may be helpful. I did not say it would be easy, just that it  may be helpful.

If one has anxiety, I think that the take away from my blog is that thyroid function testing is a very necessary place to start. Early detection and treatment is  the key to better health. Be your own best patient advocate. If you feel that you have a thyroid problem and your physician will not do the necessary tests, seek another opinion. Keep your test records- they belong to you and you have a right to have copies of them. Keeping records enables you to see for yourself the changes in thyroid hormone levels from one year to the next. There is indeed a hypothyroid/ anxiety connection. Seek treatment and know that you are not alone.