Your Psychiatric Illness May Be Caused By A Minor Glandular Issue

If you've been treating your mood disorder with antidepressants but haven't experienced much relief, doctors may have found a solution: A psychiatric illness isn't the root of your problem. For some people issues like depression and anxiety may actually be caused by thyroid imbalances so slight that doctors may not even think that they need to be treated.

The New York Times reports that Dr. Russell Joffe, a North Shore-Long Island Jewish Health System psychiatrist, has concluded that treating patients for subclinical thyroid problems can sometimes make their psychiatric issues disappear. The thyroid gland produces two hormones that regulate various functions in the body, including body temperature, heartbeat, and cognitive functioning. When someone produces way too much of the hormones, a condition known as hyperthyroidism, their metabolism speeds up and they experience symptoms like sweating, weight loss, and anxiety. Alternately, hypothyroidism leads to fatigue, weight gain, sluggishness. The problem is that what's considered a normal horomone level can vary, and doctors might not consider the problem worth medicating if your numbers are only slightly off. Yet, even if your blood test results don't set off any alarms, they could be causing mood and cognitive symptoms.

Experts have known about the connection between malfunctioning thyroids and mental health issues for some time, but it's controversial. Jennifer Davis, assistant professor of psychiatry and human behavior at Brown University, says, "It's the chicken-and-egg question. Is there an underlying thyroid problem that causes psychiatric symptoms, or is it the other way around?" Doctors may also be holding off on treatment because thyroid problems are more common in women, especially after 50. Sometimes, even when a patient has somewhat abnormal thyroid levels and complains about feeling out of sorts, doctors chalk it up to the well-known fact that ladies are moody and ridiculous. "There's a terrible bias against women who come in with subtle emotional complaints," says Dr. Davis. "These complaints tend to be pushed aside or attributed to stress or anxiety."

Some doctors are hesitant to prescribe medication for minor cases of hypothyroidism because the hormone treatment can lead to heart problems and osteoporosis in women. However, Joffe says other doctors need to start taking into account the "quality-of-life issues related to residual depression and anxiety." After struggling with psychiatric illness for years, some patients have had all of their mental health issues clear up when they started popping pills of the levothyroxine rather than Prozac. The synthetic thyroid hormone probably won't be a miracle cure for most people, but if you suspect you may have an undetected issue, it's probably worth the risk of getting the side-eye from your doctor when you tell her you believe you have a condition you read about on the internet.

For Some, Psychiatric Trouble May Start in Thyroid [NYT]

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