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Alterations in thyroid function tests in major depression.

S Y Wang, S J Shin

    Taiwan Yi Xue Hui Za Zhi. Journal of the Formosan Medical Association
    |February 1, 1989
    PubMed
    Summary
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    The euthyroid sick syndrome, characterized by abnormal thyroid function in nonthyroid illness, was studied in depression. Depressed patients showed reduced total triiodothyronine (TT3) and increased T3 uptake (T3U) and free thyroxine index (FT4I), suggesting a state-dependent phenomenon.

    Area of Science:

    • Endocrinology
    • Psychiatry
    • Clinical Medicine

    Background:

    • The euthyroid sick syndrome (ESS) describes abnormal thyroid function in clinically euthyroid patients with nonthyroidal illnesses.
    • ESS is common in acute and chronic conditions, impacting thyroid hormone levels and metabolism.
    • Understanding ESS in psychiatric disorders like depression is crucial for accurate diagnosis and management.

    Purpose of the Study:

    • To investigate the presence and characteristics of the euthyroid sick syndrome in patients diagnosed with major depression.
    • To compare thyroid function tests in depressed patients with those in normal controls and schizophrenic patients.
    • To determine if observed thyroid abnormalities in depression are reversible upon recovery.

    Main Methods:

    • Radio-immunoassay was used to measure total thyroxine (TT4) and total triiodothyronine (TT3).

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  • T3 uptake (T3U) was assessed using radio-immunoassay, and thyrotropin (TSH) by immunoradiometric assay.
  • Thyroid function was analyzed in 46 major depression patients, 44 normal controls, and 39 schizophrenic patients.

    • Main Results:

    • Depressed patients exhibited significantly lower mean TT3 levels (26% reduction) and higher mean T3U levels (6% increase) compared to controls and schizophrenics.
    • A significant increase in the mean free thyroxine index (FT4I) by 15% was observed in depressed patients.
    • While mean TSH and TT4 levels did not differ significantly, a trend towards higher TT4 was noted. Abnormalities normalized after depression recovery.

    Conclusions:

    • The euthyroid sick syndrome, specifically low T3 and altered T3U/FT4I, is present in major depression.
    • These thyroid function abnormalities appear to be state-dependent, resolving with depression recovery.
    • Findings suggest a potential link between thyroid dysfunction and the pathophysiology of depression.