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Hypothalamic-Pituitary Axis

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The response to stress—be it physical or psychological, acute or chronic—involves activation of the Hypothalamic-Pituitary-Adrenal (HPA) axis. The HPA axis is part of the neuroendocrine system because it involves both neuronal and hormonal communication. Its function is to regulate homeostatic systems—metabolic, cardiovascular, and immune—providing the necessary means to respond to a stressor.

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Anxiety is a common mental disorder featuring excessive worry, fear, and apprehension, significantly affecting daily life. People with anxiety disorders experience persistent and intense anxiety, interrupting their everyday functioning.
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Related Experiment Video

Updated: Feb 20, 2026

Social Isolation Model: A Noninvasive Rodent Model of Stress and Anxiety

Social Isolation Model: A Noninvasive Rodent Model of Stress and Anxiety

Published on: November 11, 2022

Hypothalamic-pituitary-thyroid (HPT) axis functioning in anxiety disorders. A systematic review.

Susanne Fischer¹, Ulrike Ehlert¹

¹Clinical Psychology and Psychotherapy, Institute of Psychology, University of Zurich, Zurich, Switzerland.

Depression and Anxiety

|October 25, 2017

Summary

Anxiety disorders frequently co-occur with thyroid disorders. This review found evidence of subtle thyroid dysfunction, suggesting routine thyroid screening for anxiety patients is warranted.

Keywords:

Graves’ disease Hashimoto's thyroiditis anxiety hypothalamic-pituitary-thyroid axis panic disorder phobia

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Last Updated: Feb 20, 2026

Social Isolation Model: A Noninvasive Rodent Model of Stress and Anxiety

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Using the Threat Probability Task to Assess Anxiety and Fear During Uncertain and Certain Threat

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Reducing State Anxiety Using Working Memory Maintenance

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Published on: July 19, 2017

Area of Science:

Endocrinology
Psychiatry
Neuroscience

Background:

Subclinical hypothyroidism is linked to depression, yet thyroid dysfunction in anxiety disorders is less understood.
Anxiety symptoms like palpitations and nervousness are common in hyperthyroidism, indicating a potential link.

Purpose of the Study:

To systematically review the literature on hypothalamic-pituitary-thyroid (HPT) axis functioning in anxiety disorders.
To synthesize findings on the comorbidity and HPT parameters in individuals with anxiety.

Main Methods:

Systematic literature search of PubMed and PsycINFO databases.
Inclusion of comorbidity, case-control, and correlational studies.
Risk of bias assessment using a standardized quality rating.

Main Results:

Twenty studies were eligible, with nearly all confirming significant comorbidity between anxiety and thyroid disorders.
Half of the studies indicated subtle thyroid dysfunction, showing blunted TSH responses to TRH and an inverse anxiety-TSH relationship.
HPT assessments were generally well-conducted, though adjustments for smoking, BMI, and depression were often lacking.

Conclusions:

The findings support routine thyroid disorder screening in patients with anxiety disorders.
Evidence suggests a connection between thyroid function and brain interactions relevant to anxiety.
Further high-quality, longitudinal research is needed to clarify HPT axis functioning in anxiety.