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Hypothyroidism and Depression: A Narrative Review.

Surya P Nuguru1, Sriker Rachakonda2, Shravani Sripathi3

  • 1Internal Medicine, Kamineni Academy of Medical Sciences and Research Center, Hyderabad, IND.

Cureus
|August 25, 2022
PubMed
Summary

Hypothyroidism is strongly linked to depression, particularly when undiagnosed or untreated. Treating thyroid dysfunction with thyroid replacement therapy can significantly improve depressive symptoms and aid treatment-resistant depression.

Keywords:
depressiondepression in hypothyroidismhypothyroidismlevothyroxinesubclinical hypothryroidismthyroid peroxidase antibodiesthyroid replacement therapytreatment-resistant depression

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Area of Science:

  • Endocrinology
  • Psychiatry
  • Neuroscience

Background:

  • A well-established link exists between hypothyroidism and depression.
  • Neurotransmitters like serotonin and somatostatin influence the hypothalamus-pituitary-thyroid axis, connecting thyroid function to mood disorders.
  • Autoimmune thyroiditis is also correlated with an elevated risk of depression.

Purpose of the Study:

  • To review and strengthen the evidence linking hypothyroidism and depression.
  • To highlight the benefits of treating hypothyroidism in patients with depression.
  • To explore the role of thyroid hormones and antibodies in mood regulation.

Main Methods:

  • Literature review of studies investigating the relationship between hypothyroidism and depression.
  • Analysis of the influence of thyroid hormones and antibodies on mood.
  • Examination of treatment outcomes for hypothyroidism in patients with depression.

Main Results:

  • Undiagnosed, untreated, or undertreated hypothyroidism increases depression risk.
  • Elevated thyroid-stimulating hormone (TSH), antithyroglobulin (TgAb), and thyroid peroxidase antibodies (TPOAb) are associated with depression and suicide risk.
  • Hypothyroidism is a significant cause of treatment-resistant depression.

Conclusions:

  • Treating underlying hypothyroidism with thyroid replacement therapy can substantially improve depression.
  • Levothyroxine serves as an effective adjunctive therapy for depression, offering rapid symptom improvement.
  • Addressing hypothyroidism is crucial for managing depression and improving patient outcomes.