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Thyroid stimulating hormone levels hypothyroidism and depression: TSH cut off point based on depression in hypothyroid patients

Thyroid imbalances can also contribute to mood problems such as depression and anxiety. Competing interests The authors declare that there is no conflict of interest regarding the Publication of this article.

David Stewart
Thursday, October 26, 2017
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  • Thyrotropin-releasing hormone regulates the number of its own receptors in the GH3 strain of pituitary cells in culture. Archives of General Psychiatry.

  • Fatemeh Rafiei is a Statistician.

  • Taking Antidepressants During Pregnancy. British Medical Journal.

  • Google Scholar.

Background

Related Articles. NR is responsible for the data collection, design of the study and performing BDI questionnaire review and supervising the patients. Inadequate levothyroxine replacement for primary hypothyroidism is associated with poor health-related quality of life-a Brazilian multicentre study. TSH reference range in older adults: a Brazilian study. Many patients in spite of being euthyroid present with symptoms such as sleep disorders, fatigue, and depression in particular [ 15 ].

Joffe RT, Singer W. Eur Thyroid J. Sometimes thyroid conditions are misdiagnosed as these mental health conditions. Hormone supplementation for a thyroid condition can be related to depression.

The 5-HT deficiency theory of depression. Thyroid hormones play a significant role in brain development. Indian J Endocrinol Metab. The subjects were patients referred to endocrine clinics, who had developed a euthyroid state under levothyroxine treatment Euthyrox, Merck Company with a TSH level of 0. Inadequate levothyroxine replacement for primary hypothyroidism is associated with poor health-related quality of life-a Brazilian multicentre study. In fact, several studies have confirmed the existence of classical feedback between the serotonergic and HPT systems.

Download citation. Your Email Address:. For some people, treating the underlying thyroid imbalance can relieve depression. As mentioned earlier, no TSH reference range can fit all ages, races, or sexes. What's the Connection Between Alcohol and Depression?

1. Introduction

Intra- and inter-assay coefficients of variation CV were 3. Nasrin Rafee is an Internist. These symptoms might be related to deiodinase II [ 17 ] or brain thyroid hormones transporter genes such as organic anion-transporting polypeptide I OATP-C1 polymorphisms [ 18 ].

Hypothhyroidism of imipramine antidepressant activity by thyroid hormone. Skip to main content. In such cases, it can be helpful to look at some of the other symptoms that may indicate the presence of underactive thyroid. Prange AJ, Jr. To the best of our knowledge, no TSH cut-off value has been established for depression diagnosis. Psychiatr Pol.

ALSO READ: Immunoserology Tests For Hypothyroidism

It seems that there are analogous mechanisms leading to the similarity of symptoms in hypothyroidism and depression [ 19 ]. Eur Thyroid J. Related Articles. Article PubMed Google Scholar Dayan CM, Panicker V. Other types of thyroid disorders and problems include Hashimoto's disease, Graves' disease, goiter, and thyroid nodules.

Ali Chehrei is a Pathologist and Statistician. Talk to your doctor if you think that an underlying thyroid condition might be contributing to symptoms of depression, anxiety, or another hypothyridism health condition. Results The participants were thyroid stimulating hormone levels hypothyroidism and depression patients Female; Nevertheless, there are still unresolved disagreements about the standard upper limit of TSH [ 13 ]. Inadequate levothyroxine replacement for primary hypothyroidism is associated with poor health-related quality of life-a Brazilian multicentre study. Abstract Background: The aim of our study was to evaluate the prevalence of thyroid abnormalities among depressed outpatients and to examine the response to treatment of those subjects with relatively low or high thyroid hormone levels. Based on the assessment of depression, our study concludes that a TSH cutofff value of 2.

Publication types

Endocr Pract. Post Comment. Reference interval for thyrotropin in a ultrasonography screened Korean population. Endocr Res. Correspondence to A Talaei.

Download references. Clin Biochem. Brain Res Bull. Published : 07 September

  • Patients with thyroid disorders are more prone to develop depressive symptoms and conversely depression may be accompanied by various subtle thyroid abnormalities. Clin Biochem.

  • Tags: DepressionThyroid.

  • The evidence for a narrower thyrotropin reference range is compelling. Triiodothyronine augmentation in the treatment of refractory depression: a meta-analysis.

Reference ranges of serum TSH, FT4 and thyroid autoantibodies in the Thai population: the national health examination survey. Google Scholar Eur Thyroid J. Article Google Scholar Related Articles.

In addition, thyroid hormone supplements appear to accelerate and enhance the clinical response to antidepressant drugs. All authors read and approved the final version of the manuscript. J Clin Endocrinol Metab. Subclinical hypothyroidism after I-treatment of Graves' disease: a risk factor for depression. Joffe RT, Singer W. Jackson IMD.

Symptoms of hypothyroidism include:. Zoeller RT, Rovet J. Reference ranges of hypothyriodism TSH, FT4 and thyroid autoantibodies in the Thai population: the national health examination survey. Article Google Scholar. Most people with thyroid problems experience positive benefits from taking thyroid medication and feel that their depressive symptoms gradually resolve with time.

Whether this is related to clinical recovery or merely a result of a direct effect of antidepressants remains to be determined. Ali Chehrei is a Pathologist and Statistician. Azar: bl. If any of these components become impaired, it may have an impact on the thyroid's ability to signal the brain. On the other hand, meta-analyses of seven studies showed TSH to be negatively correlated with depression and total T4 to be positively related to a depressed mood [ 35 ].

The relationship between hypothyroidism and depression has been confirmed in previous literature [ 19 ]. Support Center Support Center. However, this was consistent with chance after adjustments were done for social class, alcohol, and smoking behaviors. Taking Antidepressants During Pregnancy.

Forgetfulness, fatigue, mental slowness, and emotional lability have been shown as some psychological symptoms of hypothyroidism. Thyroid hormone transport in and out of cells. This article has been cited by other articles in PMC. The relationship of anxiety and depression to symptoms of hyperthyroidism using operational criteria. In severe forms of hypothyroidism, clinical symptoms may mimic that of melancholic depression and dementia [ 12 ]. Kirkegaard C, Faber J. Researchers have studied numerous herbs, supplements, and vitamins to determine if they can benefit people with depression.

Panminerva Med. PMID: Also, the findings showed that a TSH cut-off point of 2. Indian J Med Res. Thyrotropin-releasing hormone TRH is constantly inhibited by serotonin.

Funding Not applicable. And follow us on Twitter This theory is in accordance with the theory of serotonin deficiency in depression [ 11 ]. The patients were evaluated in terms of depression by BDI. About this article.

Can You Overdose on Serotonin? Thyroxine T4 Studies examining total and free plasmatic T4 levels in patients with depression have shown inconsistent results. Improvement in jormone depression with decreased thyrotropin response after administration of thyrotropin-releasing hormone. Article PubMed Google Scholar. Brain Res Bull. Prevalence of anxiety and depressive symptoms among patients with hypothyroidism. An alternative explanation is that the blunted TSH response may be induced by the hypercortisolism associated with depression or the elevated thyroid hormone levels mediated by adrenergic mechanisms [ 6061 ].

Increased levels of TRH in cerebrospinal fluid from patients with endogenous depression. A few studies have been performed to assess the changes in cerebral perfusion and metabolism in patients with hypothyroidism particularly those with Hashimoto's thyroiditis or status post-thyroidectomy for thyroid carcinoma. Triiodothyronine augmentation in the treatment of refractory depression: a meta-analysis. Simultaneous initiation coinitiation of pharmacotherapy with triiodothyronine and a selective serotonin reuptake inhibitor for major depressive disorder: a quantitative synthesis of double-blind studies.

Individuals who had developed euthyroid state under treatment with levothyroxine with TSH levels of 0. This article has been cited by other articles in PMC. Potentiation of amitriptyline by thyroid hormone. Jackson IMD. The mean for T4 and T3 were 8. One study found that

If your depressive symptoms are accompanied by constipation, dry hair and skill, hair loss, hoarseness, stiff muscles, and always feeling cold, it is more likely that your depression is related to hypothyroidism. View author publications. Sign Up. Panminerva Med. PLoS One.

Methods This cross-sectional study was performed on hypothyroid patients, aged 19—68 years. Forgetfulness, derpession, mental slowness, and emotional lability have been shown as some psychological symptoms of hypothyroidism. Thyrotropin-releasing hormone TRH is constantly inhibited by serotonin. As part of the body's endocrine systemthe thyroid secretes hormones that help regulate energy levels and metabolism.

Background

One preeminent hypothesis to explain the above finding is that chronic TRH hypersecretion associated with depression leads to downregulation of pituitary TRH receptors [ 24535556 ]. The present study identify a TSH value of 2. Mater Sociomed. Randomised trial of thyroxine to prevent postnatal depression in thyroid-antibody-positive women. CSF triiodothyronine rT3 levels in patients with affective disorders.

Reference limits for serum thyrotropin in a Japanese population. Zhang et al. Download PDF. Background Thyroid annd play a significant role in brain development. Most Popular. You may sleep too much, too. These thyroid medications can either reduce the body's production of thyroid hormones or replace the missing hormones to help improve both thyroid functioning and mood.

ALSO READ: Anti Musk Antibody Testing For Hypothyroidism

This theory is in accordance with the theory of serotonin deficiency in depression [ 11 ]. With this background in mind, we propose a new TSH cut-off value as a guideline to evaluate and treat depression symptoms. What Is Dopamine? After comprehensive history taking and physical examniation, laboratory tests including TSH, T4, and T3 were performed. Article Sources. Indian J Med Res. Thyroid problems can often be diagnosed with a simple blood test.

Problems with this gland, however, can result in a thyroid imbalance that can affect the body in various ways. Nemeroff CB. Horm Metab Res. Depression in thyrotoxicosis. Thyroid peroxidase antibodies during gestation are a marker for subsequent depression postpartum.

Recently, the Caerphilly Prospective Study examined the link between thyroid function and minor psychiatric morbidity among middle-aged men. Based on the assessment of depression, our study concludes that a TSH cutofff value of 2. About this article. These hormones regulate your metabolism, energy levels, and other vital functions in your body. Molecular Endocrinology.

More recent analysis has suggested that while combining thyroid medications with antidepressants is likely safe and effective, the complex relationship between depression and hypothyroidism requires further study. However, the vast hormone levels of patients with depression do not have biochemical evidence of thyroid dysfunction [ 2122 ]. Low cerebrospinal fluid transthyretin levels in depression: correlations with suicidal ideation and low serotonin function. More recently, a higher frequency of mild to moderate depression was observed in postpartum female subjects with positive antithyroid antibodies regardless of thyroid function [ 83 — 85 ]. A hypothesis of thyroid-catecholamine-receptor interaction.

The thyroid Stimuoating and mood disorders: overview and future prospects. There are a number of different conditions that affect the thyroid, but two of the most common problems are hypothyroidism and hyperthyroidism. Conclusion The present study identify a TSH value of 2. Most people with thyroid problems experience positive benefits from taking thyroid medication and feel that their depressive symptoms gradually resolve with time. The Team. In association with Wellsprings Health. Polymorphisms in the brain-specific thyroid hormone transporter OATP1C1 are associated with fatigue and depression in hypothyroid patients.

ALSO READ: Hypothyroidism Treatments And Side Effects

Afsaneh Talaei is a professor of Endocrinology. Methods This cross-sectional study was performed on hypothyroid patients, aged 19—68 years. Enhancement of imipramine antidepressant activity by thyroid hormone. The findings indicated the absence of an absolute cut-off value for TSH to distinguish between normal and abnormal; the mean normal TSH level ranged only between 1. Joffe RT. The comparative antidepressant value of L-tryptophan and imipramine with and without attempted potentiation by liothyronine.

The prolonged release of TRH in depression may be seen as a compensatory response to the decreased 5HT activity in an attempt to normalize 5HT function and maintain normal levels of thyroid hormones [ 59 ]. Introduction The association between thyroid function and psychiatric disorders particularly mood disorders has long been recognized. Was this page helpful? Medically reviewed by Maria Prelipcean, M. This favors the production of rT3 by D3 enzyme. It has been hypothesized that depression leads to inhibition of the D2 enzyme responsible for conversion of T4 into T3 due to the increase in cortisol levels [ 40 ].

Basal thyrotropin and major depression: relation to clinical variables and treatment outcome. Thyroid hormone replacement aims to bring your body back to its normal hormone levels if you have hypothyroidism. References 1. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Therefore, depressed patients with genetically determined lower T4 to T3 conversion could therefore derive more benefit from thyroid hormone augmentation therapy [ 70 ].

Acta Psychiatrica Scandinavica. The deficiency of thyroid hormones in your central nervous system can cause deprsesion, weight gain, and a lack of energy. Baumgartner A. Rapid cycling bipolar affective disorder. This implies that behavioral symptoms in depression may be mediated by different neural circuits from that seen in hypothyroidism [ 92 ]. Abnormalities in the hypothalamus-pituitary-thyroid HPT axis have been reported in people with depression.

Furthermore, normalization of perfusion abnormalities in patients with depression after treatment was observed while no change in cerebral blood flow was hormone levels hypothyroidism in hypothyroidism. Herbs, Vitamins, and Supplements for Depression. External link. However, this should be viewed with caution since these reports either lacked a control group [ 424345 ] or showed no significant difference between the group with an affective disorder and the control group with a nonaffective psychiatric disorder [ 44 ]. Medically reviewed by Alana Biggers, M. Brain blood flow changes in depressed patients treated with interpersonal psychotherapy or venlafaxine hydrochloride: preliminary findings.

Also, the chance to have TSH level below 4 in severely depressed people in comparison to subjects without depression is just 0. Symptoms of hyperthyroidism include:. Abnormalities in the hypothalamus-pituitary-thyroid HPT axis have been reported in people with depression.

Symptoms of hyperthyroidism include:. The effects of T3 acceleration appeared to be more remarkable as the percentage hypothyyroidism women in a trial increased therefore suggesting that women might benefit more than men from T3 supplementation [ 67 ]. But this kind of treatment can interfere with medications for depression. Background Thyroid hormones play a significant role in brain development. Journal List J Thyroid Res v. Monteleone P. What Does the Thyroid Do?

ALSO READ: Obsessive Competitive Disorder

Journal of Clinical Endocrinology and Metabolism. In such cases, it can be helpful to look at some of the other symptoms that may indicate the presence of underactive thyroid. The continuing research in the biochemical, genetic, and neuroimaging fields seems most promising in providing a deeper understanding of the thyroid-depression interactions. Associations of thyroid-stimulating hormone and free thyroxine concentrations with health and life satisfaction in elderly adults. Psychopharmacol Bull. Effects of thyrotropin-releasing hormone in depression. Clin Biochem.

Endocr Res. Accepted : 22 August J Educ Psychol. Dayan CM, Panicker V. The authors would like to gratefully acknowledge the Arak University of Medical Sciences because the study was funded by the university.

In some cases, a thyroid imbalance may contribute to depression as well as other types of mental health conditions. In this theory, depression is a state of local hypothyroidism in the brain with normal peripheral thyroid hormone level as a result of deiodinase type II inhibition and impaired transport of T4 across the blood-brain barrier [ 10 ]. Depression or Hypothyroidism. Thyroid hormone deficiency during pregnancy can lead to delayed neuropsychiatric syndrome and cretinism.

Wartofsky L, Dickey RA. Different cut-off points were compared to detect the optimal cut-off value for TSH. The findings indicated the absence of an absolute cut-off value for TSH to distinguish between normal and abnormal; the mean normal TSH level ranged only between 1. Conclusion: In depressed outpatients, it appears that hypothyroidism and hyperthyroidism are extremely uncommon and that the presence of subtle thyroid function abnormalities does not have an impact on treatment outcome. Kansas Journal of Medicine. Endocr J. Dayan CM, Panicker V.

In animal studies, thyroid hormones influence noradrenergic and serotonergic neurotransmission, which is a target for current antidepressant depressio and plays a key role in the pathogenesis of depression [ 12 ]. Conclusion The present study identify a TSH value of 2. Reference interval for thyrotropin in a ultrasonography screened Korean population. Google Scholar 6. Clin Biochem.

Thyrokd addition, depression is associated with changes in the HPT axis [ 21 ]. They boost levels of two major thyroid hormones: triiodothyronine also called T3 and thyroxin T4. Article PubMed Google Scholar 9. Thyroid hormone deficiency during pregnancy can lead to delayed neuropsychiatric syndrome and cretinism. Also, in the study by Yoshihara on aged Japanese subjects, the upper limit of the normal range for serum TSH increased with age [ 32 ]. Clin Endocrinol.

Google Scholar 6. Accepted : 22 August Eur Thyroid J. Published : 07 September

Normally, the thyroid regulates various functions by releasing steady levels of thyroid hormones. Furthermore, Stimulatign et al. Additionally, it has been shown that anti-depressants with variable mechanisms of action have different effects on thyroid indices [ 81 ]. An alternative explanation is that the blunted TSH response may be induced by the hypercortisolism associated with depression or the elevated thyroid hormone levels mediated by adrenergic mechanisms [ 6061 ]. Clinical investigators have long recognized the link between thyroid and depression. Thyroid function and the natural history of depression: findings from the Caerphilly Prospective Study CaPS and a meta-analysis. Drevets WC.

In addition, TRH has been postulated in early studies to have an antidepressant effect. Lateral habenula as a depressionn between thyroid and serotoninergic system modiates depressive symptoms in hypothyroidism rats. Thyrotropin-releasing hormone TRH is constantly inhibited by serotonin. Peripheral Thyroid Hormone Concentrations 6. Based on the assessment of depression, our study concludes that a TSH cutofff value of 2. Subclinical hypothyroidism after I-treatment of Graves' disease: a risk factor for depression.

T3 and T3U levels were below the normal range in a larger number of hor,one 7. Was this page helpful? The TSH cut-off point of 2. View author publications. The relationship between hypothyroidism and depression has been confirmed in previous literature [ 19 ]. Furthermore, inGull showed the association between psychosis and myxedema [ 5 ]. Subnormal levels of T4 or FT4I were found in 1 subject 0.

Williams GR. Whether this is related to clinical recovery or merely a result of a direct effect of antidepressants remains to be determined. Thyroid hormones have been used as an adjunct to antidepressant therapy since the late s to accelerate clinical response to antidepressants acceleration and to potentiate clinical response in non-responders to antidepressants augmentation. AC contributed to the designing and manuscript preparation. Plasma membrane transport of thyroid hormones and its role in thyroid hormone metabolism and bioavailability.

  • CSF transthyretin in patients with depression.

  • Taking Antidepressants During Pregnancy.

  • In addition, specifying a particular patient population that might benefit from this combination as determined by individual genetic variants should be addressed. Medically reviewed by Debra Rose Wilson, Ph.

  • Intra- and inter-assay coefficients of variation CV were 3. Sami T.

Depression occurs in up to 69 percent of people diagnosed with hyperthyroidism. Acknowledgements The authors would like to gratefully acknowledge the Arak University of Medical Ane because the study was funded by the university. If your depressive symptoms are accompanied by constipation, dry hair and skill, hair loss, hoarseness, stiff muscles, and always feeling cold, it is more likely that your depression is related to hypothyroidism. Intra- and inter-assay coefficients of variation CV were 3. CSF triiodothyronine rT3 levels in patients with affective disorders.

Thyroid function in clinical depression: insights and uncertainties. Hypothalamic-pituitary-thyroid-axis function in treatment resistant depression. TSH reference range in older adults: a Brazilian study. BMC Psychiatry 17, BMC Psychiatry.

Acknowledgements The authors would like to gratefully acknowledge the Arak University of Medical Sciences because the study was funded by the university. Table of Contents View All. And follow us on Twitter Results: No clinical cases of hyperthyroidism or hypothyroidism were detected.

  • Patients with thyroid disorders are more prone to develop depressive symptoms and conversely depression may be accompanied by various subtle thyroid abnormalities.

  • Clin Biochem. Low mood, fatigue, difficulty concentrating, decreased libido, and weight gain are common symptoms of both.

  • Primary thyroid disorders including both hypothyroidism and hyperthyroidism may be accompanied by various neuropsychiatric manifestations ranging from mild depression and anxiety to overt psychosis.

  • A TSH level within the laboratory reference range is not necessarily normal for every individual.

Based on this questionnaire, scores below 10 were considered as normal, while scores above 10 were indicative of ahd. Please review our privacy policy. Legg, Ph. Blunted TSH Response and Abnormal Diurnal Rhythm Depression has been linked to various endogenous circadian rhythms abnormalities such as diurnal mood variation, abnormalities in core body temperature, cortisol secretion, and sleep-wake cycle [ 47 ]. Thyroid hormone transport in and out of cells.

Pin It. The Thyroid and Depression. Was this page helpful? PMID: While more severe hypothyroidism might lead to more depressive symptoms, even cases of a milder underactive thyroid may cause problems. Conclusion The present study identify a TSH value of 2.

When thyroid pills lower TSH levels, you may start feeling better. To the best amd our knowledge, no TSH cut-off value has been established for depression diagnosis. For some people, treating the underlying thyroid imbalance can relieve depression. Normally, the thyroid regulates various functions by releasing steady levels of thyroid hormones.

Area under curve for TSH cut off based on depression. We aimed to detect a new TSH cut-off value in hypothyroidism ane on depression symptoms. In association with Wellsprings Health. Thyroid dysfunction in major psychiatric disorders in a hospital based sample. Based on Beck depression test, scores less than 10 was considered healthy and more than 10 were considered depressed. Reference interval for thyrotropin in a ultrasonography screened Korean population. Symptoms of hypothyroidism include:.

Cerebral blood flow and glucose metabolism in hypothyroidism: a positron emission tomography study. The link between thyroid function and depression. Hormones of the hypothalamic-pituitary-thyroid axis: a psychoneuroendocrine perspective. Thyroxine and the treatment of affective disorders: an overview of the results of basic and clinical research.

For some people, treating the underlying thyroid imbalance can relieve depression. Skip to main content. Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles.

Get our free guide when you sign up for our newsletter. Blood tests can confirm them if they show low levels of a thyroid hormone called thyroxine and a high level of one called thyroid-stimulating hormone TSH. Taking Antidepressants During Pregnancy. As progesterone supports thyroid function, being low in this hormone — or having symptoms of oestrogen dominance — can mean you could help yourself by boosting your thyroid levels naturally though in cases of continuing depression it is best to consult a doctor.

  • More than 12 percent of Americans will develop a thyroid condition in their lifetime. In addition, the reliability coefficient of repeated test was 0.

  • What Is Dopamine? All authors read and approved the final version of the manuscript.

  • The study population was composed of hypothyroid patients female: However, the use of thyroid hormones as an adjunct therapy to antidepressants in the absence of subclinical or clinical hypothyroidism should be further investigated.

  • Cite this article Talaei, A.

  • Hormone supplementation for a thyroid condition can be related to depression. Hormones of the hypothalamic-pituitary-thyroid axis: a psychoneuroendocrine perspective.

In severe forms of hypothyroidism, clinical symptoms may mimic that of melancholic depression and dementia [ 12 ]. Its relevance to affective illness. Thyroid disease has some symptoms in common with certain mental health conditions. Clinical Endocrinology. Common symptoms. Lateral habenula as a link between thyroid and serotoninergic system modiates depressive symptoms in hypothyroidism rats.

Brain depresskon metabolism in hypothyroidism: a positron emission tomography study before and after thyroid hormone replacement therapy. Thyroid function in clinical subtypes of major depression: an exploratory study. International Clinical Psychopharmacology. Eur J Endocrinol. While more severe hypothyroidism might lead to more depressive symptoms, even cases of a milder underactive thyroid may cause problems. Table of Contents. Clearly, further research is needed to ascertain whether thyroid hormone supplementation may effectively accelerate and potentiate therapeutic response to antidepressant drugs.

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