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The thyroid gland is a butterfly-shaped organ located in the front of the neck. It is an essential part of the endocrine system that releases thyroid hormones into the bloodstream. Thyroid hormones have an immense role in many bodily functions, including metabolism, heart rate control, muscle function, and brain development.
Normal functioning of the thyroid gland is essential for human body function. However, its dysfunction causes an array of issues. Such issues result from either an over or underproduction of thyroid hormone, which can affect the body's normal hormonal balance.
Hypothyroidism is due to an underactive thyroid gland that underproduces thyroid hormones. Without proper treatment, there is not enough thyroid hormone for the body to function normally. Nearly all organs in the body are affected.
Conversely, hyperthyroidism involves an overactive thyroid that produces excessive thyroid hormones. This means there is more thyroid hormone than is needed, which can affect many bodily functions.
There is a range of other medical conditions that may affect the thyroid, including Hashimoto’s Disease. This condition is an autoimmune condition, meaning the body’s own immune system begins to attack the thyroid gland. This often reduces thyroid gland function; however, in some cases, this can cause overstimulation of the thyroid.
Graves disease is another autoimmune thyroid condition. It causes overactivity of the thyroid and is characterized by swelling of the neck (goiter) and tissue surrounding the eyes.
Another common disease is thyroid nodules, often noncancerous growths on the thyroid gland. In rare cases, this can stimulate the tissue in the gland, causing hyperthyroidism.
As mentioned, there are many possible causes for both hyper- and hypothyroidism. An underactive thyroid is mostly caused by autoimmune issues. However, lack of dietary iodine, pituitary gland dysfunction, radioactive iodine therapy, or surgery of the thyroid gland can also cause hypothyroidism.
An overactive thyroid can be caused by Graves’ disease, thyroid nodules, thyroiditis, and medications that increase iodine levels.
Symptoms of these diseases can also vary. However, for hypothyroidism, they tend to include:
Intolerance to cold
Dry hair and nails
In cases of hyperthyroidism, symptoms tend to include:
Sensitivity to heat
Less commonly considered symptoms of thyroid disorders are those that are psychological in nature. In the case of hypothyroidism, these can include depression and slowed thoughts. In hyperthyroidism, these symptoms tend to include nervousness, irritability, anxiety, and frequent mood swings.
Anxiety is an emotion associated with feelings of nervousness and restlessness. It may be accompanied by physical changes such as high blood pressure, increased heart rate, and rapid breathing. It is normal to experience symptoms of anxiety on occasion.
By contrast, an anxiety disorder is when the symptoms of anxiety become severe and occur over a long period of time. People with anxiety disorders tend to avoid situations that trigger their symptoms, negatively affecting their day-to-day life.
Each person experiencing anxiety will have differing symptoms. However, if you experience any of the following, it may be time to visit a healthcare professional:
Consistent and uncontrollable worry
Issues with concentration
Nausea and heart palpitations
The thyroid has many effects throughout the body and mind. Psychological effects include alterations in mood and anxiety. Some symptoms of hyperthyroidism can mimic those of anxiety disorders, including increased heart rate, hyperactivity, and nervousness.
Similarly, in cases of hypothyroidism, sluggish thoughts and slowed movements can mimic those of depressive disorders.
Thyroid hormones, among their other functions in the body, are essential for the creation of many neurotransmitters, including serotonin. Serotonin has a well-established link with mood, particularly anxiety and depression. Thus, poor regulation of thyroid hormones can cause peculiar serotonin patterns, which can prompt anxiety, panic, and other mental health disorders.
To illustrate this, a review examining the link between hypothyroidism, anxiety, and depression found that those with hypothyroidism are approximately twice as likely to develop an anxiety disorder than the general population. The same review also found that around 30% of anxiety disorders are associated with some form of autoimmune thyroid disorder.
It can be rather difficult to differentiate the symptoms of thyroid disease and an anxiety disorder, as both tend to present with fatigue, irritability, nervousness, anxiety, and, in some cases, depression. If a patient comes in seeking help for an anxiety disorder, a clinician will often also undertake testing to see if thyroid dysfunction is present.
Another factor that makes it hard to distinguish the two is the use of the medication levothyroxine to treat individuals with hypothyroidism. This medication increases thyroid hormone levels. However, dosing that is too high can lead to increased heart rates, restlessness, and sleep disturbances, which can increase the risk of developing anxiety.
Women with hypothyroidism treated with this medication are highly likely to experience both anxiety and depressive symptoms.
One of the most common treatments for anxiety is psychotherapy, which involves meeting with a trained professional who will talk you through your specific anxieties. Cognitive behavioral therapy (CBT) is a common form of psychotherapy that aims to break down your issues into smaller parts and tackle each one by one.
There are also many anxiety medications available, often prescribed in combination with psychotherapy. These include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), benzodiazepines, and tricyclic antidepressants.
Each has its associated side effects and benefits. Your healthcare professional will help you choose which is appropriate for you.
It may also be helpful to talk to your loved ones. Building up a support network means they can pick you up when you are feeling down or assist you in the situations that most heighten your anxiety.
If your anxiety is caused or exacerbated by thyroid issues, medications that treat the thyroid disease itself may help to mitigate these issues and improve mood.
Once treatment has brought the thyroid disease under control, it’s also important to get regular check-ups to monitor thyroid levels and assess whether any further medication adjustments are needed.
Thyroid disease and anxiety disorders are extensively interlinked, with clinicians sometimes struggling to tell the difference between the two. The effect of thyroid disease on your mood may be greater than expected.
It is important to monitor for both conditions if you experience any of the symptoms mentioned in this article. Luckily, there are many available treatments for thyroid disease and anxiety disorders.
Thyroid disorders | Johns Hopkins Medicine
Hypothyroidism (underactive thyroid) | National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Hashimoto's disease | National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Graves’ disease | National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
What are thyroid nodules? | Endocrine Web
Radioactive iodine (I-131) therapy for hyperthyroidism | Radiology Info.org
Anxiety | American Psychological Association
Anxiety disorders | National Institute of Mental Health
Do I have anxiety or worry: What’s the difference? | Harvard Health Publishing
Is your thyroid causing anxiety? | Kelsey-Seybold Clinic
Hypothyroidism and anxiety: What’s the connection? | Everyday Health
Beyond worry: How psychologists help with anxiety disorders | American Psychological Association