Hypothyroidism and Depression Connection

In 2007, when I was in the hospital for a completely unrelated condition, the hospitalist (a hospital specialist physician), came to my room to discharge me and give me my orders. Included in the prescriptions was one for Synthroid, or the generic, levothyroxine. I had asked the nurse what this was for, and she seemed as surprised as I was that the doctor had not mentioned to me that I was hypothyroid.

Several months later, when the septicemia was gone, I was still not feeling well. When I went back to my doctor, with a variety of complaints, he said, "You know, maybe we should test your thyroid."

That's when I remembered the hospitalist and the levothyroxine and mentioned it. That cinched the deal and lab work was pulled to test my thyroid levels. I was then put on a high dose of levothyroxine, or Synthroid, and monitored. The difference this simple medication made in my life was profound, and prior to being hospitalized I would not have had a clue that I suffered from hypothyroidism.

Symptoms of Hypothyroidism

There are many varied symptoms of hypothyroidism, but according to my doctor, depression, lethargy, weight gain and difficulty losing weight, fatigue and difficulty concentrating are frequent complaints of those suffering with hypothyroidism. Of course, other symptoms include: dry skin, brittle nails and hair, low body temperature, slow metabolism, heat intolerance, and many more. For more symptoms related to hypothyroidism, you can read more about it at the Mayo Clinic's website.

I was told by multiple doctors that I was suffering from depression. They gave me medication for treating depression, but it didn't fix the symptoms of low energy, fatigue, tiredness, loss of appetite but weight gain and more. It wasn't until the hypothyroidism was treated that these symptoms abated somewhat.

How Do They Test for Hypothyroidism?

The thyroid gland is a small gland at the center of your neck that is responsible for releasing thyroid hormones into your body. These hormones maintain the body's wellness. The test for thyroid function will likely begin with something called a TSH test. This test tests the amount of thyroid stimulating hormone in your blood. The thyroid stimulating hormone is what's responsible for telling the thyroid to gland to make and/or release more thyroid hormone. When the TSH is high, it means the body is not making enough thyroid, so the body keeps requesting more. The TSH test is a simple, usually inexpensive lab test, where they take a tube of blood. Results usually come in a few days from most major commercial labs.

Even if your test comes back in the normal range for TSH, if your symptoms are similar to hypothyroidism, you might want to ask your doctor if they will perform a T3 and T4 test, to determine how much actual thyroid hormone you have circulating too. Thyroid levels can fluctuate from day to day as well, so lab work and levels should be tested on multiple locations, particularly if the levels are low-normal, to determine if hypothyroidism might be occurring, but isn't always detectable.

What makes a doctor decide to test usually is a bunch of vague symptoms that are similar to depression, when depression is either not suspected or has been treated and not improved or has been ruled out. The link between depression and thyroid is very clear, and while it is possible for a person with a thyroid condition to also have depression, many times the depression is lifted when the thyroid is treated, but the thyroid gland will not improve if only the depression is treated. In fact, many times the thyroid will worsen and make any treatment for depression ineffective.

How is Hypothyroidism Treated?

Treating hypothyroidism is relatively easy. For most people, it involves nothing more than taking a small pill, once per day, and having your TSH level tested a couple of times per year with your regular blood work (unless you have symptoms that worsen during treatment).

For some people, though, treating only with the T4 replacement (Synthroid, levothyroxine, synthetic T4) is not enough, and that's when T3 and T4 levels should be tested in conjunction with TSH to determine the appropriate treatment.

For most people, this replacement therapy is all that is necessary, but for optimal health, research should be performed on dietary changes, lifestyle changes (particularly losing weight, because weight loss can cause the body to need less thyroid hormone), and other changes can help improve the symptoms of hypothyroidism.

Is There a Cure for Hypothyroidism?

Unfortunately, there usually is no cure for hypothyroidism, and most people diagnosed with this condition will have to take supplementation for the rest of their lives. Failure to take the supplemental dosage can lead to worsening hypothyroidism, and eventually could lead to coma or death.

However, once properly treated, a person with hypothyroidism can usually live a normal, healthy life without any side effects or problems from the hypothyroidism. Even if depression lingers after treating hypothyroidism, once the hypothyroidism is treated effectively, depression can then be treated concurrently and it should be beneficial.

Why You Need to Be Tested for Hypothyroidism

If you're a woman who has put on a few pounds without having changed your diet, are suffering from a mild level of fatigue that never seems to go away no matter how much you sleep, who has trouble losing weight no matter how little you eat, and your hair and nails are not as healthy as they used to be, you might have hypothyroidism and not even know it. If you have mild depression symptoms that don't seem to go away, or if you've had depression and treated it but the symptoms only improved slightly or not at all, it's possible you are suffering from hypothyroidism.

I went years without knowing that I had hypothyroidism, and the symptoms are so vague, each one minor by itself but together quite problematic, and it was tough to get a doctor to listen to me. The good news is, more doctors know about this now than ever, and it's a simple and inexpensive test, so asking your doctor to check your TSH is not usually a strange request, won't hurt any, and is covered by just about every insurance plan out there. When it's your health and wellbeing, it's worth asking.

If you think you have any symptoms of hypothyroidism, please make an appointment to consult your health care professional, then do your own research and know what questions to ask the doctor before your test. Your health is worth it.

SOURCES:

~Mayo Clinic Website, "Hypothyoirdism (Underactive Thyroid)", Retrieved May 2, 2011

~Personal Experience, Information from my Physician and PA during office visits

~Medicinenet.com, "Hypothyroidism and Diet", Retrieved May 1, 2011