The influence of the Thyroid on Mental Health only someone with a thyroid disorder, such as Hashimoto’s, truly understands the impact the thyroid can have on mental health. Particularly for those suffering from anxiety or depression, it is important to know that often just small measures are enough to improve quality of life significantly. This blog article from the Institute for Modern Psychotherapy in Berlin explains in detail what these measures are.
Overview of Topics
When Hashimoto's and Mental Health Issues Go Hand in Hand
At the Institute for Modern Psychotherapy, we primarily treat patients who come to us due to panic attacks, anxiety disorders, depression, or burnout syndrome. An above-average number of these patients also suffer from Hashimoto’s and must therefore take synthetic thyroid hormones permanently. However, these medications often turn out to be the very triggers of mental health issues. This can happen either because the wrong dose is unknowingly taken or because certain preparations are generally not well tolerated.
Synthetic thyroid hormones, such as L-Thyroxine or Euthyrox, are among the most prescribed medications worldwide. Unfortunately, not everyone tolerates these medications equally well. Dosage errors, in particular, can lead to sufferers experiencing panic attacks, anxiety disorders, or depression.
Even with seemingly correct dosages, mental health issues can still arise, as the actual thyroxine requirement varies much more significantly than most people realize.
Hashimoto's and the Problem of the Correct Medication Dosage
“My dosage is correct; I have it re-evaluated by my doctor every year.”
I often hear statements like this from patients with Hashimoto’s, but unfortunately, I frequently find that they have never been properly informed about their condition. The amount of thyroid hormones a person ultimately needs or consumes also depends on how stressful their current life situation is.
You can think of it like the fuel consumption of a car. If you drive leisurely at 80 km/h on a country road, your vehicle might consume only 7 liters per 100 km. But if you speed at 180 km/h on the highway, you might use 12 liters or more for the same distance. The same applies to thyroid hormones. If you had a lot of stress in the days before the doctor’s visit when your medication dosage was checked and re-evaluated, you would have consumed more thyroxine during that period than you received from the medication.
If your doctor does not explicitly ask whether you have been under much stress recently, they may diagnose a seeming under-supply of thyroxine and increase your dosage. If the stress was only temporary, you would be taking significantly more hormones than you need until the next check-up. Over time, this leads to symptoms commonly associated with hyperthyroidism: restlessness, sudden heart palpitations, trembling hands, sweating, diarrhea, and nervousness.
Since all these symptoms are also typical for an anxiety disorder, it often leads to a misdiagnosis, as the thyroid hormones are supposedly optimally adjusted.
Thyroid Hormones are Consumed Depending on the Situation
If you were on vacation and well-rested immediately before determining your hormone levels, you would have consumed significantly fewer hormones than you were taking. If your doctor does not inquire about this, they might diagnose an apparent over-supply and reduce your medication dosage. However, your next vacation may be far off, and in the everyday stress, you would need significantly more thyroid hormones than you are now taking. Again, it is only a matter of time before the first symptoms of illness appear, this time resembling hypothyroidism: lack of drive, fatigue, depressive moods, and weight gain. Once again, there is a risk of misdiagnosis, such as depression or burnout syndrome, because the hormone levels were just checked, and the medication seemed correctly adjusted. If antidepressants are now unnecessarily prescribed, patients often find themselves in a vicious cycle, turning mentally healthy individuals into emotional wrecks in a short time.
Therefore, our tip is to have the dosage of your thyroid medications checked more frequently than just once a year, especially if you suffer from burnout, depression, anxiety, or even panic attacks. Often, these mental health issues disappear into thin air when it turns out that they were simply taking the wrong medication dosage.
The Timing of Medication Intake Can Also Be Crucial
Most patients take their thyroid medications in the morning. However, just as daily routines vary from person to person, so too can the need for thyroxine at different times of the day. This can lead to some people tolerating their daily dose better in the afternoon than in the morning, while others might ideally take 50% of their thyroxine in the morning and 50% in the early evening. Some generally tolerate evening intake better than taking thyroid tablets early in the morning. Those who frequently suffer from nighttime panic attacks, as well as many who work night shifts, often benefit from adjusting the timing of their medication intake.
If you belong to this group and want to test whether a different intake time has positive effects for you, please do so only in consultation with your treating physician. If your doctor does not have an open mind about this, a change of doctor might be advisable. A truly good doctor can be recognized by their openness to new insights and their commitment to continuous learning for the sake of your health.
Some Tolerate Natural Pig-Derived Thyroid Hormones Better Than Synthetic Ones
I am writing this article not only as a therapist who works extensively with Hashimoto’s patients but also as someone who has lived with a Hashimoto’s diagnosis for many years. I have experienced many ups and downs until I found the right medication for myself. While many people tolerate synthetic thyroid hormones, such as those found in L-Thyroxine or Euthyrox, I have found that natural thyroid hormones derived from pig thyroids suit me much better. Since switching, the severe mood swings I used to struggle with have become a thing of the past. Whether this is because natural hormone preparations have a much broader spectrum of active ingredients, I cannot say. However, L-Thyroxine and Euthyrox provide the body with only T4. The equally important T3 must then be produced by the body from the T4. Natural pig-derived thyroid hormones provide T3 directly, thus relieving the already stressed body.
For those also living with a Hashimoto diagnosis and feeling that synthetic thyroid hormones are not working well for them, it may be worth considering a medication switch. However, finding a suitable doctor to support you through such a transition can be challenging.
Therefore, we have created a website for those affected, listing doctors (without guarantee) with whom our patients have had good experiences during such a transition. The website is: better-life-with-hashimotos-disease.com.
Don't Focus Solely on the Thyroid!
No organ works in isolation. An underactive thyroid affects many other organs, leading to a range of additional complaints: fatigue, feeling cold, nausea, hair loss, constipation, overweight, headaches, and joint pain are just a few examples.
Just like football players on the field, organs work as a team. Only when all of them do their job correctly can the game be successful—in other words, one can lead a light and largely symptom-free life even with Hashimoto’s. Therefore, it is very important to also keep an eye on, for example, the adrenal cortex or the liver. The latter, for instance, converts a large portion of the hormone T4 into the needed T3. Those prescribed L-Thyroxine or Euthyrox only take in the T4 compound. If the liver is too weak to convert enough T4 into T3, the medications only partially achieve their desired effect.
Moreover, not only do our organs interact with each other, but our psyche also significantly influences our body and well-being.
The Connection Between Body and Mind is Not a One-Way Street
Just as an incorrect medication dosage can lead to anxiety and depression, constant worrying can also become self-perpetuating and increase your stress level to the point where you need significantly more thyroxine than necessary. Therefore, it makes sense not only to ensure the correct amount of thyroxine but also to address your automated thoughts that may have been revolving around anxiety and depression for far too long.
Even if you can hardly imagine it, there are numerous tips and tricks that not only Hashimoto’s patients have used to overcome anxiety, depressive moods, and burnout on their own. You will find all these tips and tricks in three books linked below this blog article.
Additionally, for anxiety patients, we offer our online online therapy “Finally Free from Anxiety!” With this course, it is possible not only to uncover the true triggers of your anxiety, but also to overcome them step by step. You can watch the first of the 52 episodes for free right here: the-anxiety-cure.com/videocourse
Troy A.
Tampa, Florida