Are Autoimmune Thyroid Dysfunction and Depression Related?¹

Abstract

The objective of this study was to examine the relationship between autoimmune thyroid disease and depression in perimenopausal women. Thyroid function [TSH, free T4, and thyroid peroxidase antibodies (TPO-Ab)] and depression (using the Edinburgh Depression Scale) were assessed cross-sectionally together with other determinants of depression. The subjects were 583 randomly selected perimenopausal women (aged 47-54 yr) from a community cohort of 6846 women. The main outcome measures were the occurrence of thyroid dysfunction (abnormal free T4 and/or TSH or elevated levels of TPO-Ab) and the concomitant presence of depression according to the Edinburgh Depression Scale. Neither biochemical thyroid dysfunction nor menopausal status was related to depression. Apart from several psycho-social determinants (the occurrence of a major life event, a previous episode of depression, or financial problems), an elevated level of TPO-Ab (> or = 100 U/mL) was significantly associated with depression (odds ratio, 3.0, 95% confidence interval, 1.3-6.8). We conclude that women with elevated TPO-Ab levels are especially vulnerable to depression, whereas postmenopausal status does not increase the risk of depression.

Thyroglobulin Antibodies are Associated with Symptom Burden in Patients with Hashimoto’s Thyroiditis: A Cross-Sectional Study

“…The same group also found that TPOAb levels are associated with decreased quality of life, but this study also did not evaluate TgAb levels (Promberger and Hermann et al, 2014). Yet another two studies suggested the role of TPOAb antibodies with the occurrence of symptoms of depression (Pop and Maartens et al, 1998) and fibromyalgia (Dardano and Bazzzichi et al, 2012) pointing to underlying autoimmunity as the cause of morbidity and clinical symptomatology (Dardano and Bazzzichi et al, 2012;Jonklaas, 2017). As shown in linear regression analysis that included TgAb, TPOAb, T3, TSH and thyroid volume, the only predictors for increased symptom load were TgAb levels.…”

Association of Hypothyroidism and Clinical Depression

“…After screening 4350 articles and excluding duplicates, we reviewed 62 in full text. Of those, 25 articles were included in this study (Figure 1). Nine studies provided data on individuals with overt hypothyroidism, 17 on individuals with subclinical hypothyroidism, and 9 on individuals with thyroid autoimmunity.…”

The link between thyroid autoimmunity, depression and bipolar disorder

“…It is hypothesized that the dysfunction of the immune system may lead to the reduction of monoamine synaptic availability, which is considered a fundamental mechanism in the pathophysiology of depression [15]. One of the first studies to show the connection between autoimmune thyroid disorders and depression was conducted in 1998 and included 583 perimenopausal women; after adjustment for psychosocial factors it was concluded that women with elevated TPOAb levels (≥100 IU/ml) are at risk for depression [19]. Afterwards the association between MDD and thyroid autoimmunity was further examined in different studies; some of them aimed to reveal the link between HT and depression (see Table 1), while others focused on the connection between increased TPOAb levels and depressive symptoms among the general population (see Table 2).…”