Concentrations of Thyroid Axis Hormones in Psychotic Patients on Hospital Admission: the Effects of Prior Drug Use

Abstract

The aim of this study was to determine the concentrations of thyroid axis hormones in psychotic patients on hospital admission and to search for the associations between the concentrations of these hormones and prior drug use as well as mental symptoms. Material and Methods. Psychiatric diagnoses, psychotropic drug use, and the severity of psychoses were evaluated using the standard methods on admission. Venous blood from patients and healthy controls was drawn for the analysis of free thyroxin (FT4), free triiodothyronine (FT3), thyroid-stimulating hormone (TSH), and sex hormone-binding globulin (SHBG) concentrations. Results. Eighty-one psychotic patients, free of a thyroid disorder, were enrolled into the study. Compared with the controls, they displayed the higher FT4 concentrations in the general group (P=0.003) and the higher SHBG concentrations only in men (P=0.013). The FT4 concentration was higher in the patients who were not taking an antipsychotic drug on admission (P=0.039). No significant correlation was found between the severity of psychosis and concentrations of thyroid axis hormones. However, the FT3 concentration in the general group and TSH concentration in women correlated with the factor of the Brief Psychiatric Rating Scale expressing elevated mood. Conclusions. Our study confirms the higher FT4 concentrations in a significant proportion of acute psychotic patients. The concentrations of thyroid axis hormones were found to be associated with prior antipsychotic treatment on hospital admission.

Thyroid axis function after in-patient treatment of acute psychosis with antipsychotics: a naturalistic study

“…Elevated serum thyroxine (T4) concentrations with or without decrease in triiodothyronine (T3) concentrations have been found in acute schizophrenic patients [ 7 ] as well as in patients with other severe mental disorders, such as acute major depression and mania [ 8 - 10 ]. In our recent cross-sectional study [ 11 ], we have confirmed that patients with acute psychosis upon admission to the hospital had elevated T4 concentrations, especially patients who were free from treatment with antipsychotics. This syndrome of elevated T4 concentrations in acutely psychotic patients is coined as transient hyperthyroxinemia because it usually resolves during recovery from a psychotic episode [ 12 , 13 ].…”

Physiopathology, Diagnosis, and Treatment of Functional Pituitary Dysfunction

“…Elevated serum SHBG as a marker of tissue effects of thyroid hormones was also observed. These changes were also found after excluding patients with autoimmune thyroid disease or prior thyroid dysfunction and untreated with antipsychotics (Steiblien_ e et al 2012). In most instances, the thyroid status normalized within 2 weeks, and no treatment directed at thyroid gland was indicated.…”

“…In most instances, the thyroid status normalized within 2 weeks, and no treatment directed at thyroid gland was indicated. Possible explanations for this phenomenon included disturbed T4 uptake or metabolism in the central nervous system or centrally mediated TSH hypersecretion (Steiblien_ e et al 2012). In some instances, a high T4 stage is viewed as an initial stage of NTIS due to acute inhibition of D1 deiodinase or increase in TBG levels often in elderly or psychiatric patients, but progressing further to low T4 stage of NTIS (Lee and Farwell 2016).…”

Mood configurations and their relationship to immune system responses: Exploring the relationship between moods, immune system responses, thyroid hormones, and social support

“…These mechanisms motivated us to explore the differential effects of the mood groups on TH secretion levels (T3 and T4 cells), which are sensitive to stress and social environment and also affect lymphocyte (NK, T and B) cell count [17, 28]. We particularly expect the relation between TH secretion levels and lymphocyte cell count to occur in the anhedonic group because hyposecretion of T3 and T4 leads to hypothyroidism and depression [30, 31]. Hypothyroidism is known to be related to lower NK cell count, which is a sign of immune system malfunctioning in people suffering from anhedonia [31].…”

“…We particularly expect the relation between TH secretion levels and lymphocyte cell count to occur in the anhedonic group because hyposecretion of T3 and T4 leads to hypothyroidism and depression [30, 31]. Hypothyroidism is known to be related to lower NK cell count, which is a sign of immune system malfunctioning in people suffering from anhedonia [31]. In contrast, people who suffer from hyperthyroidism experience mood swings; hence we expect to see T3 and T4 hypersecretion in the hedonic group [31].…”