Recently, the connection between autoimmunity and psychiatric disorders has been discovered for various autoimmune diseases. Evidence is accumulating that some psychiatric disorders have an autoimmune basis.
Study of German researchers team published this month at JAMA Psychiatry uses a sample of 36 174 participants, equally distributed between depression and anxiety. Patients with autoimmune thyroiditis, Hashimoto thyroiditis, or subclinical or overt hypothyroidism had an increased risk of developing symptoms of depression and anxiety or of receiving a diagnosis of depression and anxiety disorders.
Clinical experience shows that patients often seek medical consult due to psychiatric symptoms but are unaware of autoimmune thyroiditis. Depression and anxiety disorders associated with a thyroid disease require different treatment than usual.
The paper discusses the medication as well. Besides typical levothyroxine treatment, selenium supplementation is recommended in order to reduce thyroid antibodies and improve mood or well-being. An early use of antidepressants could be indicated to attenuate the chronic course of autoimmune thyroiditis. Due to the fact that thyroid metabolism is associated with the brain serotonin system, selective serotonin reuptake inhibitors are appropriate medications to treat depression. However, tricyclic antidepressants, are not appropriate for patients with hypothyroidism.
Patients with autoimmune thyroiditis and no depression or anxiety symptoms must be aware of the vulnerability to develop psychiatric issues. Screening for psychiatric symptoms is advisable in patients with autoimmune thyroiditis and a test for autoimmune thyroiditis is recommended in patients with depression and anxiety disorders. The test should include not just thyrotropin levels, free triiodothyronine, free thyroxine but thyroid peroxidase antibodies as well.
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Keep in mind that autoimmunity can play a role by your depression and anxiety symptoms.