Chronic Anxiety Associated with Thyroid Disorder
Symptoms of Anxiety Induced by Thyroid Disease
Jul 18, 2009
An overactive thyroid gland or “hyperthyroidism” often causes anxiety symptoms, due to an abnormal increase of metabolism in the body. The thyroid sets the metabolic rate of every cell in the body via hormones produced by the gland. When the levels of hormones increase to abnormally high levels (thyrotoxicity), the metabolism becomes speeded up, causing all organs in the body to operate at overdrive, including the endocrine system (glands that release hormones). This means the body’s response to burning energy sources coming into the body, including food and oxygen is over-reactive, so that these are used faster than the body normally needs them (hyper-metabolism and hyperventilation).
The rate at which the pancreas regulates glucose (blood sugar) via release of the hormone insulin is also increased as are hormones from the adrenal gland including adrenaline which sets the rate of blood pressure and heart function (pulse). The combination of all of these functions and mechanisms running abnormally high causes symptoms of increased energy, nervousness and anxiety symptoms. People with hyperthyroidism experience a generalized increase in free-floating anxiety, a feeling of being on edge and periods of suddenly escalated anxiety called panic attacks.
Hashitoxicosis from Hashimoto’s thyroiditis
Most cases of hypothyroidism in industrialized countries are caused by an autoimmune condition called “Hashimoto’s thyroiditis”. The under-functioning of the thyroid gland in cases of Hashimoto’s, is a result of auto-antibodies that are created and released by the immune system, to attack proteins found in the thyroid gland, causing cell death and eventual damage to the gland. Once enough damage has occurred, the thyroid gland’s ability to produce sufficient amounts of hormones is diminished.
“Hashitoxicosis” is an intermittent period of hyperthyroidism experienced by some patients with Hashimoto’s. As the hyperthyroid phases occur, sudden and severe anxiety symptoms may manifest, as well as other symptoms of hyperthyroidism. Types of temporary thyroiditis (sub-acute), that are non-autoimmune related that can occur in pregnant women and in people with respiratory viruses can also cause short term hyperthyroidism.
Medical research studies state that Hashitoxicosis does not have to occur for anxiety symptoms to be caused by Hashimoto’s, the permanent type thyroiditis but have concluded that anxiety may be associated with the “thyroid autoimmunity” itself.
Some of this research is published on the NIH/PubMed website:
Thyroid Autoimmunity a risk for Mood and Anxiety Disorders
Hot Thyroid Nodules and Toxic Diffuse Goiters
Tumors may develop in the thyroid gland, called “nodules” and these can be the type that, become “hot”, meaning they release thyroid hormone as if they have become part of the gland. When these type nodules become active enough to cause hyperthyroidism, anxiety symptoms may be a part of the symptom-complex that results, as with hyperthyroidism of other causes.
In some patients, the thyroid gland becomes enlarged with or without containing thyroid nodules. This is referred to as a goiter but the gland may also become toxic (overactive) as a result of the goiter, which is referred to as a “toxic diffuse goiter”. Most people with autoimmune-caused hyperthyroidism or “Graves’ disease” have toxic diffuse goiters. If there is a combination of goiter and nodules, it may be referred to as a multi-nodular - toxic diffuse goiter.
Treatment for Anxiety caused by Thyroid Disorders
For most cases of anxiety symptoms related to thyroid disorders, treating the disorder itself will bring relief of symptoms or even complete resolution of them. In cases of autoimmune-related hypothyroidism, replacing the low hormone levels, will correct the metabolism and help to reduce or control the thyroid antibody levels. In cases of hyperthyroidism, regardless of cause, reducing thyroid hormone levels using “anti-thyroid” and/or “beta-blocker” medications will reduce or resolve symptoms in some cases. In more severe cases of hyperthyroidism, that cannot be controlled with these type drugs partial or full thyroid removal (thyroidectomy surgery) may be necessary or destruction of the gland by radioactive iodine (ablation). Removal of part or all of the thyroid gland may also be required in cases of hot nodules and toxic diffuse goiters.
If these treatments still do not relieve anxiety symptoms, anti-anxiety medications or SSRI antidepressants may be prescribed. Therapies to help patients cope with anxiety may also be recommended, such as “Cognitive Behavioral Therapy”, which has been found to be a very effective treatment for anxiety conditions.
Additional Medical Research Study
With Hashimoto's Thyroiditis Anxiety was a Prominent Initial Symptom
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