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Mechanism

Thyroid hormones (T3, T4)

Thyroxine (T4) and triiodothyronine (T3) produced by the thyroid under regulation by pituitary TSH. They regulate basal metabolism, thermogenesis, heart rate, intestinal motility, and mood. Their deficiency (hypothyroidism) or excess (hyperthyroidism) cause clear syndromes with frequent psychiatric presentation.
Category
Scientific evidence
Very high
Number of findings
4
Sources
Our own summaries · Cited studies

Effect by goal · level of evidence

Basal metabolism

regulates Very high physiology (A)
Metabolic basis

T3 activates transcription of genes that regulate cellular energy production. Hypothyroidism: slow metabolism, weight gain, cold intolerance, tiredness. Hyperthyroidism: the opposite.

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Anxiety and hyperthyroidism

causes Very high physiology (A)
Rule out thyroid

Thyrotoxicosis causes a picture indistinguishable from severe anxiety: tachycardia, sweating, tremor, insomnia, irritability. A thyroid blood test is mandatory in de novo anxiety.

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Depression and hypothyroidism

causes Very high physiology (AA)
Rule out in treatment-resistant depression

Hypothyroidism produces fatigue, apathy, cognitive impairment, weight gain, and depression resistant to antidepressants. Correction with levothyroxine resolves the picture.

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Hashimoto's and autoimmunity

dysregulates Very high physiology (AAA)
Thyroid autoimmunity

Hashimoto's thyroiditis (anti-TPO antibodies) is the most common cause of hypothyroidism in iodine-sufficient countries. Selenium, vitamin D, and an anti-inflammatory diet may modulate antibodies.

View the study (systematic review) →

Information, not medical advice. Scientific evidence reflects the quality of the studies.

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