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July 20, 2014
by Cathy England, MA

Anxiety as a symptom of hyperthyroidism

July 20, 2014 04:55 by Cathy England, MA  [About the Author]

Physical or Mental?

It is not uncommon that anxiety problems are caused by physical illness, and it can sometimes be difficult for the professional provider to differentiate the two.  It may be that treating the medical problem can alleviate the appearance of anxiety so that when the medical condition is treated, the anxiety symptoms may disappear.  This is why it is important to have troublesome anxiety symptoms evaluated by a medical professional.  Hyperthyroidism is a medical condition that commonly co-occurs with anxiety.

Harter, Conway and Merikangas (2003) used their research to support the idea that anxiety disorders can occur as a symptom of a number of medical illnesses.  Specifically, they argued that of the anxiety diagnoses, the one most commonly encountered in relation to thyroid disease is panic disorder.  They point out that in particular, hyperthyroidism can have an effect on neurotransmitters in such a way that anxiety is often the result.  This makes it clear why, when anxiety is suspected, that it is important to rule out medical causes as a part of the treatment plan.  Hyperthyroidism and anxiety have many of the same symptoms which can make a differential diagnosis difficult to make (Apostolic, Konstantinos, Grammaticos, and Charalambos, 2001).  Cooper (2003) also linked anxiety symptoms to hyperthyroidism and indicated that anxiety should be considered an indicator that a thyroid problem may be there. It is a disease of the endocrine system.  Higher levels of thyroid hormones can manifest in symptoms of anxiety.

Hyperthyroidism

Hyperthyroidism is described as occurring when the thyroid gland becomes overactive, which results in producing too much thyroid hormone.  The thyroid gland is essential in bodily functions such as metabolism, body temperature regulation and nervous system function.  When it is not functioning properly, it can wreak havoc on the individual, and treatment is generally needed right away.  The most common cause of an overactive thyroid is Grave’s disease which is an auto-immune issue.  Many times, the goal of treatment in the diagnosis of hyperthyroidism is to remove the gland in one of a number of ways.  When the thyroid is removed, it causes a lack of thyroid hormone which is then generally replaced by taking the hormone orally on a daily basis (National Endocrine and Metabolic Diseases Information Service, 2012).

It is important to consider the possibility of medical illness when anxiety either increases suddenly or appears very quickly.  It can be worrisome to think that anxiety has a physical cause, but in the case of hyperthyroidism, getting help quickly is well advised.  High levels of thyroid hormone cause a number of health problems that can cause a lot of damage.

Mayo Clinic (n.d.) also indicates the link between hyperthyroidism and anxiety, but warns against the assumption that anxiety equals thyroid disease.  There are a number of other reasons that anxiety occurs, but it can be a key indicator, and is sometimes the first thing that people with hyperthyroidism notice.  They also indicate that it is not unusual for depression to be the result of a thyroid condition, and in fact, anxiety and depression often co-occur.  This makes for a complicated untangling of the mental from the physical.  Even though anxiety occurs in thyroid disease, it also occurs separately from thyroid disease.

Always consider the possibility of medical illness when anxiety either increases suddenly or appears very quickly. If it is determined that anxiety may be the result of increased thyroid activity, a simple procedure and a daily medication can bring almost immediate relief from anxiety problems.  It is not always the answer, but it is always a good idea to rule it out.  As physicians become more aware of the link between the two, thyroid screening has become pretty common when a patient first presents mental illness.

Talk With a Physician

It is important to understand that when dealing with symptoms of anxiety, it may be necessary for the physician to rule out underlying medical issues. The mind and body are interconnected and separating the two can be difficult.  It is also true that people with higher levels of anxiety, present to doctor’s offices more often for a variety of ailments.  For this reason, it is important to consult with a medical professional about the problems that are occurring.  It is helpful for the physician to have a good picture of what has been experienced.  Keeping a symptom journal for a week or two can offer a lot of information that can result in a diagnosis being reached more quickly.

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Apostolic Iacovides, Konstantinos N Fountoulakis, Phillipos Grammaticos, and,Charalambos Ierodiakonou. (2001). Difference in symptom profile between generalized anxiety disorder and anxiety secondary to hyperthyroidism. International Journal of Psychiatry in Medicine, 30(1), 71-81. 

Cooper, D. S. (2003). Hyperthyroidism. The Lancet, 362(9382), 459-68.

Härter, M.,C., Conway, K. P., & Merikangas, K. R. (2003). Associations between anxiety disorders and physical illness. European Archives of Psychiatry and Clinical Neuroscience, 253(6), 313-20.

Mayo Clinic (n.d.) Thyroid disease: Can it affect a person's mood? Retrieved from http://www.mayoclinic.org/thyroid-disease/expert-answers/faq-20058228

U.S. Department of Health and Human Services, National Endocrine and Metabolic Diseases

Information Service, (2012).  Hyperthyroidism. Retrieved from http://www.endocrine.niddk.nih.gov/pubs/hyperthyroidism/index.aspx

About the Author

Cathy England, MA Cathy England, MA

Cathy holds a Master’s degree in Psychology and has 13 years of work experience in counseling and social work. Cathy is an advocate for mental health awareness and enjoys educating people about mental health and the ways that it impacts people and communities. Most of her experience has been in work with court dependent or delinquent adolescents and their families. Cathy has also worked as a volunteer as a Court Appointed Special Advocate (CASA) for children under court supervision.

Professional Website: crawfordcasa.org
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