Is depression and anxiety normal in Hashimoto's?
Hashimoto’s thyroiditis induces neuroinflammation and emotional alterations in euthyroid mice. Yao-jun Cai et al 2018
What this title means is that even in mice with normal functioning thyroids that had Hashimoto’s, there was still brain inflammation.
As I have said before, you can’t always take mouse model scientific studies and carry that over to humans but I guarantee at least half of you listening have experienced difficulty with your mood at some point in your life because of this disease.
About 15 million people in the US alone are dealing with this condition, most of you are women. It is the most prevalent autoimmune disease. As a reminder, Hashimoto’s is characterized by white blood cells called monocytes infiltrating the thyroid tissue as well as antibodies against thyroglobulin and thyroid peroxidase being created. This is the major cause of hypothyroidism the world over. In more general terms this is when the immune system (the monocyte) is attacking our own body and destruction of tissue occurs. The immune system is supposed to rid itself of these immune cells that are specific for our own tissue but sometimes they get missed.
In Hashimoto’s the biggest mechanism of action in destruction is molecular mimicry. This is where our own tissue looks similar to a foreign cell- their amino acid sequence will be similar enough to be mistaken for each other. Other things that can trigger it are mental or emotional stress.
Anxiety can increase Interleukin 6 (interestingly invokes anxiety when high) and TNFa (inflammatory immune cells that make you feel tired, anxious and hostile) and both are high in people with more fat on their body. High estrogen can increase these inflammatory markers and high progesterone can reduce them. DHEA also helps to keep IL-6 in check.
Another stress contributor can be cortisol which will be involved in blood sugar management if our diet is not great or if you are always running on empty.
Many people will show lab test normal thyroid function with Hashimoto’s, this would include people with subclinical hypothyroidism where you have symptoms but labs are ‘normal’. In this state you can be dealing with anxiety and depression. In fact, these two mood disorders are more common in euthyroid Hashimoto’s patients than those with no thyroid problems.
This study discusses we are the lucky ones who have impairment in cerebral perfusion which is a fancy way of saying we don’t get enough blood supply to the brain and according to the internet gives us an increased risk for cognitive decline and a higher risk of dementia. For us this perfusion happens specifically in the frontal cortex which is the region of the brain that controls emotional behaviors. The authors state the mechanisms of action in damage to the brain are largely unknown in Hashimoto’s.
This inflammation in the brain is our body’s way of protecting us from brain injury but when it goes on too long in a state of inflammation, immune cells increase and release what are called inflammatory cytokines like IL-6, IL-1B, and TNF-a which screw up the neurotransmitters that affect mood regulation. Serotonin is the big one affected.
This was a small mouse study of 10 mice induced with Hashimoto’s and 10 mice in the control group. They were given behavioral tests measuring depressive-like behaviors and anxiety-like traits. After the tests were monitored, and the brains and thyroids were examined they found the mice with Hashimoto’s had more enlarged thyroids than the control mice with destroyed thyroid cells and infiltration of monocytes (immune cells) and antibodies were higher with normal T3, T4 and TSH levels. They also found thyroglobulin antibodies in the frontal cortex portion of the brain. And the researchers found what they were looking for in that these poor mice did show depression and anxiety traits and those pro-inflammatory cytokines were much higher than in the control group resulting in lower serotonin.
There have been other studies that show no association between anxiety and depression and Hashimoto’s in those with thyroid antibodies. All I have to say to this is there will always be studies that contradict each other. You have to get good at deciphering the difference in them to come to a conclusion.
All this to say, you are not crazy. You might be depressed and you might have anxiety and it could very well be because there is some inflammation in your brain that you may not be aware of. The best thing you can do for yourself is to figure out what is causing the inflammation and work on fixing it.
Don’t guess what it is. Don’t hope a supplement will fix the problem for you. Don’t search the internet and wonder which so called expert you should follow. Maybe you should test instead of guess. Maybe stop searching for the magic bullet online. In the last few months I’ve had so many people come to me confused about what they should believe and they have spent hundreds and hundreds of dollars on supplements hoping it will fix their problem. If you are following someone online that is telling you their products will fix your thyroid- take a step back and think about that.
There is one person online that only sells supplements for thyroid patients and their marketing says they have 70-80,000 happy customers. If those 70-80k people bought just one $40 bottle from this company, that is 3.5 million dollars. And good on them for making a great living. I’m sure many people who were basically nutrient deficient have felt much better using those products. I have no beef with that. I just want you to think about why you might want to go down that road.
Will five products help your brain inflammation that is causing anxiety or depression? Maybe. But it isn’t getting at the root cause so when you stop taking the product you might go right back to square one.
I want to help you understand why your body is fighting you so you can take the steps to make it work better so you have more energy, lose weight, feel fantastic and get your darn life back.
In the last couple weeks I lost a close family member. Out of the blue. No warning. It’s the kind of phone call you don’t want to get. The funeral home was standing room only and the words spoken about this person were amazing. They were loved by many and they lived life to the fullest.
Death always has me reflecting on my own life and how I want to live the rest of it. None of us gets out of here alive. We have to decide how we want to live. I want for you to be able to live a full and happy life- a good quality of life and I hope that you do to.
You don’t have to peruse the internet to find the right thing the might work for you. Let me help you understand just what your body needs to feel fantastic. Getting well is multi-faceted and I can help you put the pieces of this sometimes complicated puzzle together.
Thanks for listening.
You can get The Definitive Guide To Hashimoto’s on my website and while there you can also sign up for a free no obligation 3 day anti-inflammatory meal plan.
I also have a little course I created on Pre-diabetes for $47 which has a lot of fun recipes and cooking videos and is a great place to start for those of you that are new. Blood sugar dysregulation is a big problem in Hashimoto’s so it can get you started in learning about what to eat for better blood sugar. Sometimes fixing that can take you a long way to better thyroid function. Please go check it out. It’s listed under the Get Help tab and then click on Programs and select Nutrition and Lifestyle Change for Prediabetes. You get 4-6 weeks of free meal planning with the program which is a fantastic deal.
See you next time.
Cai, YJ., Wang, F., Chen, ZX. et al. Hashimoto’s thyroiditis induces neuroinflammation and emotional alterations in euthyroid mice. J Neuroinflammation 15, 299 (2018). https://doi.org/10.1186/s12974-018-1341-z