The link between Depression and Hashimoto’s Thyroid disease

The relationship between Hashimoto’s disease and depression in Australia has long been recognised, with people with thyroid disorders being more prone to develop depressive symptoms. Women are more likely than men to have thyroid disease. One in eight women throughout Australia will develop thyroid problems during her lifetime.  ^[1]

Often General Practitioners will attribute the most common symptoms of hypothyroidism, such as weight gain, depression, anxiety, brain fog, sleep problems and fatigue, to general depression or ‘just stress’. Many women are then offered anti-depressants to combat their depression.

By looking for the root cause of these symptoms, which may involve a diagnosis of Hashimoto’s disease, we can optimise health with thyroid hormones and a targeted approach to alleviate symptoms.

What is the thyroid?

The thyroid is a butterfly-shaped gland that sits at front of your neck and is part of your endocrine system, producing hormones that coordinate many of your body’s functions and setting your entire metabolic rate. It controls your weight, whether you feel sluggish or energetic, mentally sharp or foggy, cheerful or blue, and is involved in the control of everything from your cholesterol to your female hormones. ^[2]

When thyroid hormone levels are low, many organs and internal systems slow down, creating a wide range of symptoms – including depression.

What is Hashimoto’s disease & Depression?

Hashimoto’s disease, also known as chronic lymphocytic thyroiditis, is the most common form of thyroid disease.

Inflammation from Hashimoto’s disease often leads to an underactive thyroid gland (hypothyroidism). Hashimoto’s disease is the most common cause of hypothyroidism. It primarily affects middle-aged women but can also occur in men and women of any age and in children. ^[3]

Signs and symptoms of hypothyroidism other than depression include:

• Fatigue and sluggishness
• Increased sensitivity to cold
• Constipation
• Pale, dry skin
• A puffy face
• Brittle nails
• Hair loss
• Enlargement of the tongue
• Unexplained weight gain
• Muscle aches, tenderness and stiffness
• Joint pain and stiffness
• Muscle weakness
• Excessive or prolonged menstrual bleeding
• Memory lapses

A study from 2004 found an association between the presence of a mood disorder and the presence of TPO antibodies, which are early signs of an autoimmune attack on the thyroid. Further studies have connected depression, distress, obsessive-compulsive symptoms and anxiety with a high level of TPO antibodies. ^[4]

We attract patients from all over Australia including Melbourne, Adelaide, Brisbane and Sydney, even though our head office is in Perth.  All new patients get a full thyroid panel screening as part of their overall general health screening and we regularly conduct full thyroid screens on our thyroid patients to track and monitor progress. We have found many thyroid abnormalities this way, well before they have had time to develop into full blown Hashimoto’s disease.

Many factors can interfere with certain functions of the thyroid, including:

• the ability to produce adequate amounts of thyroid hormone
• conversion of the inactive form of thyroid hormone to its active form
• the effective binding of thyroid hormone to your cellular receptors – a key and lock type of effect that activates all of the thyroid’s activities in your body. [5]

There are several factors that can interfere with the Thyroid processes:

Exposure to toxins

Environmental toxins can interfere with thyroid function, causing direct damage and reducing our ability to detoxify. Pesticides, lawn chemicals, personal care products, household cleaners, plastics, makeup, water and air pollution are all cumulative in their toxicity.

Vitamin and mineral deficiencies

Women are often low in several nutrients essential to thyroid health, most importantly, iodine, as well as vitamin D, selenium, tyrosine, zinc and iron. Other vitamins and minerals necessary for optimal health include magnesium, vitamin D, and chromium, which are important for regulating blood sugar. Low levels are linked to elevated blood glucose, insulin resistance, and diabetes. Insufficiencies in omega-3 fatty acids and other essential fatty acids can lead to depression and cognitive function issues.

Stress

Hashimoto’s thyroiditis is worsened by chronic stress so learning ways to lessen stress is your key to better health. Feeling stressed has the added disadvantage of stressing your thyroid, the endocrine gland responsible for your body’s metabolism and regulation of vital body functions. Stress can suppress the release of thyroid-stimulating hormone from the pituitary gland whilst also decrease the conversion to the more active form of thyroid hormone, triiodothyronine (T3). While cortisol may limit T3 production, adrenaline may enhance selected responses to T3, suggesting that chronic, but not acute, stress may disrupt thyroid function. ^[6]

Digestive issues

Intestinal hyperpermeability and imbalance in your gut microbiome have both been shown to contribute to autoimmune disease. Common causes of leaky gut and dysbiosis include gluten intolerance, processed foods, artificial sweeteners and antibiotic overexposure.

Hormone imbalance

Estrogen is a naturally occurring hormone in the body however, the synthetic forms of estrogen we’re exposed to from the environment (xenoestrogens) are inflammatory and trigger autoimmune disease by altering the shape and functioning of specific immune cells. Xenoestrogens are found in plastics in our food packaging, cosmetics and agricultural chemical residues in our foods. ^[7]

How to improve your thyroid function naturally and minimise your risk of depression

Relieve stress

Learning how to manage your stress when you have an autoimmune thyroid disorder is very important for maintaining a healthy immune system and for your overall, long-term health.

It’s very difficult to eliminate stress entirely but the key is to learn skills that help you to react to stressful situations more effectively and relieve stress to minimise its impact on your health. Everyone relieves stress differently, so find out what works for you. It could be going on walks in nature, meditating, yoga, swim at the beach, journaling, taking a relaxing bath, or any other stress-relieving activity. ^[8]

Repair your gut

Your digestive system is protected by the intestinal wall which is the first-line barrier against the food and bacteria in your gut. It keeps the contents of your gut and your abdominal cavity separate and helps to maintain the balance between oral tolerance to food you eat and an immune reaction to the food.

Damage to the intestinal wall is known as intestinal permeability or leaky gut. This damage changes the wall thickness and can create gaps between the cells in the wall, which, in turn, leads to the onset of food sensitivities and an overactive immune system.

Support your gut with a fibre-rich and nutrient-dense diet. Eat plenty of probiotic-rich foods and take probiotic supplements to support your gut flora. Therapy using medicines that block tumour necrosis factor alpha (TNFα) reduce inflammation of mucosa and reduce leaky gut.

Zinc, butyrate, and some probiotics might help improve the mucosal layer and tighten the intestinal wall. Glutamine, an essential amino acid, a natural compound curcumin, as well as prebiotics and probiotics, can reduce inflammation and assist in the repair of the intestinal lining and reduce leaky gut. ^[9]

Eat well

Some foods have developed a reputation for playing a role in thyroid dysfunction. Avoid these inflammatory foods, such as refined sugar, refined vegetable oils, processed foods, unhealthy fats, gluten, conventional dairy and any foods to which you may be sensitive.

Instead, “choose foods that offer nutritional support for your thyroid. The production of thyroid hormones requires iodine and omega-3 fatty acids; converting the inactive T4 to the active T3 requires selenium; and both the binding of T3 to the receptor on the nucleus and switching it on require vitamins A and D, as well as zinc. You will find these nutrients in a whole-food, clean, organic diet.” ^[10]

Thyroid-boosting foods include:

• seaweed and sea vegetables (caution or avoid iodine in Hashimoto’s)
• fish (especially sardines and salmon)
• dandelion, mustard and other dark leafy greens
• smelt, herring and scallops
• brazil nuts

Avoid toxins

Our modern world is full of toxins that create inflammation and disease in your body. Exposure to toxins such as mercury, perchlorate and nitrates can make Hashimoto’s symptoms worse. Minimize toxic exposure by using organic and natural cleaning and body products, reducing the use of plastics, avoiding smoking and second-hand smoke and spending time in nature.

Identify and eliminate infections

Dormant infections in your body may be ready to activate an autoimmune thyroid condition in stressful circumstances. Through thorough testing, your Functional Medicine health practitioner can help you identify if you have any infections and help you eliminate them.  We regularly uncover parasites, overgrowth of bacteria and yeasts and high viral loads in our Hashimoto’s patients.

Exercise regularly

Regular exercise supports your immune system and overall well-being, including your supporting good mental health.

“Exercise in the form of resistance training is one of the best ways to put your body in a state of acute, controlled stress. A review of research on the anti-inflammatory effects of exercise found that resistance training can play a major role in reducing circulating levels of cytokines, and thereby, inflammation. For example, in one study, five researchers found that women who followed a moderately high resistance training program for 24-weeks had lower levels of circulating cortisol. Participants were instructed to lift weights four times a week, progressing to more difficult exercises and alternating between endurance (high reps for 2-3 sets) and strength (1-6 reps repeated for 4 sets). Similarly, decreased circulating cortisol levels were reported after just 8-weeks of resistance training that encompassed a full-body workout.” ^[11]

Get plenty of sleep

Getting regular quality sleep is essential for your overall well-being, especially in combatting mental health issues such as depression and anxiety. Seven to nine hours a night is optimal.

You can support your sleep by:

• Having a regular bedtime
• Avoid looking at a screen a few hours before bed
• Use essential lavender oil
• Meditate
• Have a calming cup of herbal tea before bed ^[12]

How Advanced Functional Medicine can help

Depression may occur early in Hashimoto’s disease and may become more severe over time. By following the above lifestyle changes and with a targeted approach to treatment, our Functional Medicine health practitioners can help you to manage your stress and control your anti-inflammatory reactions to promote a healthy thyroid.

We conduct in depth advanced medical testing that assesses the overall biochemistry of your body, neurotransmitter levels, key metabolic pathways, bacterial and viral loads and the integrity of your gut and intestinal lining.  This gives us the vital information to be able to support the whole body rather than just the thyroid.  Hashimoto’s is not just a thyroid condition, but a whole body condition that involves the entire immune system.

For more information or if you would like to book with our functional medicine practitioners please get in touch.