Anxiety Disorders and Autoimmune Thyroiditis – A Connection Rather Than Coincidence?

Evaluated Patient Population

Currently, up to 35% of the population aged 25-60 in the Western world suffers from anxiety disorders, with anxiolytic treatment not always bringing lasting relief. The presented study included patients who visited a neurologist or psychiatrist due to panic attacks. A total of 76 patients were included, specifically 29 men (average age 33.9 years) and 47 women (average age 31.7 years). On the Anxiety and Depression Rating Scale (HADS), all participants had a score ≥ 11 points, and anxiolytics only had a short-term effect on them. 

Methodology and Course of the Study

All participants underwent an ultrasound examination of the thyroid gland and serum concentrations of thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), thyroxine (fT4), and titers of antibodies against thyroglobulin (TRG) and thyroid peroxidase (TPO) were determined. Participants with increased blood flow through the thyroid gland but normal TSH levels were prescribed ibuprofen 200 mg twice daily for 14 days. Participants with increased thyroid blood flow and elevated TSH levels were also given 200 mg of ibuprofen twice daily for 14 days and additionally thyroxin at a dose of 25-50 µg for 8 weeks. Subsequently, another thyroid ultrasound and laboratory tests were performed.

Results

All patients had normal or only slightly enlarged thyroid glands and normal fT3 and fT4 values and antibodies against TRG. Antibodies against TPO were detected in all patients (ranging from 35-1000 IU/ml). Increased thyroid blood flow was observed in 71 patients (95%), with 39 of them having normal TSH levels and 32 displaying elevated TSH levels. 

Follow-up examinations showed normalized thyroid perfusion in 60 patients and normalized TSH levels in 30 patients. Despite not using anxiolytics, 71 patients (95%) had HADS scores of 4-8, which corresponds to normal values.

Conclusion

The results indicate that thyroid inflammation may be associated with anxiety disorders – after its treatment, anxious symptoms in patients were alleviated. The authors recommend checking thyroid function in all patients with anxiety disorders, as its inflammation may lead to psychological or emotional disorders. The conclusions still need to be confirmed in a larger, placebo-controlled study.

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Source: Onofriichuk I., Prystupiuk M. Anxiety disorders in patients with autoimmune thyroiditis. Endocrine Abstracts 2020; 70: EP456, doi: 10.1530/endoabs.70.EP456.