The One Hormonal Imbalance at the Root of Depression, Anxiety, and Cognitive Issues

Thyroid Disorders

Being leveled by depression or anxiety, unable to engage in daily activities, is no joke. But before seeking an antidepressant or other mood-altering medications, you may want to start by having your thyroid levels checked.


Thyroid disorders are one of the leading causes of undiagnosed mental health issues. An overactive thyroid can make you feel sped-up and anxious, in a state of perpetual over-caffeination. An underactive thyroid typically means lower brain activity, which can lead to depression, brain fog, or irritability. In more than 430,000 scientific articles, depression has been linked with lowered thyroid levels.

For more than 200 years, the medical profession has identified the connection between optimal thyroid function and mental health. Check your thyroid before taking antidepressants. Click To Tweet

“Patients with hypothyroidism and those with depression can present with similar general symptoms,” according to the American Thyroid Association.

Because many mood disorders may have a fundamental root cause in thyroid disorders, it’s wise to have blood work done to see if you may be suffering from an underactive thyroid, in the form of hypothyroidism or Hashimoto’s disease; an overactive thyroid, with a disease called Grave’s disease; or any number of other related conditions.

A gland shaped like a bowtie wrapped at the front of your lower neck, the thyroid is a key regulator of the body’s metabolic processes. It also oversees the production of many neurotransmitters, such as dopamine, serotonin and GABA, which explains its paramount role in brain health.


For more than 200 years, the medical profession has identified the connection between optimal thyroid function and mental health.

An Anglo-Welsh physician named Caleb Parry all the way back in 1825 noted “nervous affectations” in people suffering from thyroid dysfunction. More than a century later, in 1969, depression was identified as a potential early sign of thyroid disease. It is also linked to schizophrenia, borderline personality disorder, bipolar disease, ADD/ADHD, and other mental health problems.

Before seeing your doctor, look for additional symptoms that could indicate there is more than meets the eye in your mental health struggles. They may include weight loss or gain, hair loss, fluctuations in your body temperature—feeling generally too hot or too cold—changes to your menstrual cycle, or persistent troubles with diarrhea or constipation.

Other symptoms to look for include:

  • Sluggishness
  • Racing thoughts
  • Memory problems
  • Trouble sleeping or unrestful sleep
  • Cramps or pain in your muscles or joints
  • Brittle nails
  • Extra dry skin
  • Yellowing skin
  • Symptoms of psychosis
  • Episodes of mania
  • Attentional problems or difficulty concentrating
  • Swelling in the front of your neck, which could indicate a swollen thyroid

Some of these symptoms on their own, such as difficulty sleeping and concentrating, can be primary symptoms of depression. However, the existence of one or several at the same time also could indicate your thyroid is involved.

Blood work can reveal low or high levels of the three main thyroid hormones, including thyroid-stimulating hormone, or TSH; thyroxine, or T4; and triiodothyronine, called T3. If so, treating your thyroid first to re-establish optimal hormonal levels may resolve, or at least lessen, psychiatric symptoms.


While standard thinking holds that healthy levels of TSH, or thyroid-stimulating hormone, should range between .5 and 5 in blood work results, not every medical professional agrees. A TSH test reveals just how hard the thyroid gland is working to keep a person’s metabolism working. The higher the test score, the harder the gland is pumping out hormones to jolt you into gear. Generally speaking, lower TSH test results indicate the metabolism is in balance, working well enough on its own, without this assist.

Some doctors, often those with a greater focus on lifestyle or integrative health, believe optimal results should always be below 2 or 2.5. The lower reading ideally indicates the gland is not over-stressed.

So be aware that some more traditional doctors may not prescribe thyroid medication when a test shows a TSH between 2 and 5. They may only do so when the test comes in above 5, or even higher. To treat subclinical hypothyroidism may require a visit to a functional or integrative doctor.


A wide variety of factors, acting alone or in combination, can conspire to undermine thyroid health, including dietary factors and exposure to environmental toxins.

One of them is a rapid loss of a large, or even moderate, amount of weight. When you lose weight rapidly, your thyroid slows, producing lower levels of TSH. This can throw off the delicate balance that the body must maintain in producing different thyroid hormones. In particular, rapid weight loss can result in a diminished ability to convert T4, also known as a “prohormone,” into the more active T3.

Dietary factors such as gluten sensitivity and celiac disease, both of which involve reactions to the gluten in wheat, can trigger thyroid disorders. For people with either, eating gluten can create leaky gut symptoms and release an antibody that can attack the thyroid. Given that celiac disease is often accompanied by thyroid disorder, one clinical study suggests gluten-free diets can help people struggling with thyroid health. Other studies have found that a failure to adhere to a gluten-free diet, for people with these risk factors, can contribute to a host of debilitating diseases such as osteoporosis, anemia, and increased risk of mortality.

Zinc deficiency is another risk factor, a particularly pervasive one given the depletion of zinc in many plants. Along with copper and selenium, zinc is required for the production of thyroid hormones. On the other side of the coin, thyroid hormones are necessary for the body to absorb zinc, which means hypothyroidism itself can lead to a zinc deficiency. When it comes to hair loss caused by hypothyroidism, often hormone supplementation won’t be sufficient without proper zinc supplementation.

Lastly, women with hypothyroidism who take supplemental estrogen for their health may need to increase the amount of thyroxine or T4 they take in order not to prevent a drop in their thyroid function.


In addition to seeking a functional doctor, a wide variety of natural supplements can boost your thyroid health. These include ashwagandha; zinc (which supports healthy hair); selenium; the herb rosemary; l-tyrosine; potassium; chromium; and vitamins A, B2, B3, B6, C, and D. Consult with your doctor to ensure your supplements support and do not conflict with your medications.

If psychiatric symptoms, such as anxiety, depression, attention issues, psychosis, or mania persist after regulating your thyroid levels, it’s time to seek help from a mental health professional.

Depression, anxiety, bipolar disorder, and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.


  1. Family especially my son suffering from anxiety .. my daughter has hashimotos disease..both are adult age..
    Jane Friend..

    Comment by JANE FRIEND — February 6, 2023 @ 3:14 AM

  2. Interested

    Comment by Cheryl — February 6, 2023 @ 4:43 AM

  3. Thanks for this article Amen Clinics team. I’m in the middle of deep research into the issue of thyroid. I wonder why you didn’t bring the issue of iodine interference into the discussion? There’s a great deal of research showing our iodine rich diet /processed foods, and water treatment all bring debilitating levels of iodine into the body causing thyroid dysfunction. Please let us know your thoughts on that . Your team has been spot on for my daughter and many friends I referred to you. Thank you for honest discussion!

    Comment by Megan Slifka — February 6, 2023 @ 6:17 AM

  4. I have had thyroid trouble for years and suffer from anxiety and depression I have under active thyroid and fed up of weight problems

    Comment by Pat — February 6, 2023 @ 6:51 AM

  5. Thank you for great article explaining link between mental health and thyroid disease. Both my sister and I recently diagnosed with hypothyroidism. Doctors seem uneducated about some aspects of thyroid issues and somewhat lax. I often feel like I need to research and question treatments. Thank you for good general explanation and information!

    Comment by Janice — February 6, 2023 @ 8:28 AM

  6. Very interesting….I have been diagnosed with Hypothyroidism and treated for years. Even though my thyroid test has been ok, my hair does fall out a lot. Does a blood test show zinc levels?

    Comment by Angie — February 6, 2023 @ 11:53 AM

  7. So if your tsh is 4. Something and you already use these supplement, what else can you take instead of levothyroxine ? I don’t want that drug. Want a healthier product.

    Comment by Lisa — February 6, 2023 @ 12:22 PM

  8. Thank your for your article. What if someone doesn’t have Thyroid gland because of extraction because of multinodular Thyroid. Do you have functional medical doctors? How can we make an appointment with you in Florida? Miami?

    Comment by Ava — February 6, 2023 @ 12:51 PM

  9. I am 53 years old and I have had every thyroid problem you can imagine starting from the age of 12!!! Back then they used to give Iodine drops. I would have to put 3 or 4 drops of iodine in an 8 ounce glass of water every single day. I started out having hyperthyroidism as a child and then right around high school graduation, I got like a 4-6 year break. I'm thinking it healed. Nope! As I got older and definitely had children it did a 360 and now I suffer from hypothyroidism and I have every single symptom that you guys listed on here. I take Levothyroxine and they did have to higher the dosage. I used to have it checked like every 3 to 6 months to level it out . Once Corona came on the scene, everything stopped. Sudden HALT. That was the last time I had my thyroid checked. 3 years ago. I think it's time to check it again. Thank you so much for breaking all this good information down and putting it together without using long college words. You explained it so easy and even said a few things that never crossed my mind. Extremely informative and I can't thank you enough!!! God bless!!!!

    Comment by Raquel — February 6, 2023 @ 5:26 PM

  10. Hello Ava, thank you for reaching out. Yes, we have functional and integrative medicine doctors. In Florida, we have a location in Hollywood, FL:

    Comment by Amen Clinics — February 7, 2023 @ 7:58 AM

  11. What are the five lab tests that you recommend?
    I kow four but not the fifth.

    TSH, T4, T3, Antibody

    Comment by Martha Musselman — February 17, 2023 @ 6:13 AM

  12. Thank you so much for the excellent information! I have Graves Disease and comorbid mental health issues. Your article is very helpful!

    Comment by Leilani — May 21, 2023 @ 1:51 PM

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