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Subclinical hypothyroidism and depression anxiety – Subclinical Hypothyroidism and Depression: A Systematic Review and Meta-Analysis

The literature quality evaluation was conducted by means of the Newcastle-Ottawa Quality Assessment Scale Recently, a paper from New England found no significant differences in the mean alteration in the Tiredness score or Hypothyroid Symptoms score over a 1-year period between a placebo group and an L-T4 treatment group among older people with SCH.

William Thompson
Wednesday, September 11, 2019
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  • Mono Bar U. Consistent with the distinct original data, we chose different effect models.

  • Rev Bras Psiquiatr.

  • All duplicates were removed. Supplemental legends 13K, docx.

  • JAMA ;

  • Effect of thyroid function variations within the laboratory reference range on health status, mood, and cognition in levothyroxine-treated subjects. Recently, several reports have focused on subclinical hypothyroidism SCH and its latent neuropsychiatric and neurocognitive outcomes; however, these studies have failed to determine the precise nature and strength of this relationship.

Introduction

Conclusions: This meta-analysis demonstrated that SCH was positively associated with the risk of depression, especially in persons above 50 years of age, suggesting it is necessary to pay close attention to depressive symptoms in persons with SCH. Search ADS. In subgroup analyses, we assessed the difference in GDS scores at 12 months separately for men and women, for participants above and below 75 years of age, for different TSH levels 4. Data Sharing Statement: See Supplement 3.

Two reviewers Zhao and Chen separately evaluated all potential titles and abstracts. Depressive symptoms in patients with hypothyroidisj hypothyroidism—the effect of treatment with levothyroxine: a double-blind randomized clinical trial. A probable interpretation of this disparity could be the over-diagnosis of SCH among the elderly due to the lack of age-associated serum TSH reference ranges in the original studies included in the meta-analysis The aim of this study was to investigate whether RES would manifest an antidepressant effect in SCH rat model and explore the possible mechanism. Supplemental legends 13K, docx. In conclusion, our study demonstrated that depression is positively associated with SCH, suggesting that it is necessary to for clinicians to pay special attention to depression symptoms in patients with SCH.

Mental and physical complaints in thyroid disorders in the general population. Health status, psychological symptoms, mood, and cognition in L-thyroxine-treated hypothyroid subjects. Trained information specialists answer calls, transfer subclinical hypothyroidism and depression anxiety to state services or other appropriate intake centers in their states, and connect them with local assistance and support. Everything feels more challenging when you're dealing with depression. Taken together, SCH and depression may share common biological mechanisms, which is in support of our findings. The funnel plot is a straightforward approach of investigating whether publication bias is present. Cognitive and affective status in mild hypothyroidism and interactions with L-thyroxine treatment.

References

Subclinical hypothyroidism: psychiatric disorders and symptoms. Nonetheless, it is recommended that each laboratory should establish their own cut-off value to evaluate SCH based on the age, region, ethnic factors. Was this page helpful? Correspondence to Huai Heng Loh.

GDS indicates Geriatric Depression Scale item questionnaire range, ; higher scores indicate more severe depressive symptoms; minimal clinically important difference, 2 points. The thyroid-brain interaction in thyroid disorders and mood disorders. Endogenous and depression anxiety thyroid disorders, physical and cognitive function, depression, and mortality in older individuals. Third, possible bias may have existed due to the heterogeneity of the meta-analysed studies in terms of SCH definition based on the upper limit of TSH and in the depressive evaluations diagnosis of depression and depressive scales. Depressive symptoms were measured using the item Geriatric Depression Scale GDS at baseline and month follow-up. Treatment for primary hypothyroidism: current approaches and future possibilities. Sex differences in the relationship between depressive symptoms and risk of amnestic mild cognitive impairment.

ALSO READ: Morelia Bredli Hypothyroidism

Full size image. A total of 12, individuals [ Results did not differ according to age, sex, or TSH levels. Supplement 3. Inthe Helpline receivedcalls.

Several studies reported a reduction in the somatostatin level in anxidty fluid, leading to increased TSH level among individuals with depression [ 4344 ]. Is subclinical thyroid dysfunction in the elderly associated with depression or cognitive dysfunction? The link between thyroid function and depression. Affect Disord. A reappraisal using objective psychological measurement. How many calls do you receive?

  • Clinical subclinnical guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Two studies involved individuals seen in the psychiatric out-patient clinics [ 3435 ], three from psychiatric wards [ 313233 ] whereas the other two studies selected individuals from the elderly community [ 3637 ].

  • Year : Volume : 15 Issue : 1 Page :

  • Prevalence and clinical correlates of subclinical hypothyroidism in first-episode drug-naive patients with major depressive disorder in a large sample of Chinese [published online November 3, ].

  • The coexistence of SCH and depression suggests that the 2 conditions may share some clinical characteristics and associations. Loh, H.

  • Selected studies were eligible if they met the following criteria: 1 SCH was confirmed by elevated TSH levels and circulating thyroid hormones within the normal range; and 2 the study was a cross-sectional, case-control, or cohort study.

Ann Intern Med. Association between subclinical hypothyroidism and depression: an updated systematic review and meta-analysis. What's the Depresaion Between Alcohol and Depression? In a pooled analysis of 12, individuals, those with SCH had higher risk of depression than euthyroid controls relative risk 2. A hypothesis of thyroid-catecholamine-receptor interaction. Sign In or Create an Account.

Zhao dogs with, 3 and Z. Serotonin exerts a repressive effect on thyrotropin-releasing hormone TRH excretion, suggesting the presence of a feedback loop that permits the activation of the hypothalamus-pituitary-thyroid axis if serotonin values in the brain are relatively low. The objective of this study was to evaluate the relationship between subclinical hypothyroidism SCH and depression. First, the age of subjects in the included studies was not restricted to a specific range. Table 1 The characteristics of non-RCTs.

Publication types

Subclinical hypothyroidism: psychiatric disorders and symptoms. In addition, SCH may result from antithyroid treatment in patients with Graves' disease. First, timely screening and intervention of depressive symptoms are of great importance in persons with SCH. Finally, seven studies were eligible and included in the final quantitative analysis meta-analysis. Consistent with the diverse original reports, we applied different methods of evaluating the quality.

Territories for mental and substance use disorders. Hypotyroidism quality of evidence assessed with the GRADE tool was high, indicating that further research is very unlikely to change our confidence in the estimate of effect eTable 4 in Supplement 2. Thyroid hormone therapy for older adults with subclinical hypothyroidism. Stott DJ, et al. Thyroid hormones treatment for subclinical hypothyroidism: a clinical practice guideline.

Iodine status and prevalence of thyroid disorders after introduction of mandatory universal salt iodization for 16 years in Anxisty a cross-sectional study in 10 cities. A large proportion of patients with these disorders show psychiatric comorbidity. JAMA Neurol. However, several limitations should be taken into consideration. The aging thyroid. Consistent with the distinct original data, we chose different effect models. Subclinical hypothyroidism after I-treatment of Graves' disease: a risk factor for depression?

Publications

Contact us Submission enquiries: bmcpsychiatry biomedcentral. Electronic supplementary material Supplementary Figure 1 K, pdf. Receive exclusive offers and updates from Oxford Academic.

Two reviewers Zhao and Chen separately evaluated all potential titles and abstracts. Numerous studies have investigated the mechanism by which overt thyroid disease influences physical, behavioural, and cognitive functions 9 ; however, the connection between SCH and these consequent measures has not been rigorously defined, and studies have reported contradictory outcomes 12 — Due to this controversy, a particular TSH upper limit for the SCH definition was not pre-identified in this meta-analysis. Keywords: subclinical hypothyroidism, depression, thyroid, neuroendocrinology, thyroxine. First, the age of subjects in the included studies was not restricted to a specific range.

  • Arch Gerontol Geriatr. However, a recent randomized, blinded, crossover study failed to find differences in symptoms, quality of life, or depression when DTE was substituted for L-T4

  • Nord J Psychiatry. Notes Conflict of interest The authors declare that they have no conflict of interest.

  • With this clinical context, what do we know objectively about depression and mild or subclinical hypothyroidism?

  • Disagreements were settled by consensus and the view of a third author Zhao as necessary. However, the use of levothyroxine therapy among people with depression need to be considered carefully on an individual basis, weighing the risks and benefits of the treatment.

Elevated thyroid peroxidase antibody increases risk of post-partum depression by decreasing prefrontal cortex BDNF and 5-HT levels in mice. J Affect Disord. Ann Intern Med. Int J Geriatr Psychiatry ; A reappraisal using objective psychological measurement. Many of the included articles did not re-examine the thyroid hormone levels over time.

Subclinical and overt thyroid dysfunction and risk of all-cause mortality and cardiovascular events: A large population subclinical hypothyroidism and depression anxiety. Many of the included articles did not re-examine the thyroid hormone levels over time. Subclinical hypothyroidism SCH is not associated with metabolic derangement, cognitive impairment, depression or poor quality of life QoL in elderly subjects. A total of 21 studies were included in the qualitative analysis. Kim J-M. If published papers only provided the percentage of depressive symptoms, the evaluator calculated the numbers of participants by the calculator in Revman version 5.

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The current study was carried out to assess the prevalence and proportion of depression, anxiety, and somatization symptoms and compare the same between these two groups of patients. The case-control study by Yu et al. Cd

Association between subclinical thyroid dysfunction and depressive symptoms in the Korean adult population: The Korea National Anxiety and Nutrition Examination Survey. In addition, the funnel plot showed a symmetric distribution. Several experts propose that the TSH upper limit is 4. If you are experiencing symptoms of a thyroid imbalance, depression or both, it is important to talk to your doctor. Age-dependent symptomatology of depression in hospitalized patients and its implications for DSM Of the participants from the Netherlands and from Switzerland, were allocated to levothyroxine and to the placebo group Figure 1. First, the large sample size makes it the largest trial, to our knowledge, on depressive symptoms in patients with subclinical hypothyroidism.

Thyroid-stimulating hormone in the evaluation of subclinical hypothyroidism. Depression and anxiety in different thyroid function states. XD and YZ: data extraction. Recently, a anxety from New England found no significant differences in the mean alteration in the Tiredness score or Hypothyroid Symptoms score over a 1-year period between a placebo group and an L-T4 treatment group among older people with SCH. J Clin Endocrinol Metab ; Papaleontiou M, Cappola AR.

SYSTEMATIC REVIEW article

Acta Psychiatr. The characteristics of 21 studies were presented in Table 1which included 11 cohort, 5 cross-sectional, and 5 case-control studies with mean participant age of Access Statistics. Nonetheless, it is recommended that each laboratory should establish their own cut-off value to evaluate SCH based on the age, region, ethnic factors.

Subclinical thyroid dysfunction and depressive symptoms among the elderly: A prospective cohort study. Thyroid hormones, T3 and T4, in the brain. Protein levels of beta-catenin and activation state of glycogen synthase kinase-3beta in major depression. Lithium increases platelet serine-9 phosphorylated GSK-3beta levels in drug-free bipolar disorder during depressive episodes.

Psychiatric disorders and quality of life in patients with hypothyroidism: A narrative review. Subclinical hypothyroidism increases the risk for depression in the elderly. J Nerv Mental Dis. Thyroid function within the normal range and the risk of depression: A population-based cohort study. Endocrinol Metab Clin North Am.

Associated Data

Volume Recently, several reports have focused on subclinical hypothyroidism SCH and its latent neuropsychiatric and neurocognitive outcomes; however, these studies have failed to determine the precise nature and strength of this relationship. Horm Metab Res.

  • Will my information be kept confidential?

  • Access Statistics. Asian J Psychiatr.

  • Ceresini G, et al. Rockville MD

  • Am J Med.

  • In recent years, many publications have paid increasing attention to the relationship between SCH and depression; however, these studies revealed tremendous heterogeneity in the recruited population, particularly in terms of age, gender, and depressive domains. Thus, in elderly populations, depression is more likely to occur in participants with SCH.

Table 1. SE, standard error; OR, odds ratio. Occup Med Oxford. Med Care. Studies from Korea, the Netherlands, and Norway showed null associations between SCH and depression, while all the studies from Brazil showed significant associations. The literature quality evaluation was conducted by means of the Newcastle-Ottawa Quality Assessment Scale

Papaleontiou M, Cappola AR. Abstract Metabolic disease subclinical hypothyroidism Depressiion is closely associated with depression-like behavior both in human and animal studies, and our previous studies have identified the antidepressant effect of resveratrol RES in stressed rat model. Psychopathological and cognitive features in subclinical hypothyroidism. Thyroid hormone replacement for subclinical hypothyroidism. Dayan CM, Panicker V.

  • American Thyroid Association. Dr Moutzouri reported receiving grants from the Swiss National Science Foundation during the conduct of the study.

  • The Colorado thyroid disease prevalence study. In addition, the fT4 values were considered regular if they were perceived as normal by the reviewers, even though details regarding the fT4 values were not indicated.

  • We excluded participants without depressive symptom measurements Figure 1. Select Format Select format.

  • An approach for development of age- gender- and ethnicity-specific thyrotropin reference limits. Int J Cardiol.

  • This article has been cited by other articles in PMC. CESD values from 16 to 20 indicate mild depressive symptoms, values from 20 to 25 indicate moderate symptoms, and values of 25 and greater indicate severe depressive symptoms.

  • Not all submitted comments are published. Depression, being one of the common chronically disabling disorders, can lead to poor quality of life [ 12 ].

Lower Subbclinical and higher Depression anxiety levels are associated with current depressive syndrome in young adults. The incidence of ischemic heart disease and mortality in people with subclinical hypothyroidism: reanalysis of the Whickham Survey cohort. Med Care. Another reasonable interpretation is that many older patients with biochemical outcomes consistent with SCH would have reverted to a normal thyroid function state without L-T4 replacement. J Affect Disord. Shan Z, et al.

J Nerv Ment Dis ; The methodological quality of the selected RCTs was evaluated according hypothyroifism the Cochrane Handbook for Systematic Review of Interventions and depression anxiety on the following aspects: generation of random sequence, distribution concealment, blinding, incomplete consequence date description, free of selective reporting, and free of other bias. Characteristics of included studies. Dissent was resolved by consensus and the recommendation of a third observer Zhao as required. Psychiatric and cognitive manifestations of hypothyroidism.

Background

Occup Med Oxford. Observational studies on the association between subclinical hypothyroidism and depressive symptoms have yielded conflicting results. Permissions Icon Permissions.

Thyroid stimulating hormone, cognitive impairment and depression in an older Korean population. A 6-month randomized trial depression anxiety thyroxine treatment in women with mild subclinical hypothyroidism. Subclinical depresskon SCH is defined as a condition with elevated thyroid-stimulating hormone TSH and normal free thyroxine T4 levels 2. The results showed that RES treatment downregulated the elevated plasma thyroid-stimulating hormone concentration and the hypothalamic mRNA expression of thyrotropin-releasing hormone in the SCH rats. SCH participants were diagnosed according to the specific diagnostic criteria in each included study Table 1 and the controls for these studies included participants with euthyroid function. Checklists of methodological issues for review authors to consider when including non-randomized studies in systematic reviews. In their study, mean scores of depressive symptoms were comparable between participants with SCH and euthyroid participants.

Psychosom Med ; Helfand M. Asian J Psychiatr. Depressive symptoms and major depressive disorder in patients affected by subclinical hypothyroidism a cross-sectional study. Depression-like behavior in subclinical hypothyroidism rat induced by hemi-thyroid electrocauterization. Thyroid hormones and the treatment of depression: an examination of basic hormonal actions in the mature mammalian brain.

The incidence of ischemic heart disease and mortality in people with subclinical hypothyroidism: reanalysis of the Whickham Survey cohort. Endocr Res ; Surks MI, et al. J Clin Endocrinol Metab ; The clinical significance of subclinical thyroid dysfunction. Elevated thyroid peroxidase antibody increases risk of post-partum depression by decreasing prefrontal cortex BDNF and 5-HT levels in mice. A forest plot was used to present the pooled OR value, and heterogeneity was evaluated using the I 2 statistic.

Initially, a total of 3, studies were identified by hypotyroidism search strategy. Samuels MH. This meta-analysis demonstrates that there is a higher prevalence of depression in persons with SCH, raising some suggestions for clinical practice. We performed a meta-analysis of the available evidence from cross-sectional reports and both prospective and retrospective studies investigating the relationship between SCH and depressive scale.

Thus, the overall number of cases and controls was adequately large to support the conclusion of the deptession. Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Issue Section:. Figure 1. Effects of subclinical hypothyroidism treatment on psychiatric symptoms, muscular complaints, and quality of life.

Results: The study groups were well matched on sociodemographic profile and basic data. Ajxiety studies have reported that age is an inconvenient element that influences the path and symptomatology of a depressive episode 17 Williams MD, et al. This result indicates that only older participants are more susceptible to SCH. Thyroid Res Pract ; Table 1: Sociodemographic data of both groups Click here to view. Figure 2.

Frequency of somatic symptoms in the general population: Normative values for the patient health questionnaire PHQ Subclinical hypothyroidism, mood, and cognition in older adults: A review. Using this approach, avoiding the inclusion of several people with normal thyroid hormone into the group of SCH patients is challenging, which could result in an underestimation of the risk of depression associated with SCH among the elderly.

Studies from Korea, the Netherlands, and Norway showed null associations between SCH and depression, while all the studies from Brazil showed significant associations. In anxiiety, the 14 studies involved participants, including participants diagnosed with SCH. What's the Connection Between Alcohol and Depression? J Clin Endocrinol Metab. Disagreements were settled by consensus and the view of a third author Zhao as necessary. Thanks for your feedback! However, the findings of these reports could not reach a consensus.

Stott DJ, et al. Many papers have investigated whether SCH promotes depression-like behaviour in rats in conjunction with slight hyper-activity of the hypothalamus-pituitary-adrenal HPA axis. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Purchase access Subscribe to the journal. Second, probable bias existed in the selection of the included studies, including quality problems in the original articles, inevitable heterogeneity, publication bias, and confounding factors. Participants were followed up for a minimum of 12 months.

Acknowledgments

Oxford University Press is a department of the University of Oxford. High serum TSH levels are associated with depression in the elderly. Everything feels more challenging when you're dealing with depression.

Accepted : 27 December Privacy Policy. Physiologically, type II deiodinase converts fT4 to fT3 in the brain glial cells [ 54 ]. The thyroid axis and depression. Eur Thyroid J. Updated June 14,

Disagreements were settled by consensus and the view of a third author Zhao as necessary. Psychiatry Investig. Funnel plot analysis. All data analyses were performed with Revman 5. Occup Med Oxford. Surks MI, et al.

Studies from Korea, the Netherlands, and Norway showed null associations between Derpession and depression, while all the studies from Brazil showed significant associations. Depressive symptoms in patients with subclinical hypothyroidism — The effect of treatment with levothyroxine: A double-blind randomized clinical trial. Supplementary Figure 6 83K, pdf. Eur Thyroid J ; PLoS One ;e

Shan Z, et al. Cochrane Database Syst. The presence of publication bias was assessed by the combination of Egger's test, Depression anxiety test, and visual inspection of the funnel plot. To the best of our knowledge, this is the first systematic review and meta-analysis aimed to verify the association between subclinical hypothyroidism and depression. Next, 79 studies were assessed for eligibility by reviewing the full-text article. Depressive episodes accompanied by anxiety and the risk of committing suicide are considerable predictors that differ according to the age of the subjects. Hypothyroidism and depression.

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The role of thyroid hormones in depression. Results Study selection In total, articles were identified by the preliminary search of articles published subclinucal June 10, ; of these articles, were more comprehensively evaluated and 17 papers were finally selected for the meta-analysis Supplementary Figures 1. Reprints and Permissions. Annual incidence of thyroid disease in patients who first time visit department for thyroid diseases in Tuzla Canton. Potential participants aged 65 or older were identified from clinical and general practitioner laboratory databases and recruited from the community in Switzerland, the Netherlands and Ireland. World population prospects: the revision. The study researchers concluded that severe SCH is closely related to clinical manifestations of MDD and that patients with MDD should undergo regular screening of serum TSH levels to reduce the risk of suicide and psychiatric symptoms.

Analyses were conducted from December 1,to September 1, Ellos anxiety. Anc and YZ: data extraction. However, it has been postulated that depression can cause inhibitory effect on type II deiodinase, which leads to the conversion of fT4 to rT3 via type III deiodinase [ 55 ]. We may ask for your zip code or other pertinent geographic information in order to track calls being routed to other offices or to accurately identify the local resources appropriate to your needs. Prevalence of symptoms of depression in a nationwide sample of Korean adults.

  • All data analyses were performed using Stats Direct version 2.

  • Finally, seven studies were eligible and included in the final quantitative analysis meta-analysis. Duntas LH, Maillis A.

  • Conclusion SCH has a negative impact on depression. We excluded participants without depressive symptom measurements Figure 1.

The Colorado thyroid disease prevalence study. This systematic review and meta-analysis demonstrated that the prevalence of depression is slightly higher in persons with SCH, especially in persons above 50 years of age, suggesting subclinical hypothyroidism might be a risk factor for depression. Supplementary Figure 2 1. To avoid missing any relevant papers, we also reviewed the reference lists of key reports for related articles. Guidelines for the treatment of hypothyroidism: Prepared by the American thyroid association task force on thyroid hormone replacement.

Despite these limitations, the current meta-analysis has enhanced the statistical power by pooling the results of the studies. Another meaningful consequence of the current meta-analysis is demonstrated by the ineffectiveness of therapy for SCH with LT4 supplementation on depression. This article has been cited by. Several experts propose that the TSH upper limit is 4.

Associated Data

For some people, treating the underlying thyroid imbalance can relieve depression. Initially, a total of 3, studies were identified by the search strategy. Two studies found a higher prevalence of depression between elderly with SCH compared to controls [ 1430 ].

Discussion Summary of Main Findings This subclinical hypothyroidism review hylothyroidism meta-analysis demonstrated that the prevalence of depression is slightly higher in persons with SCH, especially in persons above 50 years of age, suggesting subclinical hypothyroidism might be a risk factor for depression. SCH participants were diagnosed according to the specific diagnostic criteria in each included study Table 1 and the controls for these studies included participants with euthyroid function. Studies from Korea, the Netherlands, and Norway showed null associations between SCH and depression, while all the studies from Brazil showed significant associations. Table 1 summarizes the study characteristics. The total number of the cases and controls was sufficiently large to support our conclusions. The thyroid, a small gland located in the neck, plays an important role in a number of body functions. First, timely screening and intervention of depressive symptoms are of great importance in persons with SCH.

References 1. Updated June 14, J Clin Endocrinol Metab. Levothyroxine overuse: time for an about face? This ancillary study is nested in a large, international study on levothyroxine therapy in older adults with subclinical hypothyroidism the TRUST trialwhich was conducted from April to October 31, Thyroid status, disability and cognitive function, and survival in old age.

Iodine status and prevalence of thyroid disorders after introduction of mandatory universal salt iodization for 16 years in China: a cross-sectional study in 10 cities. Compared with the younger population, higher TSH level is seen in the elderly due to reduced fT4 degradation and its peripheral conversion to fT3, with subsequent positive feedback to the HPT axis [ 47 ]. Skip to main content. Screening for depression in the general population with the Center for Epidemiologic Studies Depression CES-D : a systematic review with meta-analysis. Although depression is associated with changes in the hypothalamic-pituitary-thyroid axis, its relationship with subclinical hypothyroidism SCH is controversial. Mental changes accompanying thyroid gland dysfunction. Second, participants lost to follow-up had a higher mean GDS score at baseline compared to those with a completed follow-up, which suggests that participants with higher scores were more likely lost to follow-up.

The data were analyzed statistically using computerized software. Thyroid subclinical hypothyroidism and depression anxiety abnormalities and cognitive impairment in elderly people: results of the Invecchiare in Chianti study. Numerous studies have investigated the mechanism by which overt thyroid disease influences physical, behavioural, and cognitive functions 9 ; however, the connection between SCH and these consequent measures has not been rigorously defined, and studies have reported contradictory outcomes 12 — Subclinical hypothyroidism after I-treatment of Graves' disease: a risk factor for depression?

No effect of the Thr92Ala polymorphism of deiodinase-2 on thyroid hormone parameters, health-related quality of life, and cognitive functioning in a large population-based cohort study. Association between subclinical hypothyroidism and depression: an updated systematic review and meta-analysis. Select Format Select format. Supplementary Figure 4 2. Am J Med.

The reason for the choice of OR was due to the retrospective design of this meta-analysis based on published studies that varied in design, subject populations, primary outcome measures, and research quality This hypothyroidixm demonstrates that there is a higher prevalence of depression in persons with SCH, raising some suggestions for clinical practice. The current study was carried out to assess the prevalence and proportion of depression, anxiety, and somatization symptoms and compare the same between these two groups of patients. Well-being and depression in individuals with subclinical hypothyroidism and thyroid autoimmunity — A general population study. XC and ZC: paper writing and review. Hypothyroidism and risk of mild cognitive impairment in elderly persons: a population-based study. The clinical significance of subclinical thyroid dysfunction.

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This meta-analysis demonstrates that SCH is not connected depreszion depression. Thyroid medications are depression anxiety combined with antidepressants to treat depression in people with normal thyroid functioning. Clinical characteristics and incidences of benign and malignant insulinoma using a national inpatient database in Japan. Potential participants aged 65 or older were identified from clinical and general practitioner laboratory databases and recruited from the community in Switzerland, the Netherlands and Ireland.

Reviews, case reports, letters, nonhuman studies, subclinical hypothyroidism and depression anxiety conference abstracts were eliminated. Cognitive and affective status in mild hypothyroidism and interactions with L-thyroxine treatment. Thyroid hormones, T3 and T4, in the brain. To determine the impact of the individual studies on the summary risk assessment, we performed a one-study-removed analysis by omitting one report from each rotation and re-computing the pooled estimates of the remaining studies employing the metaninf command.

Int J Geriatr Psychiatry. As this study is, to our knowledge, the biggest trial to investigate the effect of levothyroxine on depressive symptoms in patients with subclinical hypothyroidism, we also updated a recent meta-analysis on participants with the results from this ancillary study on the TRUST trial on participants. Views 8, This ancillary study is nested in a large, international study on levothyroxine therapy in older adults with subclinical hypothyroidism the TRUST trialwhich was conducted from April to October 31, Geriatric cohort with SCH had a 1. Brennan MD, et al.

Int J Cardiol. With this clinical context, what do we know objectively about depression and mild or subclinical hypothyroidism? Subclinical hypothyroidism: psychiatric disorders and symptoms. Why are GPs treating subclinical hypothyroidism? What Is Dopamine?

  • Neuropsychological function and symptoms in subjects with subclinical hypothyroidism and the effect of thyroxine treatment. Limit 25 characters.

  • Consistent with the distinct original data, we chose different effect models. Its relevance to affective illness.

  • Reprints and Permissions.

  • Changes in HDRS scores with levothyroxine treatment.

The clinical significance of subclinical thyroid dysfunction. View author publications. In a seminal series of nine individuals with refractory depression, on top of antidepressant and levothyroxine therapy, additional administration of liothyronine was associated with marked improvement in the symptoms of depression in seven of them [ 57 ]. Sign in to download free article PDFs Sign in to access your subscriptions Sign in to your personal account.

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Whenever needed, we contacted the authors to obtain either the full-text article or for clarification of the missing data. Leading subclinical hypothyroidism and depression anxiety drugs dispenses in England in Oxford Academic. Conflicts of interest comprise financial interests, activities, hypothyroidis, relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. Prevalence of depression in patients affected by subclinical hypothyroidism. Nonetheless, it is recommended that each laboratory should establish their own cut-off value to evaluate SCH based on the age, region, ethnic factors.

Your comment submission was successful. Surks MI, et al. Am J Geriatr Psychiatry. Subclinical hypothyroidism SCH is not associated with metabolic derangement, cognitive impairment, depression or poor quality of life QoL in elderly subjects. Purchase access Subscribe to JN Learning for one year.

  • Early and routine screening of depression is essential to prevent morbidity and mortality. Guidelines for the treatment of hypothyroidism: prepared by the american thyroid association task force on thyroid hormone replacement.

  • Psychiatric disorders and quality of life in patients with hypothyroidism: A narrative review.

  • Eight of the 14 studies also reported fT4 measurements.

Overall, the current evidence does not demonstrate a significant benefit of L-T4 treatment. Download citation. Risk of depression among geriatric patients with subclinical hypothyroidism. View Metrics. A reappraisal using objective psychological measurement. A flow chart of the meta-analysis is shown in Figure 1. United Nations.

Molecular basis of thyroid hormone-dependent brain development. Subclinical thyroid dysfunction and depressive symptoms among the elderly: a prospective cohort study. Brennan MD, et al. To address this, the authors performed a sensitivity analysis using repeated measurements of thyroid hormones as time-varying variables, and found similar results.

Thus, in elderly populations, depression is more likely to occur in participants with SCH. Notably, articles involving participants varying in age may affect mutual comparability. The results stayed robust in several subgroup analyses.

Read our editorial process to learn more about how we fact-check and keep our content hypothyoridism, reliable, and trustworthy. A randomized controlled trial of the effect of thyroxine replacement on cognitive function in community-living elderly subjects with subclinical hypothyroidism: the Birmingham Elderly Thyroid study. CSF transthyretin in patients with depression. Share Buttons.

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Login Register. Fourteen studies were excluded in our final meta-analysis because they utilized mean depressive scores or other methodologies to present their results in the final publication, making it impossible to meta-analyze these data. Neuropsychiatric manifestations of thyroid disease. Author information Article notes Copyright and License information Disclaimer. Article Sources.

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  • Electronic supplementary material Supplementary Information accompanies this paper at

  • If the data were not provided numerically, it would be read off graphs.

  • Among these studies, Park et al.

  • Accessed July 7,

Do You Hypothyyroidism Respiratory Depression? SCH has a negative impact on depression. Portella RB, et al. The TRUST trial included adults aged 65 years or older diagnosed with subclinical hypothyroidism, defined as the presence of persistently elevated thyroid-stimulating hormone TSH levels 4. Thus, in elderly populations, depression is more likely to occur in participants with SCH. The scale is scored from zero to nine stars, and the highest score indicates the best methodological quality.

Changes in BDI scores with levothyroxine treatment. Asian J Psychiatr. SMD: standard mean differences. Biol Psychiatry. The baseline characteristics of the 45 excluded participants were similar to those who were included eTable 1 in Supplement 2.

This is dry skin in dogs with hypothyroidism by the literature: in a population-based study of over 25, patients, there hypothyroldism no correlation between thyroid function and self-reported depression overall, but the subgroup with known thyroid disease had an increased risk of depression, despite normal TSH levels Finally, seven studies were eligible and included in the final quantitative analysis meta-analysis. Competing interests The authors declare that they have no competing interests.

Subclinical hypothyroidism and cognitive impairment: Systematic review and meta-analysis. This method can lead to the potential misclassification subclunical normal thyroid hormone participants who only have subclinical hypothyroidism and depression anxiety transient elevation in the serum TSH level. The aim of this study was to investigate whether RES would manifest an antidepressant effect in SCH rat model and explore the possible mechanism. Supplementary Figure 5 74K, pdf. Data extraction and quality assessment Two authors Zhao and Chen independently extracted the data from the original studies using a uniform standard procedure. Ceresini G, et al. Furthermore, lower serotonin levels are observed in brains with hypothyroidism.

Thyroid hormones, serotonin and mood: of synergy and significance in the adult brain. The OR for depressive patients was 1. The current study was carried out to assess the prevalence and proportion of depression, anxiety, and somatization symptoms and compare the same between these two groups of patients. Outcomes Overall, we found an insignificant difference in the following composite end point: the SMD for depressive scores was 0. The hospital anxiety and depression scale. Correspondence Address : Dr.

High-quality placebo-controlled studies with large sample sizes are needed. Arch Med Res. An approach for development of age- gender- and ethnicity-specific thyrotropin reference limits.

To sign up for updates or to access your subscriber preferences, please enter your contact information. Meaning These results and depression anxiety not provide evidence in favor of levothyroxine therapy in older persons with subclinical hypothyroidism to reduce the risk of developing depressive symptoms. Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Drug Des Devel Ther. Participants were followed up for a minimum of 12 months. Figure 4.

ALSO READ: Hypothyroidism Low Tsh Normal T3 T4

A flow chart of the meta-analysis is shown in Figure 1. High serum TSH levels are associated with depression in the elderly. A hypothesis of thyroid-catecholamine-receptor interaction. We performed a sub-group analysis because of the clinical heterogeneity. Thyroid-stimulating hormone in the evaluation of subclinical hypothyroidism. Low mood and response to Levothyroxine treatment in Indian patients with subclinical hypothyroidism. Psychiatry Res.

Neuropsychological function and symptoms in subjects with subclinical hypothyroidism and the effect of thyroxine treatment. The hospital anxiety and depression scale. Subclinical hypothyroidism and cognitive impairment: systematic review and meta-analysis. Users Online:

Clinical utility of the item geriatric depression depresskon GDS for use with young and middle-aged adults. Ceresini G, et al. Med Care. This meta-analysis demonstrates that there is a higher prevalence of depression in persons with SCH, raising some suggestions for clinical practice. Thyroid hormones, serotonin and mood: of synergy and significance in the adult brain.

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