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Depression subclinical hypothyroidism tsh: Subclinical Hypothyroidism Associated With Incident Depression?

Affect Disord.

Matthew Cox
Sunday, October 18, 2020
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  • Am J Geriatr Psychiatry.

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  • Clinical review: a review of the clinical consequences of variation in thyroid function within the reference range.

Introduction

Privacy Policy Terms of Use. X-axis: positive values equal to the aggravation on depressive tendency. Enjoying our content?

In this study, 92, young to middle-aged adults without depression or known thyroid disease at baseline were examined at least twice in a 4-year time period. Log in to depression subclinical hypothyroidism tsh reading this article. Third, there may be possible bias due to the heterogeneity of the analyzed studies in terms of the definition of SCH and the evaluation of depression. Get free access to newly published articles Create a personal account or sign in to: Register for email alerts with links to free full-text articles Access PDFs of free articles Manage your interests Save searches and receive search alerts.

The studies used various depressive tests to assess a wide scope of depressive domains. Endocrine 45— Bone Miner. Which one of the following statements is least applicable to this patient?

Subclinical hypothyroidism after I-treatment of Graves' disease: a hypothyroifism factor for depression. In cases of overt thyroid disorder, treating psychiatric symptoms with L-T4 supplementation is well indicated. L-thyroxine therapy in subclinical hypothyroidism: a double-blind, placebo-controlled trial. Despite these limitations, the current meta-analysis has enhanced the statistical power by pooling the results of the studies. Subsequently, we collected the full versions of the qualified reports. Zhao, T. Supplementary Figure 2.

References

Strengths of these latter studies, compared with many of the earlier studies, include large sample sizes, broad age ranges, sucblinical absence of bias population based. Dissent was resolved by consensus and the recommendation of a third observer Zhao as required. Forman-Hoffman, V. Subclinical Hyperthyroidism: a mild form of hyperthyroidism where the only abnormal hormone level is a decreased TSH.

Email alerts Tsh activity alert. Try out PMC Labs and tell us what you think. Disclosure Summary: The authors have nothing to disclose. Monthly Email. Hypothyroid patients and their physicians may be more aware of depressive symptoms and ascribe them to the thyroid disease when in fact it is a separate problem, as depression is extremely common in the general population.

Serotonin exerts a depression subclinical hypothyroidism tsh effect on thyrotropin-releasing hormone TRH ysh, 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. Epub Jan 1. Try out PMC Labs and tell us what you think. However, the upper limit of the TSH reference range is controversial. Aging Neurosci. Hypothyroid patients and their physicians may be more aware of depressive symptoms and ascribe them to the thyroid disease when in fact it is a separate problem, as depression is extremely common in the general population. For some people, treating the underlying thyroid imbalance can relieve depression.

  • The patient and care provider may attribute the depressive symptoms to the mild thyroid disorder and initiate L-T4 therapy.

  • Stott et al.

  • In addition, entire thyroid hormone profiles were not examined, and all the instruments were in Chinese only. Shan, Z.

  • Please see our commenting policy for details.

  • Aging Neurosci. Low mood and response to Levothyroxine treatment in Indian patients with subclinical hypothyroidism.

The baseline characteristics of the 45 excluded participants were similar to those who were included eTable hypothyoidism in Supplement 2. Our findings favor early and routine screening for depression among individuals with SCH especially the elderly, to prevent morbidity and mortality. Given the world population ageing and an increased risk of depression in the elderly with SCH as shown in our analysis [ 52 ], there is an urgent need for TSH and depression screening in this vulnerable population, in order to improve health and well-being for all. Gulseren et al. Fourth, this study on depressive symptoms was an ancillary study of the TRUST trial; therefore, we were not able to include all participants from the original study, as depressive symptoms were not measured at all sites of the TRUST trial. T3 augmentation of antidepressant treatment in T4-replaced thyroid patients.

Advanced Search. A meta-analysis of 13 studies concluded that the lipid profile improved with therapy. The Colorado thyroid disease prevalence study. JAMA— Data on health-related quality of life and symptoms did not show significant differences between intervention groups.

Associated Data

Among the 15 studies included, there were nine questionnaires used to evaluate depression. The Colorado thyroid disease prevalence study. Recently, a large cohort study conducted by Kim et al.

The authors also acknowledge some limitations, including the relatively short follow-up period. N Engl J Med. Subclinical Hypothyroidism: a mild form of hypothyroidism where the only abnormal hormone level is an increased TSH. The papers were considered qualified if they met the corresponding criteria: published data, cross-sectional study, case control report, prospective study, retrospective study, RCTs, clearance and use of a unique commercial product to perform the TSH assay, specified depressive measurement and domains, and number of depressed patients included with well-described criteria for depression. Endocr Res.

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This suggests that L-T4 is often prescribed for depressioh reasons, which are commonly neuropsychiatric in nature. JAMA Neurol. To the best of our knowledge, our report has explored further in details the relationship between SCH and depression, by including the geriatric cohort and examining the effect of levothyroxine therapy in individuals with these co-existing illnesses. No other disclosures were reported. We defined the primary outcome as GDS score at 12 months, adjusted for scores at baseline, age, sex, country, and starting dose of levothyroxine.

Electronic supplementary material. Correspondence to Z. Tsu medications are sometimes combined with antidepressants to treat untreated subclinical hypothyroidism in people with normal thyroid functioning. The OR for depressive patients was 1. Lower TSH and higher T4 levels are associated with current depressive syndrome in young adults. Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women: the Rotterdam Study. Email alerts Article activity alert.

Acknowledgments

Psychopathological and subclinkcal features in subclinical hypothyroidism. Cognitive and affective status in mild hypothyroidism and interactions with L-thyroxine treatment. Figure 1 shows the flow of studies selection. Thus, in elderly populations, depression is more likely to occur in participants with SCH. Disagreements were settled by consensus and the view of a third author Zhao as necessary.

These publications reveal elevated serotonin levels in the cerebral cortex of rats tsh T3 administration. Synapse usbclinical36—44 The serum TSH distribution curve is not Gaussian; there is a tail end at the upper limits of normal. Int J Cardiol. Thyroid 16— The authors would like to gratefully acknowledge the Arak University of Medical Sciences because the study was funded by the university.

  • Close mobile search navigation Article Navigation.

  • Bone Miner. Shan, Z.

  • Due to the potential clinical heterogeneity, a random-effect model was chosen to synthesize data instead of a fixed-effect model.

  • The odds ratio OR for depressive patients was 1. Neuropsychological function and symptoms in subjects with subclinical hypothyroidism and the effect of thyroxine treatment.

  • Wilkowska-Chmielewska, J.

Save Preferences. Manciet et al. Hong et al. Sign in to customize your interests Sign in to your personal account. Psychiatry Investig.

Karege F, et al. SMD: standard mean differences. Mental changes accompanying thyroid gland dysfunction. Of course there are some limitations due to small sample size, convenience recruitment and also the population of the study was not large enough to provide the statistical power to analyze the effects of sex or age and there is the need for broad based studies. Marwaha concluded that a TSH cut-off point should be age- and gender-specific [ 31 ].

Acknowledgments

Surks, M. We aimed to detect a new TSH cut-off value in hypothyroidism based on depression symptoms. Zhao3 and Z. Williams, M. Forgetfulness, fatigue, mental slowness, and emotional lability have been shown as some psychological symptoms of hypothyroidism.

The objective of this study was to evaluate the relationship between subclinical hypothyroidism SCH and depression. Depression subclinical hypothyroidism tsh function abnormalities and cognitive impairment in elderly people: results subclibical the Invecchiare in Chianti study. We also found an insignificant difference in the composite endpoint between the L-T4 supplementation group and placebo group in SCH patients. When the ranges were compared separately in women and men, women in the lower two ranges had significantly higher rate of depression while there was no significant difference in men. Table of Contents View All. Furthermore, inGull showed the association between psychosis and myxedema [ 5 ].

In fact, various studies have introduced different population-based cut-off points in individuals tsh any clinical or serological evidences of thyroid disease. Gordon, J. Try out PMC Labs and tell us what you think. The present study suggests that a clinically helpful TSH cut-off value for hypothyroidism should be based on associated symptoms, not just in population studies. Subclinical hypothyroidism: a review of neuropsychiatric aspects.

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We conducted several sensitivity analyses to test the robustness of hypothyroidism tsh results. Psychiatry Investig. Conflicts of interest comprise financial interests, activities, and 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. Psychiatric and cognitive manifestations of hypothyroidism.

It hypothyroidiem concluded that LHb could mediate the effect of thyroid system on serotonin function in DRN [ 23 ]. Normal serum TSH values in the first trimester of pregnancy differ from nonpregnant values. This suggests that L-T4 is often prescribed for marginal reasons, which are commonly neuropsychiatric in nature. Search ADS.

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Curr Psychiatry Rep. Enhancement of imipramine antidepressant activity by thyroid hormone. Six studies found a higher prevalence of sepression among individuals with SCH compared with controls [ 71214192324 ], although only three studies achieved statistically significant difference [ 71430 ]. A total of 21 studies were included in the qualitative analysis. CSF somatostatin in affective illness.

We assessed the pooled effect size using a random effects model when considerable depression subclinical hypothyroidism tsh heterogeneity was assumed; for contradistinction, we also chose a fixed effects model. Peer Review reports. A total of 12, individuals [ SCH, subclinical hypothyroidism; CI, confidence interval. A hypothesis of thyroid-catecholamine-receptor interaction.

E-mail: samuelsm ohsu. This ancillary study is nested in a large, international subclincial on levothyroxine therapy in older adults with subclinical hypothyroidism the TRUST trialwhich was conducted from April to October 31, We found an insignificant difference for the composite endpoint: standard mean difference SMD of 0. Accessed July 7,

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This study has some limitations. Compr Physiol. Correspondence to Z. BMC Psychiatry 19, 12

  • Occup Med Untreated subclinical hypothyroidism. Given the world population ageing and an increased risk of depression in the elderly with SCH as shown in our analysis [ 52 ], there is an urgent need for TSH and depression screening in this vulnerable population, in order to improve health and well-being for all.

  • Mikhail, G.

  • To determine the depression subclinical hypothyroidism tsh 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.

  • Given the world population ageing and an increased risk of depression in the depression subclinical hypothyroidism tsh with SCH as shown in our analysis [ 52 ], there is an urgent need for TSH and depression screening in this vulnerable population, in order to improve health and well-being for all.

  • Supplemental legends. 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.

Thus, the overall number of cases and controls was adequately large to support the conclusion of the meta-analysis. Ipsative imputation for a item Geriatric Depression Scale in community-dwelling elderly people. Received Aug 21; Accepted May Figure 3. Thyroid hormone therapy for older adults with subclinical hypothyroidism. Hypothyroidism and major depression: a common executive dysfunction? Park, Y.

  • Six studies found a higher prevalence of depression among individuals with SCH compared with controls [ 71214192324 ], although only three studies achieved statistically significant difference [ 71430 ].

  • The clinical significance of subclinical thyroid dysfunction.

  • Geriatric cohort with SCH had a 1. Our findings can potentially influence the clinical practice and improve the quality of life of patients.

  • Prevalence of symptoms of depression in a nationwide sample of Korean adults.

Age-dependent symptomatology of depression in hospitalized patients and its implications for DSM Horm Metab Res. The aging thyroid. J Clin Pathol. Front Endocrinol.

In recent decades, numerous studies have investigated the relationship between age and depression. Lowering the upper limit of normal for the serum TSH level from 5. Parsaik AK, et al. Park, Y.

Introduction

Normally, the thyroid regulates various functions by releasing untreated subclinical hypothyroidism levels of thyroid hormones. Sign In or Create an Account. Am J Med. If any of these components become impaired, it may have an impact on the thyroid's ability to signal the brain.

Cota, G. Given that depression is known to be associated with changes in the hypothalamic-pituitary-thyroid HPT axis [ 4 ], studies have reported its positive correlation with overt hypothyroidism [ 5 ]. Conclusion SCH has a negative impact on depression. Download references. An introduction to kernel and nearest-neighbor nonparametric regression. Purchase access Subscribe now.

The thyroid-brain interaction in thyroid disorders and mood disorders. Table 2 indicates the characteristics depression subclinical hypothyroidism tsh the RCTs included in hypothyroieism meta-analysis. This is based on the rationale that many L-T4—treated hypothyroid patients have low serum levels of the active thyroid hormone T3 despite normal TSH levels and high-normal to mildly elevated free T4 levels 3. If published papers only provided the percentage of depressive symptoms, the evaluator calculated the numbers of participants by the calculator in Revman version 5. Sign in to save your search Sign in to your personal account. Expert Opin Drug Saf.

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JAMA— Full size image. Exercise performance in young and middle-aged female patients with subclinical hyperthyroidism. Second, symptoms are more apparent when patients are aware of their thyroid status, suggesting that they may be related to the self-knowledge of thyroid disease. Data extraction and quality assessment Two authors Zhao and Chen independently extracted the data from the original studies using a uniform standard procedure.

  • Accuracy of the item geriatric depression scale GDS in a community sample of the oldest old.

  • Full size image.

  • JAMA— Background: Thyroid function is closely associated with neuropsychological functions, including mental state and cognitive functions.

  • Two studies involved individuals seen in the psychiatric out-patient clinics [ 34depression subclinical hypothyroidism tsh ], three from psychiatric wards [ 313233 ] whereas the other two studies selected individuals from the elderly community [ 3637 ]. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

  • Park, Y. Bauer, M.

  • Gender differences in depression and anxiety: the role of age. The incidence of ischemic heart disease and mortality in people with subclinical hypothyroidism: reanalysis of the Whickham Survey cohort.

Thyroid hormones, serotonin and mood: of synergy and significance in the adult depressiln. Footer Note Have a question about government service? Create a free personal account to download free article PDFs, sign up for alerts, and more. Wang, L. You can also search for this author in PubMed Google Scholar. Arch Gerontol Geriatr.

Observational studies on the association between subclinical hypothyroidism and depressive symptoms have yielded conflicting results. Neuropsychological function and symptoms in subjects with subclinical hypothyroidism and the effect of thyroxine treatment. Full size image. Subclinical hypothyroidism and depression: a meta-analysis. Meta-analysis of observational studies in epidemiology—a proposal for reporting. These inconsistent results could be attributed to the heterogeneous study populations, small sample size, lack of control arm for comparison and differences in study design. However, a recent study 24 reported the opposite conclusion.

Supplement 2. Featured Issue Featured Supplements. Early and routine screening of depression is essential to prevent morbidity and mortality. A total of 12, individuals [ However, sub-group analysis according to age found that SCH is related to depression in younger patients, but not in older patients.

Background

Sign in to customize your interests Sign in to your personal depression subclinical hypothyroidism tsh. The secretion of thyroid hormones is reduced with increasing age, with a lower fT3 level but a relatively unchanged fT4 concentration. Previous studies investigating possible links between depression and reference-range thyroid hormone levels have been variable, although the largest and best conducted reported no correlations 1.

Association of thyroid hormone therapy with quality of life and thyroid-related symptoms in patients with subclinical hypothyroidism: a systematic review and meta-analysis. We found an insignificant difference for the composite endpoint: standard mean difference SMD of 0. Overt hypothyroidism is a cause of major mood disorder, including melancholia, and may result in deteriorating dementia 1. Two authors Zhao and Chen independently extracted the data from the original studies using a uniform standard procedure.

Compr Physiol. Changes in HDRS scores with levothyroxine treatment. Subclinical hypothyroidism increases the risk for depression in the elderly. This ancillary study included a subgroup of participants from the Netherlands and Switzerland; after exclusions, a total of participants randomized to levothyroxine and to placebo were analyzed. Thyroid hormone therapy for older adults with subclinical hypothyroidism.

Publications

Given the tsh summarized above and the valuable contribution by Kim et al. Please review our privacy policy. Individuals with overt hypothyroidism experience a wide variety of clinical signs and symptoms including cold intolerance, weight gain, cognitive dysfunction and mood disturbances [ 4849 ].

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. A study depressiln postmortem prefrontal cortex. Thyroid hormones play a significant role in brain development. Levothyroxine therapy will reduce cardiovascular risk Overnight oximetry will be helpful Hyperlipidemia is caused by subclinical hypothyroidism SCH Levothyroxine therapy will lower homocysteine levels Levothyroxine therapy will reduce lipoprotein a levels A year-old woman presents with fatigue and a weight gain of 9. What Is Dopamine?

Kansas Journal of Medicine. The strongest arguments for levothyroxine therapy are the high risk of progression to overt hypothyroidism, the possible improvement of quality of life, and the possibility that SCH is a cardiovascular risk factor. The clinical significance of subclinical thyroid dysfunction. 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. Henley, W.

Background

Use untreated subclinical hypothyroidism thyroid hormone for depression treatment has been controversial for a long time. However, few randomised controlled trials have investigated L-T4 supplementation for the treatment of SCH 67and the evidence regarding its effect on depressive symptoms is limited. Google Scholar The evidence for a narrower thyrotropin reference range is compelling.

  • Falling threshold for treatment of borderline elevated thyrotropin levels-balancing benefits and risks: evidence from a large community-based study.

  • This study was conducted in accordance with the Declaration of Helsinki.

  • In recent decades, numerous studies have investigated the relationship between age and depression. Health status, psychological symptoms, mood, and cognition in L-thyroxine-treated hypothyroid subjects.

The authors designed this study to look for an association between TSH levels and risk of developing depression going hypothyrodiism in a large group of Brazilian adults. Taking Antidepressants During Pregnancy. Shan, Z. Thus, serum TSH measurement is the necessary test for diagnosis of mild thyroid failure when the peripheral thyroid hormone levels are within normal laboratory range. Download PDF.

Supplementary Figure 5 74K, pdf. Subclinical hypothyroidism: when to treat, when to watch? Many studies have reported that age is an inconvenient element that influences the depression subclinical hypothyroidism tsh and symptomatology of a depressive episode 17 hyothyroidism, 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. Cognitive and affective status in mild hypothyroidism and interactions with L-thyroxine treatment. Moreover, the relationship between depressive symptoms and SCH is controversial, particularly in older patients, as the prevalence of SCH increases with age.

  • Results In a pooled analysis of 12, individuals, those with SCH had higher risk of depression than euthyroid controls relative risk 2.

  • Williams MD, et al. In animal studies, thyroid hormones influence noradrenergic and serotonergic neurotransmission, which is a target for current antidepressant therapies and plays a key role in the pathogenesis of depression [ 12 ].

  • Eight studies reported the mean depression scores between individuals with SCH and healthy controls, of which five used HDRS [ 1213151622 ] and three used BDI [ 172324 ].

  • The possibility that an elevated serum TSH level is a cardiovascular risk factor is still highly controversial. TSH, or thyroid-stimulating hormone, is a hormone secreted by the pituitary gland that acts to stimulate the production of more thyroid hormone.

Not all submitted comments are published. Purchase access Subscribe to JN Learning for one year. In a sensitivity analysis including only 3 studies that were not only conducted in elderly participants, we found an overall SMD of 0. In recent years, an increased number of studies investigated the association between SCH and depression 56. Garmendia Madariaga. Table 1. 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.

Limit characters. Figure 2. Subclinical hypothyroidism SCH is not associated subclihical metabolic derangement, cognitive impairment, depression or poor quality tsh life QoL in elderly subjects. However, subtle deficits in mood may exist in subclinical hypothyroidism, at least in subsets of patients, and this requires further targeted investigation. Several studies using animal models have examined the relationship between SCH and depression, which was demonstrated by increased immobility performance on the forced swimming test FST and tail suspension test TST 21 ,

References

Age Ageing. First, timely screening and intervention of depressive symptoms are of great importance in persons with SCH. Thyroid status, disability and cognitive function, and survival in old age.

  • Arch Gerontol Geriatr.

  • Fourth, none of the selected reports applied age-adjusted expected limits, resulting in the unavoidable misclassification of older adults as suffering from SCH. Park YJ, et al.

  • 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. To sign up for updates or to access your subscriber preferences, please enter your contact information.

No significant sepression was observed in the composite end point between the L-T4 therapy group and placebo group in SCH patients Fig. X-axis: possitive values equal to the aggravation on depressive tendency. These publications reveal elevated serotonin levels in the cerebral cortex of rats after T3 administration. Several studies using animal models have examined the relationship between SCH and depression, which was demonstrated by increased immobility performance on the forced swimming test FST and tail suspension test TST 21 Data related to aggravation of depression, bipolar disorder, and effect on cognitive function have been presented. Preventive Services Task Force. Polymorphisms in the brain-specific thyroid hormone transporter OATP1C1 are associated with fatigue and depression in hypothyroid patients.

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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 hypothyroidism tsh values in the brain are relatively low. Panminerva Med. This method can lead to the potential misclassification of normal thyroid hormone participants who only have a transient elevation in the serum TSH level. Moreover, the relationship between depressive symptoms and SCH is controversial, particularly in older patients, as the prevalence of SCH increases with age. References 1.

Arch Gen Psychiatry. Symptoms of hyperthyroidism include:. Effects of subclinical hypothyroidism treatment on psychiatric symptoms, muscular complaints, and quality of life. Psychological well-being in patients on 'adequate' doses of l-thyroxine: results of a large, controlled community-based questionnaire study. Its relevance to affective illness. Which one of the following patients is most likely to benefit from levothyroxine therapy?

What Is Dopamine? Despite these limitations, the current meta-analysis has enhanced the statistical power by pooling the results of the studies. Which one of the following statements is least applicable to this patient? In addition, depression is associated with changes in the HPT axis [ 21 ]. Chen2 X. Subsequently, we collected the full versions of the qualified reports. Abstract The objective of this study was to evaluate the relationship between subclinical hypothyroidism SCH and depression.

Stott, D. High-quality placebo-controlled studies with large sample sizes are needed. Arq Bras Endocrinol Metabol. Forman-Hoffman, V.

Thyroid deficiency in the Framingham Tsh. In addition, depression is associated with changes in the HPT axis depressoon 21 ]. She has a sister who is receiving levothyroxine therapy for hypothyroidism. 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. Dissent was resolved by consensus and the recommendation of a third observer Zhao as required. Gender differences in depression and anxiety: the role of age. At baseline, participants 1.

The Colorado thyroid disease prevalence study. Some evidences suggest that one single TSH reference range does not fit the entire population [ 14 ]. J Gen Intern Med. Table 1 The characteristics of non-RCTs.

Corroborating this clinical impression, a recent report from the United Kingdom showed tsh L-T4 is being prescribed more frequently and for more hypotgyroidism degrees of hypothyroidism 2. A flow chart of the meta-analysis is shown in Figure 1. However, this is not a universal finding. Gender differences in depression and anxiety: the role of age. Strengths of these latter studies, compared with many of the earlier studies, include large sample sizes, broad age ranges, and absence of bias population based. In a pooled analysis of 12, individuals, those with SCH had higher risk of depression than euthyroid controls relative risk 2.

In a subgroup tsn including participants with a GDS of at least 2, the adjusted depression subclinical hypothyroidism tsh difference was 0. Functional capacity and muscular abnormalities in subclinical hypothyroidism. Henley, W. We also evaluated the mean depression scores among individuals with SCH, compared with their euthyroid counterparts based on the depression scales used.

TSH and free T4 levels were measured at baseline. Open in a separate window. Search Menu. Download citation. Villar H.

The results stayed robust in several subgroup analyses. The Colorado thyroid disease prevalence study. If you wish to read unlimited content, please log in or register below. Hong et al. Razvi, S. Oxford University Press is a department of the University of Oxford. About this article.

P sychiatric and C ognitive D ysfunction Data related to aggravation depression subclinical hypothyroidism tsh depression, bipolar disorder, and effect on cognitive function have been presented. Published online Oct The authors appropriately accounted for a number of relevant covariates, including age, sex, body mass index, smoking status, alcohol use, exercise, and medical comorbidities.

Participants in these studies depression subclinical hypothyroidism tsh from different regions, including America, Europe, and Asia. Samuels MH. Purchase access Subscribe now. Depressive episodes accompanied ttsh anxiety and the risk of committing suicide are considerable predictors that differ according to the age of the 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.

The TRUST trial included adults aged 65 years or older diagnosed with subclinical hypothyroidism, defined as the tsh of persistently elevated thyroid-stimulating hormone TSH levels 4. Create a free personal account to download free article PDFs, sign up for alerts, and more. We conducted several sensitivity analyses to test the robustness of the results. Rev Bras Psiquiatr. Study characteristics Table 1 illustrates the characteristics of the five cross-sectional and nine prospective studies included in the meta-analysis.

A reappraisal using objective psychological measurement. In addition, levothyroxine replacement therapy could lead to the symptomatic improvement of depression [ 9 ]. Supplementary Figure 5 74K, pdf. Endocr Rev.

Anxiety, depression, and quality of life in primary care patients. J Clin Invest. Among other indicators, depressive symptoms are a common reason for starting levothyroxine therapy in patients with subclinical hypothyroidism.

  • Lancet London, England.

  • Another meaningful consequence of the current meta-analysis is demonstrated by the ineffectiveness of therapy for SCH with LT4 supplementation on depression. First, some data were obtained from observational studies, many of which are cross-sectional studies.

  • Of the participants from the Netherlands and from Switzerland, were allocated to levothyroxine and to the placebo group Figure 1. Current guidelines on subclinical hypothyroidism recommend taking into account age, TSH levels, and the presence of related symptoms when deciding whether to treat a patient with subclinical hypothyroidism with levothyroxine.

  • For part I, we examined the prevalence of depression in individuals with SCH compared with healthy controls.

Google Scholar PubMed. We will not ask you for any personal information. However, exclusion of outlier TSH levels would depression subclinical hypothyroidism tsh only strengthen their conclusions. 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, ]. Serum-free triiodothyronine T3free thyroxine T4and thyroid-stimulating hormone TSH levels were measured in order to either diagnose participants with subclinical hypothyroidism or classify them as euthyroid.

Banners Banner - National Helpline. Lower TSH and higher T4 levels are associated with current depressive syndrome in young adults. Given the world population ageing and an increased risk of depression in the elderly with SCH as shown in our analysis [ 52 ], there is an urgent need for TSH and depression screening in this vulnerable population, in order to improve health and well-being for all. For cross-sectional studies, the common deficiency was the lack of a direct description of response rates and the completeness of data collection that could be determined.

Full size image. Thyroid 16— Effects of subclinical hypothyroidism treatment on psychiatric symptoms, muscular complaints, and quality of life. In recent decades, numerous studies have investigated the relationship between age and depression.

Hence, decision for levothyroxine therapy for this group should be individualized and should depend on the age of the patient favoring therapy for younger personsassociated medical conditions, degree of TSH elevation, persistence and gradual increase of TSH, presence of antithyroid antibodies, presence of goiter, and hypothyroid symptoms Table 2. Wang, L. However, most of the studies showing benefit are not categorized for serum TSH levels of 5. Hyperthyroidism: a condition where the thyroid gland is overactive and produces too much thyroid hormone. This article has been cited by other articles in PMC. This article has been cited by other articles in PMC. P sychiatric and C ognitive D ysfunction Data related to aggravation of depression, bipolar disorder, and effect on cognitive function have been presented.

  • They performed additional analyses to address two common issues in this field. Supplementary Figure 5.

  • Zhang et al. Acknowledgements The authors would like to gratefully acknowledge the Arak University of Medical Sciences because the study was funded by the university.

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  • Recent evidence shows that any possible increased cardiovascular risk would be tsh persons younger than 70 years; those aged 70 and 80 years have no additional risk, and those older than 80 years may actually enjoy a protective benefit.

  • Supplemental legends. Binary logistic regression showed that patients with suicide attempts and psychiatric symptoms were more likely 4.

The clinical significance of hypothyroidism tsh thyroid dysfunction. TSH, free T4, and free triiodothyronine T3 were measured at each visit. Strengths and limitations of this meta-analysis This analysis has four main limitations. Fourth, none of the selected reports applied age-adjusted expected limits, resulting in the unavoidable misclassification of older adults as suffering from SCH. Effects of subclinical hypothyroidism treatment on psychiatric symptoms, muscular complaints, and quality of life.

Thyroid 16— The most important implication of SCH is high likelihood of progression to clinical hypothyroidism. Third, possible depression subclinical hypothyroidism tsh 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. PMID: Protein levels of beta-catenin and activation state of glycogen synthase kinase-3beta in major depression. With this clinical context, what do we know objectively about depression and mild or subclinical hypothyroidism?

Thyroid 16— Does treatment with L-thyroxine influence health status in middle-aged and older adults with subclinical hypothyroidism? Close mobile search navigation Article Navigation. Sign In or Create an Account.

More well-designed population-based prospective studies or randomized controlled trials are needed to gain more insights of the pathogenesis and natural history of depression in SCH, as well as the efficacy and safety of levothyroxine therapy to improve mood disorders among these high-risk individuals of varying age groups. Potential participants aged 65 or older were identified from clinical tsh general practitioner laboratory databases and recruited from the community in Switzerland, the Netherlands and Ireland. Five other studies showed no difference in the number of individuals with depression between SCH and control group [ 815202130 ], whereas three found no difference in the depression scores [ 131517 ]. Search all BMC articles Search. Wilkowska-Chmielewska, J. Several studies using animal models have examined the relationship between SCH and depression, which was demonstrated by increased immobility performance on the forced swimming test FST and tail suspension test TST 21 The authors appropriately accounted for a number of relevant covariates, including age, sex, body mass index, smoking status, alcohol use, exercise, and medical comorbidities.

Abstract Background The prevalence of depressive symptoms in hypothyroidism tsh high. If any of these components become impaired, it may have an impact on the thyroid's ability to signal the brain. Associations of thyroid-stimulating hormone and free thyroxine concentrations with health and life satisfaction in elderly adults. To the best of our knowledge, no TSH cut-off value has been established for depression diagnosis. Zhao, T.

Psychiatry Res. Article Google Scholar 9. Initial search identified articles and yielded 21 full-text articles after abstracts screening and duplicates removal. 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. The mean age was higher among individuals with depression than healthy controls Future studies should focus on the underlying mechanism behind the association between SCH and depression and whether depression or other neuropsychological conditions could be treated through the supplement of L-T4.

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. Are autoimmune thyroid dysfunction and depression related? Eur Thyroid J. For part III, we evaluated the effect of levothyroxine replacement therapy on depressive symptoms among individuals with SCH. Depressive symptoms and major depressive disorder in patients affected by subclinical hypothyroidism a cross-sectional study.

Thyroid function is closely associated with neuropsychological functions, including mental state and cognitive tsh 1. J Clin Invest. Neuroscience 93— Depressive symptoms in patients with subclinical hypothyroidism—the effect of treatment with levothyroxine: a double-blind randomized clinical trial. Subclinical hypothyroidism: summary of evidence in

Dayan CM, Panicker V. Thus, the subflinical number of cases and controls was adequately large to support the conclusion of the meta-analysis. Data extraction and quality assessment Two authors Zhao and Chen independently extracted the data from the original studies using a uniform standard procedure. Introduction The connection among overt thyroid dysfunction, abnormal mood, and cognitive disorder has been well documented 12. Endocr Res. This article has been cited by other articles in PMC. If the distribution is extrapolated to be Gaussian, then the upper limit for the

  • The incidence and prevalence of thyroid dysfunction in Europe: a meta-analysis. Second, we updated the previous meta-analysis to include this study.

  • Center for Epidemiologic Studies—Depression.

  • Corroborating this clinical impression, a recent report from the Hypothyroidism tsh Kingdom showed that L-T4 is being prescribed more frequently and for more mild degrees of hypothyroidism 2. Abstract Background Although depression is associated with changes in the hypothalamic-pituitary-thyroid axis, its relationship with subclinical hypothyroidism SCH is controversial.

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Depressive symptoms in patients with subclinical hypothyroidism--the effect of tsh with levothyroxine: a double-blind randomized clinical trial. Close mobile search navigation Article Navigation. Updated March Subclinical hypothyroidism increases the risk for depression in the elderly. 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.

Introduction Hypothyroidism tsh connection among overt thyroid dysfunction, abnormal mood, and cognitive disorder has been well documented 12. In addition, the diagnosis of SCH was typically based on a unitary assessment of TSH without at least a second verified measurement. Serum biomarkers for cardiovascular inflammation in subclinical hypothyroidism. The funnel plot is a straightforward approach of investigating whether publication bias is present.

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