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#hypothyroid #depressionrecovery #levothyroxine #Mentalhealthmatters

Objectives
~ Identify the connection between thyroid hormones and mental and cognitive health
~ Explore the relationship between thyroid hormones and gonadal hormones and mental and cognitive health
~ Identify interventions to assist people with thyroid and mood disorders.

Thyroid Hormones
~ T4 is Thyroxine an excitatory hormone and the main thyroid hormone
~ T4 is converted to T3 (triiodothyronine)
~ T3 tests are useful for diagnosing HYPERthyroidism, but not as useful for detecting HYPOthyroidism
~ Thyroid Stimulating Hormone (TSH) tests detect whether the thyroid is being triggered to release T4. Normal or low TSH and low T4 indicate hypothyroidism
~ “T3 testing rarely is helpful in the hypothyroid patient, since it is the last test to become abnormal. Patients can be severely hypothyroid with a high TSH and low FT4, but have a normal T3.”

Stress and Thyroid
~ Acute stress has been shown to causes transient activation of the HPT axis, whereas prolonged stress is associated with decreased activity
~ Significantly lower TSH and T3 levels have been found in populations reporting stress-related mental health problems
~ Low-T3 syndrome is a condition characterized by a reduced peripheral conversion of T4 to T3 in the presence of normal thyroid hormone secretion. It occurs in a variety of nonthyroidal illness (NTI) including autoimmune disorders and is defined as nonthyroidal illness syndrome (NTIS).

Thyroid Hormones and Inflammation
~ Hyperthyroidism and hypothyroidism have been shown to be associated with oxidative stress and inflammation
~ Hypothyroidism is associated with obesity and/or chronic stress which are associated with increased estrogen and secretion of proinflammatory hormones and cytokines

Interventions
~ Proper functioning of the thyroid gland iodine, requires a number of elements, including idodine, selenium, iron, zinc, copper, and calcium
~ Recent studies revealed the emerging role of excess uptake of lipids in the development of hypothyroidism.
~ Monitoring of patients on lithium which can contribute to hypothyroid
~ Effective treatment of thyroid abnormalities may also reverse cognitive issues
~ Addressing trauma and chronic stress to reduce cortisol and help regulate the HPA-Axis

Interventions
~ Sobriety to address dysfunction of the hypothalamic-pituitary-thyroid axis in alcohol dependence
~ Adequate, quality sleep and circadian rhythm regulation since thyroid function, is known to be influenced by the sleep/awake status and circadian rhythm
~ Sleep studies may be necessary for people with apnea

Summary
~ Thyroid hormones can be altered by physical or emotional stress
~ Thyroid hormones via the HPT axis are intertwined with the HPA-Axis –dysfunction in one produces dysfunction in the other
~ Many cognitive, affective and behavioral symptoms commonly seen in behavioral health settings may have some underpinnings in thyroid dysfunction
~ Mental health clinicians can educate patients about the far-reaching impact of thyroid hormones; help them address cognitive and emotional stress and trauma and address sleep and circadian rhythms.

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