Transcription
[Music]
Okay, so in this podcast, we're going to go over: Is your mood, depression, anxiety issues caused by your thyroid?
So, the first thing you need to know is if you have any history or symptoms of consistent depression or any kind of chronic mood disorders or anxiety, you definitely need to check your thyroid gland and work with your doctor and get your thyroid tested. And the test, the very basic test, is to really get something called the TSH measurement done. And TSH will measure if you're in a hypothyroid state.
But you should also know that for some people that have hypothyroidism, their levels of TSH can fluctuate all the time. And one of the ways to identify if they really have an underlying thyroid issue, maybe to just measure thyroid antibodies. And the major cause of hypothyroidism is actually a condition called Hashimoto's. And in this condition, antibodies are positive, meaning they're elevated when they're tested in the blood.
And in the early stages of Hashimoto's, people will have fluctuating levels of thyroid hormones because their immune system, and this Hashimoto's disease process, is destroying their thyroid gland. And sometimes it's flared up, and sometimes it calms down. And sometimes it's flared up, sometimes it calms down. And because of that, TSH levels that are used to diagnose a thyroid disorder sometimes fluctuate from week to week, or even sometimes from day to day. And it can take years before someone that has Hashimoto's actually gets enough thyroid gland destruction where they're hypothyroid all the time.
And in that period of time, whether it's five years or ten years, they could really have all these chronic mood disorders, depression, and anxiety issues that are not being addressed because they're waiting for that clear diagnosis of hypothyroidism that eventually, uh, transitions into from the underlying condition of Hashimoto's.
So, if you have chronic depression and mood changes and anxiety, the first thing is really just to make sure you get a thyroid panel checked with your healthcare professional. And if, if that's still something that's normal, you definitely want to ask for thyroid antibodies, the two antibodies: your TPO antibodies and thyroglobulin antibodies.
Now, let's talk about this in more detail and how thyroid impacts the brain and impacts depression, mood, and anxiety with much, much more detail. So, if you are hypothyroid, or if you have Hashimoto's, and typically 95, 90 or more people that have hypothyroid actually have Hashimoto's as the underlying cause, which means they have this autoimmune inflammatory response that's taking place.
So, there's two things that really impact depression, mood, and anxiety when it comes to the thyroid. One is the inflammatory response from Hashimoto's, that's a factor. And the other one is really just the lack of thyroid hormones that can fluctuate with people that have hypothyroidism. Even though hormone replacement can have fluctuating reactions in the brain, because one of the mechanisms that we understand about Hashimoto's now is that the inflammatory response from Hashimoto's makes thyroid receptor sites not respond very well. So, there's different degrees of receptor site efficiency based on the degree of unknown information they have.
So, once again, if you have chronic depression, mood, anxiety disorders, in addition to getting a thyroid panel done, always make sure you get your antibody screen to see if you have Hashimoto's as the underlying part of this.
Now, thyroid hormones have significant impacts on the brain. So, let's talk about that first. So, thyroid hormones impact various regions of the brain. So, they impact neurons, they impact immune cells in the brain called neuroglia, and they also impact the blood-brain barrier. And they're all important when it comes to things like depression.
Now, let's talk about depression first and how thyroid hormones play a role in these different tissues with depression. So, depression in the world of neurology is decreased frequency of activity in the frontal limbic regions of the brain. So, the areas of your, uh, frontal limbic regions, the areas of the front and midline structures of your brain are really involved with activating your mood, your motivation, your desire, your executive functions, and so forth. If these areas of the brain are not firing well, then you can have depression.
Now, the majority of research done the past 30 years has really been focused on the neurotransmitter model of depression. And this is where they really link depression to being, being due to, let's say, a serotonin imbalance or a dopamine imbalance. And, you know, they have all these different types of medications, antidepressants, that really address neurotransmitters, right? So, Abilify and Prozac and various types of medications that have been used over the years, and, and tricyclic antidepressants, all these different types of antidepressant medications to deal with depression. And they have really been shown to have limited effects for most people. And, and for some people that have benefits, the benefits don't seem to last when it's used long term. So, at some point, they stop responding to them. And for some people, though, however, these reactions do have a significant impact for a short period of time because it is due to some of these neurotransmitter imbalances.
Now, thyroid hormones have been shown to directly impact all the different receptors in the brain. So, thyroid hormones impact serotonin receptor signaling, dopamine signaling, GABA signaling, acetylcholine signaling. These are all the major neurotransmitters involved with, with brain function, mood, executive functions, motivation, and so forth. So, you know, it should be a retained protocol that anyone that has chronic depression should have their thyroid checked. And even further, be checked for Hashimoto's, which can fluctuate thyroid levels between normal and abnormal. So, that's one mechanism.
Now, thyroid hormones also impact the glial cells. And this comes to the next area of explosion and research in the field, in the field of psychiatry, as it relates to depression, which is now getting a lot of momentum, which is called the inflammatory model of depression. So, the inflammatory model of depression, it's not really due to a neurotransmitter imbalance that's causing depression. It's really due to inflammation in the brain. So, inflammation will basically slow down what's called nerve conduction. So, the way your neurons fire, how fast they are, is really called your, your nerve conduction velocity or, or your synaptic speed. And in states of neural inflammation, neuro being neurons, and inflammation being the inflammatory cascade that takes place with different chemicals, the neuroinflammatory model of depression leads to decreased speed of neurons firing. And that's been shown to cause depression because it slows down activation of the areas of the brain.
So, now they're finding that when people have major depressive disorder, the depression that does not respond to anti-depressant medications, that there really may be an inflammatory component. And that inflammatory component has been associated with, like, past traumatic brain injuries that have turned on brain inflammation, strokes, or any other type of injury to the brain. There's now lots of research showing relationships between inflammation and the gut, and systemic inflammation in the body, even from the lungs and respiratory issues causing inflammatory response in the brain and leading to depression.
And for many people that have, for example, hypothyroidism, they actually have an underlying condition called Hashimoto's. And this Hashimoto's pattern is an autoimmune disease that causes significant inflammation throughout the body. And one of the reasons why people that have thyroid disorders still don't feel the depression resolved when they go on thyroid hormone replacement is because their autoimmunity is still not checked, and their autoimmunity continues to activate cells in the brain called glial cells. And then, in combination with maybe periods of time where they have low thyroid hormones, really causes the brain to shut down. And when areas of the brain shut down in the limbic frontal regions, it can lead to people having massive depression.
So, you have to understand that if you've ever been diagnosed with hypothyroidism, Hashimoto's, and you have persistent depression and you haven't responded to an antidepressant, you may really be one of these people that are really having the inflammatory model of depression being a factor.
Now, what's very interesting also with Hashimoto's is they have found that the antibodies that are responsible for destroying the thyroid gland, called thyroid peroxidase antibodies and thyroglobulin antibodies, and those are what's used to diagnose it with blood, blood elevation of those antibodies, those antibodies not only bind to the thyroid gland which leads to destruction, but those antibodies have been found to actually bind to the brain. And they actually bind to the cerebellum. And these are called molecular mimicry reactions or cross-reactivity reactions. So, they're finding that many people that have Hashimoto's, hypothyroidism, are also having chronic neural inflammation. And, and this is due to the antibodies not just binding to the thyroid, but to the brain.
So, again, many people that have chronic depression from thyroid-related conditions may never really feel better with an antidepressant, may never really feel better with taking thyroid replacement. They really just have to get their autoimmunity under control. And that's something that is a very real clinical observation I've seen in many practitioners that work with Hashimoto's patients have seen.
So, in those cases, you have to dampen whatever is triggering the inflammatory autoimmune response.
Now, in addition to depression, mood changes and mood swings take place all the time with people that have hypothyroidism. And part of those are also related to the inflammatory model and the neurotransmitter model, but it's just fluctuating levels. But a big part of mood changes with people have Hashimoto's, in addition to neuroglial activation through the inflammatory response or lack of hormones, is blood sugar fluctuations. So, whenever, you know, whenever a clinician hears mood changes, you know, they should immediately think blood sugar stability. And if you're suffering from mood changes, whether your mood goes up and down, you really want to look at your diet and see if it's related to your blood sugar levels dropping.
Now, sometimes it could be like having a sugar high, you get mood changes, and then you crash. Other times, your blood sugar levels can drop, you can have mood changes. But it's not uncommon for many Hashimoto's people to have blood sugar fluctuations. We talked about that in a previous podcast related how thyroid hormones impact your body. So, um, hypothyroid states and thyroid low thyroid functions make blood sugar signaling pathways inefficient. So, you're more prone to insulin resistance and fatigue after meals, more prone to drops in blood sugar or hypoglycemia afterwards. So, those are things to be aware of.
And the other key thing is anxiety. And anxiety is much, much more common than people think. But when you look at anxiety, the mechanisms of anxiety in the world of neurology are associated with increased activation of what are called the amygdala and limbic regions of the brain. And what happens in these states is, uh, in a normal response, the brain is always dampening these amygdala limbic regions. For example, if you think of something that would cause you anxiety, if you reason your way through it, you can actually calm down your anxiety in most cases. And that's because your frontal lobe has a projection, it's called the frontal striatal projection, and it actually dampens these limbic regions.
But when the brain is fatigued, when the brain has inflammation, when the brain has unhealthy neurotransmitter activity or slow nerve conduction, then it loses the ability to activate inhibition of these amygdala regions, and people get massive anxiety. So, a lot of times, people that have Hashimoto's or hypothyroid issues are dealing with depression, mood changes, or anxiety. Sometimes some people have greater expression of anxiety than other people. Sometimes people have more patterns of depression. But it's really due to these, in many cases, inflammatory parts of the condition that are not being managed.
Now, we also know that when people have Hashimoto's as a cause of their hypothyroidism, the Hashimoto's autoimmune response is associated with intestinal permeability and leaky gut. And leaky gut patterns have also been shown to open up the blood-brain barrier, making the brain much more prone to inflammation. And lots of studies have now linked intestinal permeability to blood-brain permeability. We published a study in the International Journal of Molecular Science two years ago where we showed that relationship with people that have inflammatory bowel disease. We clearly showed that there was a direct relationship between leaky gut and leaky blood-brain barrier. And those are with autoimmune disease patients.
So, with many people that have, that have Hashimoto's and have this consistent depression, anxiety, mood disorders, they have a multivariate mechanism. So, things are driving inflammation, these are causing brain inflammatory responses, their blood-brain barrier can be permeable, especially if in a low thyroid state, because thyroid hormones are important to heal the blood-brain barrier. And then they have intestinal permeability, like a leaky gut. And then you add in things like gluten sensitivity, which many Hashimoto's people have, because they have a gene type called HLA-DQ2/8, which makes them very sensitive to, to gluten. Some have celiac disease, but there's a reaction there. And then disrupt microbiome, and this underlying inflammatory autoimmune response, all promoting it. And then they produce antibodies that then also cause neuroinflammation.
You really get a patient that has Hashimoto's as a cause of hypothyroidism with massive ongoing patterns of major depression, mood disorders, and anxiety. And they then get finally get diagnosed hypothyroid. They may or may not get diagnosed with Hashimoto's, even though it's the majority of the cause of hypothyroidism. They go on thyroid replacement. They may have some benefits for a short period of time, called the honeymoon phase, then they don't last. Then they may try a whole series of antidepressants, which may have also a honeymoon period, but then it doesn't last.
And really, what's triggering this is this ongoing inflammatory pattern, slowing down nerve conductance, turning on these glial cells, causing brain inflammation that then lead to neurochemical imbalances, shuts down brain activity to depression, mood swings, blood sugar imbalances that that coincide with Hashimoto's, hypothyroidism mechanisms, and antibodies that also cross-react to the brain.
And the really only way out of this is to really go after the autoimmune part of this. And going after this autoimmune part of it is looking at diet, looking at nutrition, looking at lifestyle factors that can decrease the expression of the autoimmunity and things that dampen inflammation.
So, it could be a simple, well, here's the thing, it's never just one thing. So, first of all, there isn't a magic nutraceutical or supplement you're going to take that's going to unwind all these things. You really have to go through a, a pattern of, of, of untangling the web, that we call it. So, this could include reducing the inflammatory foods, changing your diet, making sure lifestyle isn't promoting autoimmunity, whether it's dealing with your stress, dealing with getting proper sleep. If you're looking at different modulators for the immune system, maybe changing lifestyle factors and dietary factors that change your microbiome, healing things like intestinal permeability. This is the multivariate model that's involved with, with, with really looking at Hashimoto's.
Now, uh, this, this model, I created a program called Hashimoto's Solving the Puzzle. If you go to DrKNews, we go into great detail of how to walk you through each of these steps. It's, it's much more intense than any podcast, and we give you recipes and menus and educational development work controls to go through the process.
But if you're dealing with chronic mood, depression, anxiety issues, and you have hypothyroidism, and you have not responded, hasn't been resolved with thyroid hormone replacement, and hasn't been resolved within antidepressants, you really have to consider the underlying autoimmunity inflammatory spots that can really disrupt these, these chemical patterns in your brain that are typically overlooked.
Anyways, I hope this, uh, this podcast gives you some insight if you're dealing with ongoing mood, depression, anxiety issues, and you have a thyroid condition. Thank you.