Page 29 - Complementary and Alternative Medicine Treatments in Psychiatry

The Comprehensive Medical Exam in Psychiatry | 29

Mental symptoms of hypothyroidism include:
− Depression
− Cognitive dysfunction
− Psychosis (in severe hypothyroidism—“myxedema
madness”)
Subclinical hypothyroidism is a condition in which TSH
(thyroid stimulating hormone) is elevated, but T4 is low or
normal and the patient has few or no symptoms. Psychiatric
symptoms include:
− Depression
− Rapid cycling in bipolar disorder (a common cause)
− Subtle signs of cognitive dysfunction (Levenson 2006)
Thyroid irregularities are not only common but many people
don’t know they have them. Even those being treated for them
frequently show lab signs of thyroid hormones that are above or
below the norm:
− 9.5% of the public have elevated TSH levels—indicative of
hypothyroidism—including some who are being treated for
it.
− 2.2% of the public have subnormal TSH levels, including
some who are being treated for it.
− 40% of patients taking thyroid medications have abnormal
TSH levels.
− Symptoms are reported more often in hypothyroid vs.
euthyroid individuals (Canaris 2000).
Amongst bipolar patients in the depressive phase, two-thirds
are found to have TSH in the high normal range and a low-
normal free thyroid index (FTI). These individuals have been
found to recover significantly more slowly than those with
optimum thyroid profiles—an average of one year versus eight
months (Cole 2002).
Given that nearly 10% of the population has hypothyroidism
and that this condition, due to its mental and behavioral