Risk of Depression, Chronic Morbidities, and l-Thyroxine Treatment in Hashimoto Thyroiditis in Taiwan

Abstract

The aim of this study was to evaluate the risk of depression in and effect of l-thyroxine therapy on patients with Hashimoto thyroiditis (HT) in Taiwan.In this retrospective, nationwide cohort study, we retrieved data from the Longitudinal Health Insurance Database 2000. We collected data of 1220 patients with HT and 4880 patients without HT for the period 2000 to 2011. The mean follow-up period for the HT cohort was 5.77 years. Univariate and multivariate Cox proportional hazards regression models were used to estimate the risk of depression in the HT cohort.In the HT cohort, 89.6% of the patients were women. Compared with the non-HT cohort, the HT cohort exhibited a higher prevalence of diabetes mellitus, hyperlipidemia, and coronary artery disease. Furthermore, the HT cohort showed a higher overall incidence of depression compared with the non-HT cohort (8.67 and 5.49 per 1000 person-year; crude hazard ratio [HR] = 1.58, 95% confidence interval [CI] = 1.18–2.13). The risk of depression decreased after administration of l-thyroxine treatment for more than 1 year (adjusted HR = 1.02; 95% CI = 0.66–1.59).In Taiwan, the overall incidence of depression was greater in the young HT cohort. l-thyroxine treatment reduced the risk of depression.

The link between thyroid autoimmunity, depression and bipolar disorder

“…The results of one study showed a higher prevalence of MDD among euthyroid HT patients and the findings of another one indicated that HT may increase the predisposition to depression [20,21]. Even though HT patients have been reported to be at higher risk for depression, l-thyroxine (T4) treatment for more than one year was found to reduce the chance of MDD [22]. Robert Krysiak with colleagues [23] hypothesized that the development of depression in patients with HT may be linked to decreased sexual function.…”

Association of Hemorrhoids With Hashimoto's Thyroiditis and Associated Comorbidities: A Nationwide Population-Based Cohort Study

“…It leads to multisystemic manifestations: constipation and reduced peristalsis (gastrointestinal); increased cholesterol (endocrine); obstruction of the upper airways by enlarged soft tissue, causing chronic or persistent coughing (pulmonary); bradycardia, decreased ventricular contractility, and increased peripheral resistance (cardiovascular); liquid retention or dehydration from decreased glomerular filtration (urinary); and inability to concentrate, memory loss, and depression (neuropsychiatric) (8). Our previous study also identified an association between depression and HT (17). Another study reported that HT causes insulin resistance and metabolic syndrome (18) and noted the role of obesity in insulin resistance and hypothyroidism (19).…”

Mood Disorders in Levothyroxine-Treated Hypothyroid Women

“…In our study, we found that women with hypothyroidism were 3.13 times more likely to suffer from depression than women without hypothyroidism and 2.37 times more likely to suffer from anxiety. Lin (2016) [23] and Giynas (2014) [41] also reported an increased risk of depression in patients with hypothyroidism, although the risk was reduced by taking levothyroxine [23]. Lin also points out that the risk of depression was higher in women [23].…”

“…Lin (2016) [23] and Giynas (2014) [41] also reported an increased risk of depression in patients with hypothyroidism, although the risk was reduced by taking levothyroxine [23]. Lin also points out that the risk of depression was higher in women [23]. Regarding anxiety, Benseñor (2015) found an increased risk of panic disorders in subjects with subclinical hypothyroidism [21].…”

“…The usual treatment for clinical hypothyroidism is levothyroxine sodium monotherapy [22]. Its use has shown an evident reduction in symptomatology, including depression [23,24]. It also makes it possible to normalize the levels of thyroid hormones and thyroid-stimulating hormone (TSH) serum [25,26].…”