The role of thyroid hormones in depression

Kirkegaard, C.; Faber, Jens

doi:10.1530/eje.0.1380001

Cited by 165 publications

(101 citation statements)

References 70 publications

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“…This could be secondary to decreased conversion of T4 into T3 in the brain due to cortisol inhibition of type II deiodinase, and/or decreased T4 transport across the blood-brain barrier. 141 Another hypothesis for the HPT axis alterations in patients with depression suggest that changes could be related to alterations in serotonin and/or noradrenalin in the brain.…”

Section: Neuroendocrine Dysregulations In Patients With Mddmentioning

confidence: 99%

Brain-immune interactions and disease susceptibility

2005

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Many studies have established the routes by which the immune and central nervous (CNS) systems communicate. This network of connections permits the CNS to regulate the immune system through both neuroendocrine and neuronal pathways. In turn, the immune system signals the CNS through neuronal and humoral routes, via immune mediators and cytokines. This regulatory system between the immune system and CNS plays an important role in susceptibility and resistance to autoimmune, inflammatory, infectious and allergic diseases. This review focuses on the regulation of the immune system via the neuroendocrine system, and underlines the link between neuroendocrine dysregulation and development of major depressive disorders, autoimmune diseases and osteoporosis.

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Section: Neuroendocrine Dysregulations In Patients With Mddmentioning

confidence: 99%

Brain-immune interactions and disease susceptibility

2005

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“…However, many of the patients in these studies were treated with doses of T 3 causing iatrogenic borderline or overt hyperthyroidism. These studies have formed the basis for the hypothesis that the addition of T 3 -to-T 4 therapy in hypothyroid patients with depression could relieve symptoms of depression (21). This has primarily been investigated in small studies, but recently Sawka et al (22) performed a well-designed randomised, double-blind, controlled noncross-over study including 40 patients on combination therapy with T 4 and T 3 versus the usual T 4 monotherapy.…”

Section: Discussionmentioning

confidence: 99%

Effect of combination therapy with thyroxine (T4) and 3,5,3′-triiodothyronine versus T4 monotherapy in patients with hypothyroidism, a double-blind, randomised cross-over study

Nygaard¹,

Jensen²,

Kvetny³

et al. 2009

European Journal of Endocrinology

142

156

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Background: Treatment of hypothyroidism with 3,5,3 0 -triiodothyronine (T 3 ) is controversial. A recent meta-analysis concludes that no evidence is present in favour of using T 3 . However, the analysis included a mixture of different patient groups and dose-regimens. Objective: To compare the effect of combination therapy with thyroxine (T 4 ) and T 3 versus T 4 monotherapy in patients with hypothyroidism on stable T 4 substitution. Study design: Double-blind, randomised cross-over. Fifty micrograms of the usual T 4 dose was replaced with either 20 mg T 3 or 50 mg T 4 for 12 weeks, followed by cross-over for another 12 weeks. The T 4 dose was regulated if needed, intending unaltered serum TSH levels. Evaluation: Tests for quality of life (QOL) and depression (SF-36, Beck Depression Inventory, and SCL-90-R) at baseline and after both treatment periods. Inclusion criteria: Serum TSH between 0.1 and 5.0 mU/l on unaltered T 4 substitution for 6 months. Results: A total of 59 patients (55 women); median age 46 years. When comparing scores of QOL and depression on T 4 monotherapy versus T 4 /T 3 combination therapy, significant differences were seen in 7 out of 11 scores, indicating a positive effect related to the combination therapy. Forty-nine percent preferred the combination and 15% monotherapy (PZ0.002). Serum TSH remained unaltered between the groups as intended. Conclusion: In a study design, where morning TSH levels were unaltered between groups combination therapy, (treated with T 3 20 mg once daily) was superior to monotherapy by evaluating several QOL, depression and anxiety rating scales as well as patients own preference.

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“…Adipose tissue is an important energy source, a source of bioactive free fatty acids, and is also the largest endocrine organ in the human body [30]. Additional biological candidate mechanisms that relate birth weight and gestational time to depression may be related to other hypotha lamic-pituitary-end organ axes, such as the hypothalamic-pituitary-thyroid (HPT), [31] and -gonadal (HPG) [32] axes.…”

Section: Possible Etiological Mechanis Msmentioning

confidence: 99%