Psychological disturbances such as intense irritability, stress, anxiety, and cognitive difficulties may be under-recognized symptoms of hypothyroidism, a condition affecting an estimated 1.4 million people in the UK. Experts are calling for physicians to more routinely test thyroid function in patients presenting with these symptoms, especially when combined with physical signs.
Hypothyroidism occurs when the thyroid gland, a butterfly-shaped organ in the neck, produces insufficient thyroid hormones. These hormones are crucial for regulating metabolism, and their deficiency can lead to a range of physical symptoms including fatigue, weight gain, feeling cold, constipation, dry or thinning hair, muscle weakness, hoarse voice, and slowed speech and movement.
However, thyroid hormones also play a vital role in brain function. Research indicates that low thyroid hormone levels can manifest as psychological issues, which are often not recognized as being thyroid-related. Many individuals suffer from these symptoms for extended periods without suspecting a thyroid disorder. This is particularly true for middle-aged women, who may attribute their symptoms to stress or busy lives, and older individuals who might fear the onset of dementia.
Kristien Boelaert, professor of endocrinology at the University of Birmingham and a trustee of the British Thyroid Foundation, stated that hypothyroidism is frequently undiagnosed. She advises that if patients seek medical help for anxiety or depression, and exhibit any common physical symptoms of hypothyroidism, doctors should consider thyroid function tests. Lyn Mynott, chief executive of Thyroid UK, echoed this sentiment, noting that thyroid-related psychological issues are often misdiagnosed, and treatments like antidepressants may be prescribed without addressing the underlying thyroid problem.
Undiagnosed hypothyroidism carries significant health risks. It can lead to severe heart problems, including elevated blood pressure and cholesterol levels, and a slowed heart rate. For women, it can disrupt ovulation, alter menstrual cycles, and increase the risk of miscarriage. In rare, severe cases, untreated hypothyroidism can result in a myxedema coma, a life-threatening condition where vital organs begin to shut down.
Jim Harwood, a 73-year-old computer programmer, experienced profound irritability and anger over trivial matters, alongside a decline in his focus and concentration. He struggled to manage his words and actions, initially considering serious conditions like dementia or mad cow disease before suspecting his thyroid. His condition worsened to include significant weight gain, a persistent feeling of cold, and crippling fatigue. A swollen neck also became apparent, a common indicator of thyroid dysfunction.
It was only after these physical symptoms emerged that Harwood's thyroid condition was identified. He was subsequently prescribed artificial thyroid hormones, which have nearly eliminated his symptoms. "Once I started on the drugs, my mood completely lifted," he reported, expressing a wish that the diagnosis had not taken so long.
Hypothyroidism affects approximately 2% of the population, with a higher prevalence in women and older individuals. It is estimated that around 5% of people in their 60s and 10% of those over 80 are affected.