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Indian Journal of Psychiatry logoLink to Indian Journal of Psychiatry
. 2000 Jul-Sep;42(3):243–246.

A STUDY OF THYROID HORMONES (T3, T4 & TSH) IN PATIENTS OF DEPRESSION

Jalal Saxena *,*, PN Singh , Uma Srivastava , AQ Siddiqui §
PMCID: PMC2958345  PMID: 21407950

Abstract

In this study, 32 unmedicated patients of unipolar depression were included and blood samples were analysed for T3, T4 and TSH. These were compared with age and sex matched controls. Subnormal T3 and T4 levels in 90.6% and 9.3% respectively and an increase of TSH levels in 18.7% of the total patients was observed in this study. The patients were classified into mild, moderate and severe grade of depression as per DSM-IV criteria. Of the mild 66.6%, 93.3% of moderate and all of the severe grade depression patients had low T3 levels.

Of the moderately depressed patients 13.3% and 9.0% of severe depression patients had low T4 levels. TSH was increased than normal in 54.5% of the patients and all these patients were of severe grade. ANOVA with multiple comparison testing shows significant decrease in levels of T3 (F2.29 >3.33) and significant increase in TSH levels (F2.29 >3.33) at 5% level of significance amongst mild, moderate and severe grade of depression patients. This study suggests a subclinical hypothyroidism in most of the patients which could lead to nonresponsiveness to the conventional antidepressant therapy. Therefore, evaluation of thyroid status prior to antidepressant therapy and subsequent thyroid hormone substitution in subclinical hypothyroid patients is suggested.

Keywords: Thyroid hormones, depression

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Selected References

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  1. Bauer M., Priebe S., Kürten I., Gräf K. J., Baumgartner A. Psychological and endocrine abnormalities in refugees from East Germany: Part I. Prolonged stress, psychopathology, and hypothalamic-pituitary-thyroid axis activity. Psychiatry Res. 1994 Jan;51(1):61–73. doi: 10.1016/0165-1781(94)90047-7. [DOI] [PubMed] [Google Scholar]
  2. Baumgartner A., Campos-Barros A., Meinhold H. Thyroid hormones and depressive illness: implications for clinical and basic research. Acta Med Austriaca. 1992;19 (Suppl 1):98–102. [PubMed] [Google Scholar]
  3. Bottai T., Levy C., Lancon C., Azorin J. M., Grignon S., Valli M., Jadot G., Tissot R. Contribution á l'étude du MHPG plasmatique marqueur noradrénergique périphérique et des taux plasmatiques hormonaux de cortisol-T3-T4-TSH dans les syndromes dépressifs. Encephale. 1991 May-Jun;17(3):203–211. [PubMed] [Google Scholar]
  4. Duval F., Mokrani M. C., Crocq M. A., Bailey P., Macher J. P. Influence of thyroid hormones on morning and evening TSH response to TRH in major depression. Biol Psychiatry. 1994 Jun 15;35(12):926–934. doi: 10.1016/0006-3223(94)91239-4. [DOI] [PubMed] [Google Scholar]
  5. Fava M., Labbate L. A., Abraham M. E., Rosenbaum J. F. Hypothyroidism and hyperthyroidism in major depression revisited. J Clin Psychiatry. 1995 May;56(5):186–192. [PubMed] [Google Scholar]
  6. Garbutt J. C., Loosen P. T., Blacharsh J., Prange A. J., Jr The prolactin response to thyrotropin-releasing hormone in depressed patients and normal subjects. Psychoneuroendocrinology. 1986;11(2):213–219. doi: 10.1016/0306-4530(86)90056-9. [DOI] [PubMed] [Google Scholar]
  7. Maes M., Meltzer H. Y., Cosyns P., Suy E., Schotte C. An evaluation of basal hypothalamic-pituitary-thyroid axis function in depression: results of a large-scaled and controlled study. Psychoneuroendocrinology. 1993;18(8):607–620. doi: 10.1016/0306-4530(93)90037-l. [DOI] [PubMed] [Google Scholar]
  8. Orsulak P. J., Crowley G., Schlesser M. A., Giles D., Fairchild C., Rush A. J. Free triiodothyronine (T3) and thyroxine (T4) in a group of unipolar depressed patients and normal subjects. Biol Psychiatry. 1985 Oct;20(10):1047–1054. doi: 10.1016/0006-3223(85)90003-4. [DOI] [PubMed] [Google Scholar]
  9. Roca R. P., Blackman M. R., Ackerley M. B., Harman S. M., Gregerman R. I. Thyroid hormone elevations during acute psychiatric illness: relationship to severity and distinction from hyperthyroidism. Endocr Res. 1990;16(4):415–447. doi: 10.1080/07435809009107116. [DOI] [PubMed] [Google Scholar]
  10. Spratt D. I., Pont A., Miller M. B., McDougall I. R., Bayer M. F., McLaughlin W. T. Hyperthyroxinemia in patients with acute psychiatric disorders. Am J Med. 1982 Jul;73(1):41–48. doi: 10.1016/0002-9343(82)90922-6. [DOI] [PubMed] [Google Scholar]
  11. Stewart J. W. Thyroid stimulating hormone and depression. Am J Psychiatry. 1982 Dec;139(12):1646–1646. doi: 10.1176/ajp.139.12.1646a. [DOI] [PubMed] [Google Scholar]
  12. Tappy L., Randin J. P., Schwed P., Wertheimer J., Lemarchand-Béraud T. Prevalence of thyroid disorders in psychogeriatric inpatients. A possible relationship of hypothyroidism with neurotic depression but not with dementia. J Am Geriatr Soc. 1987 Jun;35(6):526–531. doi: 10.1111/j.1532-5415.1987.tb01399.x. [DOI] [PubMed] [Google Scholar]
  13. Targum S. D. Persistent neuroendocrine dysregulation in major depressive disorder: a marker for early relapse. Biol Psychiatry. 1984 Mar;19(3):305–318. [PubMed] [Google Scholar]
  14. Wahby V., Ibrahim G., Friedenthal S., Giller E., Kosten T., Mason J. Serum concentrations of circulating thyroid hormones in a group of depressed men. Neuropsychobiology. 1989;22(1):8–10. doi: 10.1159/000118584. [DOI] [PubMed] [Google Scholar]

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