Osnaya-Brizuela Norma, Valenzuela-Peraza Armando, Santamaría-Del Ángel Daniel, García-Martínez Yuliana, Pacheco-Rosado Jorge, Pérez-Sánchez Gilberto, Sánchez-Huerta Karla
Laboratorio de Neurociencias, Subdirección de Medicina Experimental, Instituto Nacional de Pediatría, Ciudad de México, Mexico.
Departamento de Fisiología "Mauricio Russek", Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Ciudad de México, Mexico.
Front Psychiatry. 2024 Jul 19;15:1429255. doi: 10.3389/fpsyt.2024.1429255. eCollection 2024.
Hypothyroidism is a prevalent thyroid condition in which the thyroid gland fails to secrete an adequate amount of thyroid hormone into the bloodstream. This condition may develop due to genetic or acquired factors. The most frequent cause of acquired hypothyroidism is chronic autoimmune thyroiditis, also known as Hashimoto's disease. Acquired hypothyroidism is diagnosed when patients present with overt hypothyroidism (also known as clinical hypothyroidism), as they exhibit increased TSH and decreased T and T serum levels. This article examines the prevalence of psychiatric disorders among patients diagnosed with acquired hypothyroidism with or without Levothyroxine treatment. We discuss the available evidence indicating that acquired hypothyroidism may be a risk factor for psychiatric disorders, and the effectiveness of thyroid treatment in relieving psychiatric symptoms. Additionally, we provide critical details on thyroid hormone cutoff values reported in the literature, their potential clinical importance, and their correlation with psychiatric symptoms. Finally, we examined the various mechanisms by which acquired hypothyroidism can lead to depression. The high rate of comorbidity between hypothyroidism and psychiatric disorders deserves special attention, indicating the importance of consistent monitoring and timely identification of psychiatric symptoms to prevent disease exacerbation and facilitate therapeutic management. On the other hand, several mechanisms underlie the strong association between depression and acquired hypothyroidism. Deeper research into these mechanisms will allow knowledge of the pathophysiology of depression in patients with acquired hypothyroidism and will provide clues to design more precise therapeutic strategies for these patients.
甲状腺功能减退是一种常见的甲状腺疾病，甲状腺无法向血液中分泌足够量的甲状腺激素。这种疾病可能由遗传或后天因素引起。后天性甲状腺功能减退最常见的原因是慢性自身免疫性甲状腺炎，也称为桥本氏病。当患者出现明显的甲状腺功能减退（也称为临床甲状腺功能减退）时，即促甲状腺激素（TSH）升高且血清T3和T4水平降低时，可诊断为后天性甲状腺功能减退。本文研究了诊断为后天性甲状腺功能减退且接受或未接受左甲状腺素治疗的患者中精神障碍的患病率。我们讨论了现有证据表明后天性甲状腺功能减退可能是精神障碍的一个危险因素，以及甲状腺治疗缓解精神症状的有效性。此外，我们提供了文献中报道的甲状腺激素临界值的关键细节、它们潜在的临床重要性以及它们与精神症状的相关性。最后，我们研究了后天性甲状腺功能减退导致抑郁症的各种机制。甲状腺功能减退与精神障碍之间的高共病率值得特别关注，这表明持续监测和及时识别精神症状对于预防疾病恶化和促进治疗管理的重要性。另一方面，抑郁症与后天性甲状腺功能减退之间的强关联有多种机制。对这些机制进行更深入的研究将有助于了解后天性甲状腺功能减退患者抑郁症的病理生理学，并为为这些患者设计更精确的治疗策略提供线索。
