Thyroid Antibodies, Depression, and Anxiety

We all know that low thyroid hormones can lead to feelings of sadness and anxiousness. One of the most common causes of low thyroid hormones is an auto-immune condition called Hashimoto’s thyroiditis. With this condition, your body attacks and injures your thyroid gland which contributes to reduced thyroid function.

One of the hallmarks of this conditions is elevated thyroid antibodies—anti-thyroperoxidase and anti-thyroglobulin antibodies. For the longest time, these were viewed as markers of Hashimoto’s thyroiditis but not much attention was paid to them in the doctor’s office.

Now, more research is showing that high thyroid antibodies may be playing a role in mental health regardless of thyroid hormone levels. In other words, we should be paying attention to antibodies in addition to hormone levels.

A 2024 meta-analysis by Wang et al. examined 11 studies on this topic. Patients had normal thyroid hormone levels but high thyroid antibodies, a state known as euthyroid Hashimoto’s thyroiditis. Most patients were from Europe and China and there were over 1300 patients with depression and over 1000 patients with anxiety across all of these studies.

Those with normal thyroid hormones but elevated thyroid antibodies had 2.5 times higher odds of having an anxiety disorder. They were also more likely to experience depression symptoms based on validated questionnaires.

But why might the thyroid antibodies themselves impact mood? What could they be doing to the body? Researchers think that thyroid antibodies may negatively impact the nervous system. They may impact nerve cells or brain function—scientists aren’t completely sure yet.

It’s important to note that some studies show no link between thyroid antibodies and mental health. That being said, this assessment of multiple studies provides illuminating insight into the potential link between thyroid antibodies and mental health. In my practice, I regularly test thyroid antibodies for my patients with anxiety and depression because there are natural ways to address this issue. I wrote another article on this topic a couple years ago, before this new paper came out. You can read it HERE.

If you’re in Ontario and you need help uncovering the underlying factors impacting your mental health, book a free 15 minute phone consultation and we can chat about it.

Myo-Inositol: What You Should Know

What is myo-inositol?

Inositol is a compound produced naturally in the human body and found in foods such as grains, organ meat, almonds, beans and certain fruits but it may be difficult to get all of the inositol our body needs from a modern diet alone. It’s typically sold in two different supplement forms: myo-inositol and chiro-inositol. Certain factors increase our body’s need for inositol. These include having a high amount of refined sugar in the diet, high blood sugar and increasing age. 

Myo-inositol plays a role in many functions in our body including how hormones (like insulin) and neurotransmitters communicate with our cells. It seems to be important in organs like the brain and ovaries because of these roles. 

What conditions is it used for?

Inositol is a popular supplement used for a wide array of conditions such as PCOS, diabetes and insulin resistance, thyroid disorders, elevated cholesterol, anxiety, depression and obsessive compulsive disorder. 

What doses are used?

The dose used depends on the condition being treated with lower doses being used for PCOS and thyroid issues (anywhere from 1-9 grams) and higher doses being used for mental health conditions. Studies on inositol often span from 3 months to a year so it may take time before improvements in symptoms are noticed. 

What about D-chiro-inositol? 

D-chiro-inositol is another form of myo-inositol found naturally in the body. It’s made from myo-inositol and is found in many body parts including muscle and the liver. Many studies on conditions like PCOS show that myo-inositol supplementation alone can improve symptoms. However, there may be cases when supplementing with both forms is beneficial. Your naturopathic doctor can help you decide the best course of action. 

Does it have side effects?

Bloating and gastrointestinal discomfort are possible side effects but this typically happens at higher doses. Taking it with food may help prevent this. It may interact with certain medications which your naturopathic doctor can help you figure out. 

If you have questions about the supplements you’re taking, book a free 15 minute phone consultation so we can talk about how I can help.

Soy and Thyroid Health

Out of all the foods out there, soy seems to generate a lot of controversy. Soy contains many nutrients and plant chemicals. Isoflavones are compounds found naturally in soy that can impact hormonal health. For example, soy isoflavones may help minimize some of the symptoms of menopause like hot flashes. Soy consumption has been associated with a number of benefits such as improved heart health and even reduced breast and prostate cancer risk.

That being said, soy has also been feared for a number of different reasons. One reason is that many believe soy can shut down thyroid function by reducing the production of thyroid hormones. Lab studies not conducted on humans have found that soy isoflavones can inhibit an enzyme called thyroid peroxidase (TPO). TPO helps to make inactive and active thyroid hormone (T4 and T3).

A large amount of studies have been conducted in recent years to examine this question. Studies show that in healthy people, soy consumption does not appear to increase the risk of developing hypothyroidism.

Where things become more unclear is in those who already have lower thyroid function. This may include those who have abnormal TSH levels even though other thyroid tests are normal. In cases like these, soy isoflavones in high enough quantities can raise TSH levels enough to have a negative impact on thyroid health. More research is needed to confirm this and work out the details such as what quantity of dietary soy could have this impact.

In general, soy is a healthy food when prepared in a healthy way. By “healthy way”, I mean minimally processed soy such as a homemade tofu Thai curry rather than a soy hot dog full of other additives. I don’t like to restrict generally healthy food from patients unless there is a good reason to. If a patient is wondering whether to reduce soy in their diet to help their thyroid, my answer will vary depending on the case.

If you’re wondering how evidence-based naturopathic medicine can support healthy thyroid function, feel free to book a free 15 minute consultation.

How Thyroid Antibodies Affect Your Mood

Figuring out the causes of your anxiety and depression can be frustrating. Anti-anxiety and anti-depressant medications and supplements certainly have an important role to play in relieving mood symptoms. But I’m always disappointment when I see that the treatment plan usually stops there. We should be doing a much better job at uncovering and treating potential contributing factors to anxiety and depression. The health of your thyroid is one such factor.   

If your thyroid is overactive or underactive it can contribute to depression and anxiety. Pretty much all health care providers are aware of this so if you complain about your mood or anxiety levels, there’s a good chance your TSH and T4 (maybe T3) will be tested. If these come back normal, your thyroid is crossed off the list as a cause of concern.

But did you know that the health of your thyroid could be affecting your mood even if your thyroid hormone levels are normal? There is growing evidence that elevated thyroid antibodies can play a role in depression, anxiety, bipolar disorder and panic attacks even if thyroid hormone levels are normal. I’m starting to see a few more patients coming to me with thyroid antibody test results, but I’m still surprised that antibodies are not tested more often.

What are thyroid antibodies? Your thyroid is a gland in your neck that governs your metabolism and is in charge of a number of different functions. Thyroid antibodies form when your immune system accidentally decides to attack various components of your thyroid. This leads to inflammation and damage in your thyroid. Sure, this damage can cause abnormalities in your actual thyroid hormones - but not always. Just because your thyroid hormones are normal doesn’t mean we can ignore thyroid antibodies.

Testing thyroid antibodies involves a simple blood test and it’s relatively inexpensive. I run antibody tests for my patients all the time and the results help me to decide what treatments are worth while and what aren’t.

Anxiety and depression can have multiple different root causes. Sometimes the causes are obvious and sometimes they’re not. If you really feel ready to do a deep dive into the potential contributing factors to your mood symptoms, reach out to me and we can discuss options. You deserve to have a comprehensive, robust treatment plan for your mood symptoms.  

For a free list of foods linked to lower anxiety levels, click the link below.

My Approach to Gluten

It’s a common cliché to think that naturopathic doctors put all their patients on a gluten free diet. The term gluten describes specific proteins in plants like wheat, rye and barley. Gluten gives foods made from these grains a unique texture that is hard to mimic. This is why gluten-free breads taste so different from the breads we’re used to.

I don’t believe everyone needs to be on a gluten free diet and I only recommend it when I think it’s necessary. I also don’t believe that only those with celiac disease need to consider reducing gluten intake. There is a growing body of research on non-celiac gluten sensitivity although this research is still controversial right now. Wheat and gluten sensitivities have been associated with skin conditions like eczema, irritable bowel syndrome, chronic pain and even mood disorders.  

I’ve seen a number of patients benefit from a trial of reducing gluten in their diet – even if they were already eating a healthy diet before. Personally, when I include gluten in my diet, I tend to get hives, seasonal allergies, my thyroid levels go out of whack, I get more fatigued, more “brain fog”, my mood suffers and I sometimes get mild joint pain. When I remove or even just reduce gluten, these symptoms all go away and I usually feel great.

It’s important to note that whenever I reduce my gluten, I try to avoid processed gluten free foods. A lot of these processed gluten free foods are not nutritionally valuable. I’ll have gluten free bread or gluten free treats here and there but for my staples, I prefer to stick to foods that are minimally processed and naturally gluten free like rice, sweet potato, quinoa, chickpeas, etc.

My latest gluten free stretch of time was 2017 - 2018. I was able to be almost gluten free for a big chunk of the year. I didn’t really miss it at all. However, towards the end of 2018, I started to feel deprived. As I mentioned in my article on intuitive eating, it’s really important to me that I eat healthy without feeling deprived. That’s why I decided to reintroduce gluten back into my life for now. I still try not to have it every day, but I am having it more than in 2017. The mild hives have returned, and I do feel a slight dip in my energy but I’m ok with temporarily paying this price so I can feel happy about my diet and less deprived. I know that in time I’ll be open to cutting gluten out again.

And that’s how it goes for me. I’m aware of my gluten intolerance and I fluctuate my level of gluten intake based on my motivation and sense of deprivation. My intolerance symptoms are mild enough that I can live with them when they come back. If they get more severe, then I might prefer to be more strict with my gluten avoidance.

The point is that the power is in my hands to use my awareness of my intolerance as I see fit. When I tell my patients that they may benefit from reducing certain foods in their diet, I will never sit there and judge them if they don’t follow my recommendations to a tee every single moment of their life. You have to know yourself and your relationship with food. You have to know what you’re willing to do and what you’re not ready for yet. I’ve had many patients tell me that they do want to change their diet but only to a certain extent. That’s ok. I will meet you where you’re at and we can change as much as you’re ready for and save the rest for another time.

My job is to arm you with the awareness of all the things that you can do to benefit your health. Your job is to communicate to me what you’re ready for and what you’re not ready for. Our job together is to use this information to build a plan that works for you on every level.

Fed up With Feeling Irritable all the Time? Hormone Balancing May be the Answer

I’ve gone through it. I know others who have gone through it. Many of my patients complain about it. That feeling of inexplicable irritability and anger. Snapping at your husband, kids or parents. Complaining about everything. Feeling jealous, stubborn and like you just want to argue against every idea or plan being sent your way. Life sure would be easier if you could get along with everyone…but you just don’t feel like it.

But then the guilt comes. You wish you could be a more pleasant mom, wife, daughter, friend, co-worker. You might feel like you’re “failing” in these roles. You wish you had more patience and that your home or work environment could be happier. It just feels so out of your control.

First, don’t beat yourself up. You’re only human and you have every right to experience all the emotions that come with being human. Second, some of your irritability may be totally justified. Some of it may be a sign that you need to work some things out with yourself emotionally. But some of it could also be a sign that something is off with your health. Often, hormonal imbalances can contribute to grumpiness. Common culprits are estrogen, progesterone, testosterone, cortisol and thyroid hormones. When these hormones are too high or too low you could end up feeling anxious, depressed or irritable.

I went through a period of extra irritability myself. It was not like me at all to feel so grumpy for no reason. Sure, I would get irritable from time to time like anyone else - but this was a whole different level. I hated feeling like this so I decided it was time to test my hormones and sure enough there were imbalances. When I put myself on a protocol to re-balance my hormones I felt amazing. I felt like myself again and my energy, mood and motivation skyrocketed (a crazy acne breakout also cleared up as an added bonus). I’ve seen this type of transformation in my patients as well when we committed to testing and treating their hormone imbalances. Sometimes the change is quick (like in my case) and sometimes it’s a gradual transition to brighter, happier days. Either way it’s worth it.

So if you feel like you’ve tried everything to calm your irritability and it’s not working, consider investing in your hormonal health. Get back to feeling like yourself and shining your light on everyone around you.

Stress Part 2: Hormones

This is the second article of my series on stress. To read the previous article click here.

Last week I discussed how stress can affect the skin. Today I’ll be talking about some different ways stress can make hormones go haywire. Most women remember a time when their period went wonky during a stressful episode in life. This is just one example of how stress can impact hormones. Read on to find out how stress can play a role in hormonal conditions.

 

Irregular/ Absent Periods

Amenorhea is the term used for when you miss your period for multiple cycles. When this is caused by stress it’s known as hypothalamic amenorrhea. This fancy term is used because when you're stressed the part of the brain called the hypothalamus triggers a release of different stress hormones like cortisol. This can cause the brain to release less of the hormones important for your cycle (like LH and FSH). This ends up disturbing the ovulation process and the whole cycle. A similar process can lead to irregular periods.

 

Infertility

One of the most common pieces of advice given to women trying to get pregnant is to be less stressed. Like with hypothalamic amenorrhea, stress can lead to less consistent ovulation. This can make getting pregnant more complicated. Preliminary studies have found that stress can lead to something called reproductive aging. This involves decreased ability for the ovaries to produce a healthy egg.

 

Diabetes

There is some research suggesting that stress hormones like cortisol can make your body respond less to the hormone insulin. This makes it harder for your body to control blood sugar. Blood sugar may remain high for longer after meals when you’re stressed.

 

Thyroid Dysfunction

Improving stress levels has been shown to improve thyroid hormone levels. Cortisol can reduce thyroid hormone levels.

 

Men’s Health

Don’t think that stress only impacts women’s health! Hormones in men are also affected by stress. The effects are less understood though. There is research suggesting that stress may lower testosterone levels in men.

As you can see stress management is an important part of a plan to treat any of these conditions. If you need help with your hormones or your stress levels book an appointment or free 15 minute consult.

Chemicals and Your Thyroid

In a previous article on a similar topic I discussed how household chemicals can impact hormones. In this article I go into more detail on how specifically the thyroid may be affected by self care products. I also list some of my favourite natural alternatives that I use for self care.

It’s not yet clear how exactly chemicals hurt the thyroid. Most of the chemicals studied decrease thyroid function. Some over-stimulate the thyroid. This is a very difficult area to make conclusions about. Chemical effects happen so gradually over time so it’s hard to detect in a study. Much of the research is in its early stages but it's gaining attention.

Not all the chemicals that may hurt the thyroid are in self care products, but some are. Until more is known on this subject it may be worthwhile to play it safe.

What About Antibodies

When you have an auto-immune thyroid condition, your body produces antibodies that lead to an attack on your thyroid. Hashimoto’s thyroiditis and Graves’ disease both fall into this category. Hashimoto’s is the most common cause of hypothyroidism. Graves’ is the most common cause of hyperthyroidism. 

There is emerging research showing that certain chemicals can increase thyroid antibodies. 

Often people with auto-immune thyroid conditions are genetically predisposed to them. It’s believed that a trigger may be the final straw that “activates” the condition in such people. Possible triggers include infections, mental or physical stress, nutrition levels and chemicals.

Product Inventory

Here are some potential products to keep your eye on with some alternatives that I love:

- Soap with triclosan: choose soaps without this antibacterial ingredient or more natural soaps like castile soaps

- Fragranced perfumes, soaps, shampoos, conditioners, creams: either get more natural versions from a health food store or at least fragrance-free versions

- Perfume: switch to essential oils (many places sell great blends)

- Body, hand, face creams: switch to oils and keep them in a glass jar (yes, it’s long been established that even oily skin benefits from certain plant oils) 

o Face: right now, I blend jojoba and olive oil, I’ve also done grapeseed or almond oil

o Body: in the summer I prefer coconut which is often not hydrating enough for winter, in the winter I prefer olive or grapeseed oil

o If you’re attached to creams use cocoa or shea butter. These have to be melted. You can also use a blender to combine them with other oils so they stay soft.

- Nail polish: I can’t think of a good alternative so I just limit my use!

- Hair spray: same idea as nail polish 

- Exfoliant: just use sugar, coffee or salt blended with some olive or almond oil

- Masks: stick with masks that are just clay combined with some plant oils/ herbs

- Lip balm: use 100% shea in a little glass jar, it warms up as you rub it with your finger

- Spot treatment: tea tree oil or castor oil

- Face cleanser: I don’t wear full makeup often so when I do I will use a makeup remover even if it’s not 100% natural. Otherwise, when I just wear eye makeup I remove my eye makeup with olive oil and wash my face with honey

Try using this list to do a little inventory of your self care products. Pick and chose what you want to swap out.

If you want to learn more about how naturopathic medicine can help your thyroid, book and appointment or free-15 minute consult.