Can Hypothyroidism Cause Anxiety?

Everyone experiences brief periods of anxiety from time to time, whether you know what’s causing you stress or you’re not sure what’s causing your feelings this particular time.

For many people though, anxiety is a frequent emotional state that negatively affects their quality of life. In fact, around 40 million adults in the U.S. currently have an anxiety disorder.

You may be looking not only for effective anxiety treatments, but also for the cause of your anxiety. Similar to other mental health conditions and mood disorders like depression, the exact reason why some people develop anxiety is unknown. Researchers believe though that different factors — such as a chemical imbalance, environmental factors or genetics — may all play a role.

Some researchers believe anxiety disorders may also be the result of malfunctions in the body’s endocrine system — our body’s hormonal messenger system, which is comprised of several organs, including the thyroid. More specifically, research points to a thyroid condition known as hypothyroidism — a deficiency of thyroid hormones — as a possible cause of anxiety.

You may be wondering if problems with your thyroid can cause anxiety, and if so, what can be done to manage thyroid-related anxiety.

We’ll break down any possible connection between the thyroid and anxiety and what you can do about it.

Before we get into answering the question of whether hypothyroidism can cause anxiety, we’ll go over what hypothyroidism is and the connection between the thyroid and anxiety.

Your thyroid gland — a small gland in your neck that has two “wings” like a butterfly — is responsible for controlling your metabolism, the process of turning the food you consume into energy. This gland also produces thyroid hormones, which control many bodily functions, including heart rate, breathing, digestion, weight and mood.

The thyroid gland works to control metabolism by creating specific hormones — T4 (thyroxine) and T3 (triiodothyronine) — and when your thyroid works properly, it makes these hormones in the right levels to keep your metabolism working the way it should.

When the pituitary gland — the gland that monitors and controls thyroid hormones in your bloodstream — senses too few or too many hormones in your body, it adjusts the amounts by releasing thyroid stimulating hormone (TSH).

When the thyroid doesn’t work properly, it can impact your entire body and lead to thyroid disorders like hyperthyroidism and hypothyroidism. Having an overactive thyroid that produces too much thyroid hormone is a condition called hyperthyroidism. If you have an underactive thyroid that produces too few thyroid hormones, this is hypothyroidism. 

This decrease in thyroid hormone levels can have several causes, including:

• An autoimmune disorder such as Hashimoto's disease

• Surgery on the thyroid

• Radiation treatment of the thyroid

• Inflammation of the thyroid (thyroiditis)

• Hypothyroidism present at birth (congenital hypothyroidism)

• Certain medicines

Hypothyroidism is a common condition that can affect people of all ages and backgrounds but is most common in women over 60 and those who have gone through menopause.

Symptoms of hypothyroidism include:

• Fatigue

• Weight gain

• Depression or depressive symptoms

• Slowed heart rate

• Forgetfulness

• Joint and muscle pain

• Constipation

• Dry skin

• Decreased sweating

• Heavy or irregular menstrual periods

• Fertility problems in women

So, can hypothyroidism cause anxiety? Below we go over if thyroid-related anxiety is a possibility. 

You may be wondering if hypothyroidism can cause anxiety? Or if there’s a connection between the thyroid and anxiety in general. But before we get into hypothyroid anxiety, we’ll give a quick rundown on anxiety.

According to the American Psychiatric Association, anxiety is a normal way that people react  when they encounter stressful situations.

But while occasional anxiety in stressful situations — worrying about money or a relationship problem — is normal, worry and fear that persists and interferes with your life can be an anxiety disorder.

Anxiety disorders are a common group of mental health disorders that affect how you feel, think and act.

There are several types of anxiety disorder, including:

• Generalized anxiety disorder (GAD). Generalized anxiety disorder (GAD) can cause excessive or persistent feelings of anxiety or worry. People with generalized anxiety disorder may worry excessively about their health, work and social life, among other things.

• Social anxiety disorder. Also known as social phobia, social anxiety disorder can cause intense fear or anxiety of being viewed negatively or rejected in social situations. Sweating, trembling, increased heart rate, trouble making eye contact and feeling self-conscious are common signs of social anxiety disorder.

• Panic disorder.Panic disorder can cause people to experience sudden and frequent panic attacks, either after being exposed to a trigger or at random. A panic attack involves a rapid heartbeat, trembling, sweating, feeling out of control and chest pain.

• Obsessive-compulsive disorder (OCD).Obsessive-compulsive disorder is when someone has uncontrollable, recurring thoughts and behaviors (obsessions and compulsions). People with OCD may check certain things, wash their hands, clean their home or perform other “rituals” repetitively to provide relief from obsessive thoughts.

• Post-traumatic stress disorder (PTSD). Post-traumatic stress disorder occurs in someone who goes through a scary or dangerous event and continues to experience trauma symptoms like nightmares, flashbacks and feelings of stress long after the event.

While symptoms of anxiety vary based on the type of anxiety disorder, there are some common symptoms, including:

• Difficulty concentrating on anything other than current worries or concerns

• Trouble sleeping

• Feeling nervous and restless

• Avoiding people, objects or situations that may cause anxiety

Anxiety can also have physical symptoms like shortness of breath, heart palpitations, sweating, stomachaches, feeling weak or tired and more.

People may also experience a depressive disorder or feelings of depression at the same time as they experience symptoms of anxiety.

Hypothyroidism can also contribute to weight gain and mood changes, so the connection to depression is not surprising. But can hypothyroidism symptoms also include anxiety?

Maybe your symptoms of hypothyroidism are causing you anxiety. Or maybe you happen to be feeling symptoms of hypothyroidism and anxiety at the same time. Either way, you may wonder, “Can my thyroid cause anxiety?”

A 2018 review published in JAMA Psychiatry found people with hypothyroidism are more than twice as likely as people without the condition to develop anxiety disorders and that 29.8 percent of all anxiety disorders are associated with autoimmune thyroid disease.

Another study also found anxiety to be very common alongside hypothyroidism. A study from the Indian Journal of Endocrinology and Metabolism looked at 100 people with hypothyroidism and found that 63 percent of them had at least some level of anxiety.

So what causes anxiety in hypothyroidism? One possible reason is that chronic or unidentified illnesses can cause additional stress and worry, leading to anxiety.

The symptoms of hypothyroidism — such as fatigue, muscle pain, brain fog or depression — can also be stressful.

Regardless of the cause, managing stress and anxiety symptoms is possible.

In addition to regulating the hormones for growth and metabolism, thyroids also have a hand in everything from muscle function and heart health, to digestive processes and energy levels.

And since hypothyroidism is a condition in which a person’s thyroid is less productive than normal, it can cause problems both physical and mental because the thyroid wears many hats, far as job duties are concerned. 

Here’s a quick list of the symptoms of hypothyroidism, for context:

• Cold Intolerance

• Dry Skin

• Insomnia

• Menstrual Cycle Abnormalities

• Weight gain and weight loss

• Complications in pregnancy

• Fatigue

• Neck pain

• Depression

• Anxiety

• Memory loss

As you can see, a lot of problems can result from thyroid performance issues. But is the thyroid causing them? It’s not always clear.

When it comes to mood, we have more information in the analysis for risk factors to support the cause connection. 

Studies show that both an inactive and hyperactive thyroid can affect mental health. 

A 2020 review pointed out that the thyroid hormone T3 has been closely linked to depression and anxiety, as well as the regulation and production of serotonin and norepinephrine.

A 2015 review explored mental health and cognitive issues associated with hypothyroidism to try and better determine the relationship between problems like anxiety disorders and thyroid performance. 

Researchers concluded that yes, hypothyroidism (which is already a stressful situation) increased mental and emotional stress and anxiety symptoms for many people.

But there are some caveats to explain here. 

While the study generally found that hypothyroidism increased the risk of anxiety, not every study supported these findings. Some believed the link to be negligible based on their criteria. 

Many studies also drew the conclusion that a person’s risk for anxiety, when confronted with hypothyroidism, varies — and that outcomes are potentially due to other attributable risk factors.

In other words, hypothyroidism and anxiety are connected, but there are stronger connections to be considered before judging their relationship, which  should be considered on a case-by-case basis. 

Most experts agree that hypothyroidism can increase your risk of developing an anxiety disorder or panic disorder, but not all of them believe it can cause anxiety disorders to happen outright.

While anxiety seems to have a connection to thyroid problems, we weren’t able to find any research suggesting a connection between anxiety disorders and resulting thyroid disorders. 

There doesn’t appear to be any causal relationship between thyroid disorders like hypothyroidism and anxiety disorders. 

That is not to say that anxiety can’t exacerbate existing thyroid problems — particularly when it comes to the side effects. 

A 2010 review looked at studies of the relationship between pain and mental illnesses like anxiety and depression. What they found was a deep link between the degree of pain you experience and the degree of mental illness severity — the degree of anxiety or depression. 

Basically, if you’re experiencing patterns of depressed mood or anxious mood, those mood swings can make pain worse, and the worse your mental illness, the worse the pain gets.

That’s hardly a deep bond when you consider that — by this logic — depression makes toe stubbing more painful. 

However, chronic conditions like hypothyroidism can cause chronic discomfort as a result of those side effects we already mentioned, and research is pretty clear that if anxiety and depression are a play as well, they’re going to amplify those effects for you as long as they persist.

If you’re diagnosed with an anxiety disorder, your healthcare provider will likely recommend one or several different approaches to treat this type of mental disorder.

Based on your symptoms and their severity, a healthcare provider may recommend therapy, medication, lifestyle changes or a combination of approaches.

One way to calm down anxiety and reduce stress is through easy lifestyle changes. Changes like reducing caffeine consumption, exercising regularly, taking up meditation and avoiding alcohol may help to lower anxiety and improve your control over feelings such as fear and worry.

Medication is another effective option to help manage anxiety symptoms. The different types of anti-anxiety medications include benzodiazepines, antidepressants and beta-blockers.

Benzodiazepines can provide almost immediate relief from specific anxiety symptoms but can also cause side effects, dependence and withdrawal symptoms when stopped abruptly.

Antidepressants are commonly prescribed to treat anxiety. Usually, this will mean a selective serotonin reuptake inhibitor (SSRI) such as sertraline (Zoloft®), escitalopram (Lexapro®) or fluoxetine (Prozac®).

You can learn more about medications for anxiety in this guide.

Or your healthcare provider may recommend psychotherapy. This typically involves working with a therapist to identify the factors contributing to your anxiety and taking action to reduce the severity of your symptoms. Cognitive behavioral therapy (CBT) and exposure therapy are just two types of therapy for treating anxiety.

If you want to get started with therapy, we offer online therapy and online group therapy for anxiety. Both can provide you with the opportunity to discuss your symptoms with others and learn effective tools and strategies for managing symptoms of anxiety.

So, can hypothyroidism cause anxiety? Possibly. But you’ll want to talk with your healthcare provider first about your symptoms. They can determine — through either a thyroid test or another diagnostic test — if you have an anxiety diagnosis or a hypothyroidism diagnosis.  

No matter what the cause, if you’re struggling with any of the above symptoms of anxiety, there are ways to get help. You can start your search for anxiety treatment online using our telepsychiatry services or learn more about identifying and treating anxiety with our collection of free online mental health resources.