February 20, 2014
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Low TSH increased risk for depression in older patients

Older patients with low-normal thyroid-stimulating hormone levels exhibited more concurrent depressive symptoms and an increased risk for developing a depressive syndrome later in life, according to data published in the Journal of Clinical Endocrinology and Metabolism.

“These results provide insight into the powerful effects thyroid activity can have on emotions and mental health,” Marco Medici, MD, of the Erasmus Medical Center in Rotterdam, the Netherlands, said in a press release. “This information could influence the process of diagnosing and treating depression, as well as treatments for individuals with thyroid conditions.”

The cohort study included 1,503 Dutch men and women (aged 70.6 years) who underwent measurements of serum TSH, thyroperoxidase antibody levels and depressive symptoms based on the Center for Epidemiologic Studies Depression Scale (CES-D).

Eight-year follow-up data indicated that patients were continuously monitored for the occurrence of incident depressive syndromes (n=156).

In a cross-sectional analysis, patients in the lowest TSH tertile (0.3 mU/L to 1 mU/L) demonstrated more depressive symptoms (mean CES-D score: 7.95 vs. 6.63, P=.014) and an increased risk for a CES-D score ≥16 (10.7% vs. 5%; OR=2.22; 95% CI, 1.18-4.17) compared with patients in the highest normal range TSH tertile (1.6 mU/L to 4 mU/L), according to data.

However, prospective analyses indicated that patients in the lowest TSH tertile who were free of depression at baseline had a greater risk for developing incident depressive syndromes (12.3% vs. 7.6%; OR=1.85; 95% CI, 1.1-3.11), according to data.

“This suggests that people with even minor changes in thyroid function may experience similar mental health effects as those with overt thyroid disorders, including hypothyroidism and hyperthyroidism,” Medici said.

Disclosure: The researchers report no relevant financial disclosures.