THYROID DEFICIENCY: IS IT PSYCHOGENIC?

On a warm day a few years ago, a middle-aged housewife was brought into my office by her husband, a professional man who had happened to read some of my reports on low thyroid function in the medical literature. He felt that before carrying her off to a mental institution for extended treatment—a recommendation of both family physician and psychiatrist after fruitless attempts to help her—it would do no harm to have her thyroid function investigated.

In addition to the pajamas and heavy bathrobe she wore, she was wrapped in a heavy blanket, yet she sat before me shaking with cold. For a year, she had experienced loss of appetite, loss of weight, sleeplessness, eye inflammation, hoarseness, nervousness, poor memory, difficulty in thinking. Even before that, she had become frightened of crowds and wouldn't leave the house. She was unable to cook because she could not remember what ingredients she had already added.

There had been extensive examinations and laboratory tests. All results were within the normal range. Seemingly, hers must be a mental problem. Yet, what had been overlooked by her previous physicians was that mental conditions are common in thyroid disorders; indeed, British studies had demonstrated this even before the turn of the century. Her shivering and shaking on a warm day, despite being well wrapped, was in itself a clue to hypothyroidism.

When her low thyroid function was confirmed by temperature test, she was started on thyroid therapy with the advice that it would be at the very least a month before any improvement could be anticipated. Meanwhile, to make the family feel better, she was referred to a competent neurologist to rule out the possibility of any serious neurological problem. The neurologist found nothing and advised her to continue with thyroid therapy. Improvement did begin in a month and continued. Within several months, she was free of all symptoms, including her fears.

An example of what might erroneously be supposed to be mental deterioration associated with aging is the case of a sixty-five-year-old woman whose history suggested that she might have had some relatively mild manifestations, particularly a tendency to undue fatigue, of hypothyroidism for much of her life. But there had been serious difficulties only for the past three years. For each of the past three winters, she had required hospitalization and had been given shock treatment for depression accompanied by mental aberrations. She was better each summer, but slumped again each winter. This suggested the possibility of thyroid deficiency since more thyroid is needed in cold weather to step up the body's burning of fuel required to combat cold. Her hypothyroidism was confirmed by temperature test and she was started on thyroid therapy. She has now passed through four winters without difficulty, full of gratitude for her escape from further shock therapy.

I have seen many other problems, otherwise mysterious and unyielding, associated with low thyroid function and responsive to thyroid treatment to restore thyroid levels to normal. And it is gratifying to report that so have other physicians, when they are suspicious of the possibility that hypothyroidism may be at fault.

Recently, for example, Mayo Clinic physicians have found that poor equilibrium, muscle aches and weakness, some hearing disturbances, and nervous system changes leading to burning and prickling sensations are due in some cases to reduced thyroid activity and respond to thyroid therapy. Recently, too, in University of North Carolina School of Medicine studies, hypothyroidism has been found associated with varied mental disturbances, including depression, memory loss, and difficulties in concentrating.

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