Thyroid Disorders and Diseases

Thyroid Disorders and Diseases are a group of medical conditions that affect the function of the thyroid gland.

Asymptomatic, non-pregnant, adults over the age of 18, with no prior history of thyroid disorders are recommended to not have routine screening for thyroid dysfunction.[1] Generally speaking, if a patient has depressive symptoms or cognitive dysfunction, then they are not asymptomatic.

Treatment of subclinical hypothyroidism in adults with depression has been shown to improve depressive symptoms.[2]

Thyroid peroxidase antibody (TPO) is elevated in 20% of women with postpartum psychosis, compared to 5-7% of all postpartum women.[3] There is an association between postpartum thyroid dysfunction and depression. In some cases, TSH should be ordered in women with a history of goitre, type I diabetes, prior postpartum depression, thyroid disease history (including prior low free T4 level), a family history of thyroid disease, or a personal history of smoking. If the TSH level is abnormal, a free T4 should also be ordered.[4]

Screening for thyroid dysfunction is a part of the work up for cognitive impairment and dementias.