Mood Disorders in Levothyroxine-Treated Hypothyroid Women
Open accessAbstract
Background: Hypothyroidism has several symptoms (weight gain, arrhythmias, mood changes, etc.). The aims of this study were (1) to assess the prevalence of anxiety and depression in levothyroxine-treated hypothyroid women and in women without hypothyroidism; (2) to identify variables associated with anxiety and depression. Methods: A case-control study was performed with 393 women. Case-group: 153 levothyroxine-treated hypothyroid women. Control-group: 240 women without hypothyroidism. Convenience sampling. Instrument: The Hamilton Hospital Anxiety and Depression Scale (HADS), and a sociodemographic questionnaire. Results: The prevalence of anxiety in levothyroxine-treated hypothyroid women was higher than in women without hypothyroidism (29.4% vs. 16.7%, χ2 p < 0.001). The prevalence of depression in the case group was higher than in the control group (13.1% vs. 4.6%, χ2 p < 0.001). Levothyroxine-treated hypothyroid women were more likely to have anxiety (OR = 2.08, CI: 1.28–3.38) and depression (OR = 3.13, IC = 1.45–6.45). Conclusion: In spite of receiving treatment with levothyroxine, women with hypothyroidism are more likely to have depression and anxiety. Health professionals need to assess the mood of women with hypothyroidism. Although levothyroxine is a good treatment for the symptoms of hypothyroidism, it may not be enough to prevent development or persistence of depression and anxiety by itself.
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In the Romero‐Gómez et al. 2019 case-control study, depression occurred in 20 of 153 levothyroxine-treated hypothyroid women versus 11 of 240 non-hypothyroid controls, with a risk ratio of 3.13 (95% CI 1.45-6.73), which was statistically significant.
“depression in 20 of 153 patients (13.07%) vs. 11 of 240 patients (4.58%) with (RR 3.13, 95% CI 1.45–6.73)”
From Risk of cardiac, neuropsychiatric and musculoskeletal adverse events with levothyroxine: Systematic review (2026) · cites this paper as [25]
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredIn the Romero‐Gómez et al. 2019 case-control study, the significant anxiety and depression symptoms represent residual mood complaints in treated, euthyroid patients rather than adverse events caused by levothyroxine therapy or biochemical thyrotoxicosis.
“These symptoms, therefore, represent residual mood complaints in treated, euthyroid patients rather than AEs caused by LT4 therapy or biochemical thyrotoxicosis”
From Risk of cardiac, neuropsychiatric and musculoskeletal adverse events with levothyroxine: Systematic review (2026) · cites this paper as [25]
The Methods (section 2.1) specify that the treated case group had normalized TSH, and the Conclusions (section 5) report higher anxiety and depression prevalence despite treatment and euthyroidism. This supports residual mood complaints rather than biochemical thyrotoxicosis in the studied group, but the case-control study does not establish that levothyroxine could not have caused the symptoms as adverse events. (LLM, conf=0.87)
Experimental — accuracy not yet measuredIn the Romero‐Gómez et al. 2019 case-control study, anxiety occurred in 45 of 153 levothyroxine-treated hypothyroid women versus 40 of 240 non-hypothyroid controls, with a risk ratio of 2.08 (95% CI 1.28-3.38), which was statistically significant.
“anxiety occurred in 45 of 153 patients (29.41%) vs. 40 of 240 patients (16.67%) with (RR 2.08, 95% CI 1.28–3.38)”
From Risk of cardiac, neuropsychiatric and musculoskeletal adverse events with levothyroxine: Systematic review (2026) · cites this paper as [25]
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredA case-control study indicated that women with hypothyroidism continued to have a higher prevalence of anxiety or depression than a control group of euthyroid women, even after correction of TSH using LT4.
“A case-control study indicated that a population of women with hypothyroidism continued to have a higher prevalence of anxiety or depression than a control group of euthyroid women, even after correction of TSH using LT4”
From Pharmacodynamic and Therapeutic Actions of Levothyroxine (2021) · cites this paper as [80]
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Гусакова, Е. А., & Gorodetskaya, I. V. (2024) · Российский физиологический журнал им И М Сеченова · doi:10.31857/s0869813924050077
Hilmon, M., Kulińska, J., Krzyżanowski, D., & Skórkowska‐Telichowska, K. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15082893
Feng, Z., Wu, Z., Zhou, J., Mao, M., Wen, Y., & Feng, S. (2026) · Journal of Perinatal Medicine · doi:10.1515/jpm-2026-0105
- Authors
- Romero-Gómez, B., Guerrero-Alonso, P., Carmona-Torres, J. M., Notario-Pacheco, B., & Cobo-Cuenca, A. I.
- Affiliations
- Andalusian Health Service (ES)
- Servicio Riojano de Salud (ES)
- Facultad de Fisioterapia y Enfermería y Fisioterapia de Toledo, Universidad de Castilla la Mancha, 45005 Toledo, Spain
- Facultad de Enfermería de Cuenca, Universidad de Castilla la Mancha, 16071 Cuenca Toledo, Spain
- Venue
- International Journal of Environmental Research and Public Health
- Publisher
- MDPI AG
- Published
- 2019-11-28
- Volume
- 16
- Issue
- 23
- Pages
- 4776
- ISSN
- 1660-4601 (ISSN-L)
- PMC
- PMC6926863
- OpenAlex
- W2990341048
- Cited by
- 25
- References
- 63
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 8 · 2023: 5 · 2022: 1 · 2021: 2 · 2020: 3
- FWCI
- 1.22
- Type
- journal article
- Language
- en
- Open access
- gold
- dx.doi.org
- Licence
- Locations
- International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Funders
- European Regional Development Fund ((DOCM 24/01/19)].)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Keywords
- hypothyroidism, levothyroxine, anxiety, depression, mood disorders, women, thyroid hormone replacement, prevalence, risk factors
- MeSH terms
- Adult, Female, Humans, Hypothyroidism, Surveys and Questionnaires, Thyroxine, Prevalence, Case-Control Studies, Mood Disorders
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