Thyroid Disease as a Cause of Psychosis: Hashimoto's Encephalopathy
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- čas přidán 1. 07. 2024
- Thyroid Disease as a Cause of Psychosis: Hashimoto's Encephalopathy
I make the argument in this talk that clinicians should seriously consider adding a simple antibody screen to their standard medical workup for psychosis because some cases of Hashimoto’s Encephalopathy present with symptoms that very much resemble schizophrenia.
Hashimoto’s Encephalopathy is diagnosed by the presence of psychiatric symptoms and/or neurological symptoms in the context of autoimmune thyroiditis. Antibodies against thyroid peroxidase are present in more than 90% of cases. Hashimoto’s Encephalopathy is frequently accompanied by EEG abnormalities. These can be detected in about 90% of cases.
The argument for routine screening for Hashimoto’s Encephalopathy is that it can be effectively treated - but not with antipsychotic medications.
Treatment of Hashimoto’s Encephalopathy is focused on the immune system. Glucocorticoid steroids like prednisone are the first-line treatment for the psychosis associated with Hashimoto’s Encephalopathy. First-line antipsychotic medications might make symptoms worse, according to some reports.
This lecture was given at the August 29, 2020 meeting of the SZconsult learning community.
SZconsult is a free consultation + education service offered by Northeast Ohio Medical University. It’s open to any clinician who wants to learn more about schizophrenia-spectrum illness, or who wants to tap into the collective wisdom of the learning community to find answers to clinical problems.
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#askapsychiatrist # Psychosis - Věda a technologie
Rarely do any physicians do a complete thyroid panel which would include testing for thyroid antibodies. Instead you will get a simple TSH test which is definitely not a complete picture of what is going on with the thyroid. It should become a standard practice to test for thyroid antibodies for those that have been dx with any "mental illness" and especially for those that have had some symptoms of feeling that their brain feels "off" with ataxia, unsteady gait along with other thyroid symptoms. I was told I probably had a brain tumor. Not helpful at all. Hashimoto's thyroiditis can be rather complex as it does involve the gut and infections as well as vitamin and mineral deficiencies. A really good source of information on helpful dietary measures to take and healing the gut is Pharmacist Izabella Wentz. Her book is called Hashimoto's Thyroiditis Root Cause. Thank you Dr. Messamore for being such a pioneer and great source of information for those who have been dx with mental illness.
Once we accept that we are flesh & spiritual... we can take on these issues head on!
Thank you! My husband was misdiagnosed with bipolar for years before it was discovered that he had Hashimoto's. He did not respond to anti depressants etc. I have Hashimoto's and, on occasion, have experienced various symptoms that align with bipolar. At one point my antibody level was 3,200; I had extreme anxiety, mania, euphoria, as well as some physical symptoms such as idiopathic skin conditions. My original diagnosis, before the blood work came back, was manic syndrome. Fortunately, the psychiatrist I was sent to was very knowledgeable. However, being on regular thyroid medication and having normal thyroid levels did not always preclude relapses with mania.
I was misdiagnosed as bipolar too
Trying to help someone if you don’t mind my questions. So having normal levels did not always prevent relapse psychosis or your mental issues? Does your Dr. Have a plan for that? How did you feel when dealing with mania? Were you able to communicate your thoughts? Any hallucinations? My sister is really struggling right and I’m trying to learn to best inform her doctors. Has a good career don’t want her to lose but she can’t work like this. Hopefully can go on some medical leave🤞🏽 I find it draining to even talk with her but I know she’s there. Sometimes she’s lucid but next sentence will be delusional. Best of luck to all. Grateful for lecture too.
@@othersbyuri My mania was in the nature of super human energy and accomplishing vast amounts of things that boggled the minds of people around me; also, talking a lot, I mean, really! I did a lot of searching and found peer reviewed articles on the ability of selenium, daily, in reducing antibodies. In 8 months I was down to 1,800, and the following year I was in the 600s. After about 6 months on selenium I noticed a distinct change in mental and physical health, for the better; my allergies decreased dramatically (specifically, recently acquired food allergies). In 2017, after reviewing a new peer reviewed article I added inositol; antibodies went down to 244 in one year, and again, improvements in a sense of well being. If I go off these supplements the antibodies rise again. Endocrinologists are not immune specialists; their opinion is that antibodies cannot be controlled, or they do not have the ability to assist with that, therefore they will not test for them; I ask for the test and offer to pay myself as this info is relevant to me. One more thing, I started vitamin D at about 4-6000 IUs daily (2yrs ago) as this proh-ormone is also essential for immune function (keeping the immune system under control). I hope I have answered any questions. I am not a physician, merely a long time patient fighting to regain function. Cheers and good luck
@@othersbyuri kratom has helped me and members of my family with depression and mental issues. Kanna has good reviews but I haven't found any locally. Of course, I an not suggesting using this for or instead of thyroid meds. Just saying this has worked better than any antidepression. Gluten can also cause schizophrenia. It's hard to get doctors to find a cause of psychological problems. Eso. With all the crazy food we will eat as humans! My chickens would not touch Fruity Pebbles. (My pig did, lol) I know I didn't buy those Fruity Pebbles. Those colored cereals just look toxic! Sorry to get off the thyroid topic, because it seems no one wants to check anything more than feeling your throat and saying, thyroid is good!
@@othersbyuri and good luck. I know several "bi polar, etc" people. It's hard when it's a close family member. When you talk to someone and they clearly are somewhere else in their head. Pray for strength and guidance. I'll pray for peace for you. Take care of yourself too.
So many amazing video!!!
EXCELLENT TOPIC!
Really interesting, thanks!
was labelled as treatment resistant scizophrenia when it was hypothroidism the psychiatrist told me himself his words im a mental health doctor not a phisical health doctor i know nothing about hypothyroidism ..so 20 years on still treated as treatment resstant scizophrenia but not had psychosis for 16 years since being given my levo ..but still forced to take all the antipsychotics
❤ extremely informative
So not just losing my thyroid, i might be crazy too. Good to know! :/
I feel your pain. I deal with this too
Wonderful lecture!
I know it is kinda randomly asking but does anyone know of a good site to watch new series online?
@Canaan Eric try flixzone. You can find it by googling :)
Radioiodine treatment for hyperthyroidism can also trigger Hashimoto Encephalopathy. RAI increases ALL thyroid auto-antibodies after ablation of the thyroid cells.
RAI is poison. Just like the name suggests. At best it turns hypers into hypos and at worst it will give you cancer or even kill you. It certainly won't ever cure anything. It just destroys the gland. Glad I avoided it and I was healed naturally instead. Been normal for many many years
Really informative lecture. Hypothetically, if a patient with hashimoto’s chooses not to take medication to regulate thyroid hormone production appropriately, and they are displaying psychological symptoms, could they be more likely to experience psychosis? Specifically delusions of persecution?
I have a family member that suffered 4 difficult years with psychosis and received a schizophrenia diagnosis. I asked his doctor to test his thyroid and he was hospitalized. It was so severe that he was in the hospital for a week. i don't know why the doctor did not test for thyroid before the schizo diagnosis. Now, his thyroid is still not 100%. Meanwhile he is still on Clozapine for schizophrenia and waiting for follow up with endocrinologist. Is it true that Clozapine can cause hyperthyroidism?
Does Hashimoto’s encephalopathy relapse?
I have a 22 year old daughter who has hypothyroidism and she wasn’t taking her thyroid pills for a while and now she’s experiencing psychosis very anxious hardly no sleep restless and gets angry at times please tell me what I I can do
I want to pray for yall.And encourage yall.
I spent over twenty years misdiagnosed.
Sevondly I developed mes thyroid cancer.I am healed by Jesus.
But I beg you as my oldest daughter is stuck in a dementia type hell.
And my baby
Has just been found to hv
Tbyrpid problems
Doing research for my loved one. Talk to her Dr. I’ve pasted what I just read in psychiatry times “Summary
Hypothyroidism is a common clinical disorder
that psychiatrists frequently encounter. However,
symptoms of thyroid dysfunction are often vague
and nonspecific, which can lead to delayed or
missed diagnosis. Thyroid dysfunction can cause
an array of physical and neuropsychiatric
disturbances and, thus, early diagnosis and
treatment are important for reducing morbidity.
Psychiatric symptoms can be the initial
presentation of thyroid dysfunction. Psychiatrists
must have a high degree of suspicion for potential
underlying, exacerbating, or treatment-related
thyroid disorders.”
How is she doing?
Hey I was wondering if I could talk to you sometime! My sister is 30 and is experiencing psychosis for 2 yrs now I had no idea what was going on untill I read your comment. I think that is exactly what she is going thru. She has thyroid problem for about 3 yrs now
What do you do when a Behavioral Neurologist says that the algorithm identifies "reasonable exclusion of other causes" away from Hashimoto Encephalopathy, it's steroid responsive, but the patient has been shipped to a Psych-only facility who states they will not review medical records or call Specialists?
Might consider trying to speak with a physician at the insurance company, explaining the (obvious) importance of getting correct treatment and wondering out loud about the significance of the steroid-responsive nature of the symptoms.
And/or wonder out loud whether the insurance money is being misspent at that facility if medical explanations of the symptoms are being deliberately not considered.
@@AskAPsychiatrist thank you for replying. It seems my update reply may have been too long, so I'll just link the advocacy video made previous to investigation. Would love your input but this is also to shine some light. czcams.com/video/sbG9JAMK3HE/video.html
Can thyroid cause suicidal thoughts ?
Yes
So can cortisol issues
I have schizophrenia, my vitamin D level Is 7.03. B13 is 211 and TSH is 9.94.
I am trying to work in D3 and B12 by shots but don't know what to do with TSH.
Age F30
TSH is very high. You have to get a level above 10 to get a Levothyroxine script.
Have you looked up AIP diet?
@Desiree Noel thanks for the clarification. I've spoken with other ppl with Hashis and they weren't put on a dose until their tsh was that high.
@@PedroLopez-jq6qx can thyroid cause suicidal thoughts???
@@BoshiNagare ehh, I was suicidal, but that was after I got diagnosed. With that being said, I've had suicidal ideation my entire adult, and late teen life, and I am quite sure it is relates to my thyroid.
I do not even have any slightest scritzo problems and not violent or depressed or up and down but have a parsi and punjabi community deadilly on me since i left my ex husband and nx door they intocrevenge on me and raciest on me and hurt me delibrately and knowing i hace brain swelling and have directed nhs sonic with their cruiseland and david miscavige cults and not stopping.
Ugh. Misinformation. I’m in a HE group and a good bit had a normal EEG! You need to update this.
But that is what he mentioned when he said most patients have slow waves in the eeg report.