Thyroid and mood: when tiredness and low mood share a cause

The thyroid is a small, butterfly-shaped gland at the front of your neck. It makes hormones that affect things like your heart rate, your body temperature and how much energy you have.

When it makes too little hormone (an underactive thyroid), many things can slow down, including your energy and your mood. When it makes too much (an overactive thyroid), things can speed up, and you may feel wired, anxious and unable to settle.

That is why thyroid problems are easy to mistake for stress, depression or anxiety, and why it helps for a doctor to look at your mood and your hormones together.

The NHS says symptoms of an underactive thyroid usually develop slowly and may be mild and easy to miss. Some of them are common and can be caused by other conditions.

Signs some women notice include:

• feeling extremely tired, even after rest
• low mood or depression
• difficulty concentrating or thinking clearly
• putting on weight
• feeling cold more than usual
• constipation
• dry skin, dry hair or hair loss
• a croaky voice
• irregular or heavy periods

Because tiredness and low mood come on slowly, many women put them down to age, work or "just life". If you recognise the signs of depression in women alongside tiredness and some of the signs above, mention both to a doctor.

An overactive thyroid can cause a wide range of symptoms. Signs some women notice include:

• nervousness, anxiety and irritability
• mood swings
• difficulty sleeping
• persistent tiredness and weakness
• feeling hot when others don't
• a fast or irregular heartbeat
• twitching or trembling
• weight loss without trying

Many of these overlap with anxiety. If anxiety has come on suddenly, or comes with a racing heart, shaking or weight loss, it is worth asking a doctor whether your thyroid should be checked.

Common. About 1 in 6 Indian women has an underactive thyroid.

That figure comes from a study of adults in eight Indian cities, including Hyderabad, Bengaluru, Chennai, Delhi and Mumbai. It counted women who already knew about their thyroid and women who had not yet been found to have a problem.

The NHS also notes that the most common cause of an underactive thyroid, Hashimoto's disease, is most common in women and usually starts between the ages of 30 and 50.

To check your thyroid, a doctor may ask for a blood test that measures thyroid-stimulating hormone (TSH) and thyroxine (T4). The doctor decides which tests you need and how to read the results.

The doctor may also ask about your symptoms, whether anyone in your family has had a thyroid condition or an autoimmune condition, and whether you have recently been pregnant. They may examine your neck to see whether your thyroid is swollen.

If your thyroid turns out to be underactive, it is a common condition that a doctor can help you manage, usually with daily tablets that replace the missing hormone. Your doctor will explain what fits you.

The NHS lists low mood or depression among the symptoms of an underactive thyroid, and nervousness, anxiety, irritability and mood swings among the symptoms of an overactive one. So a thyroid problem can be part of why you feel low or anxious.

It is not always the whole story. Low mood can have more than one cause at once, and other things, like sleep, stress, low iron or PCOS, can feel similar. If a doctor has already talked to you about PCOS or PCOD, read about PCOS and mood. Only a doctor can tell what's going on.

The more clearly you describe what has changed, the easier it is for the doctor to decide what to check. Tell them about your mood and your body together; don't split them into separate visits. Before you talk to someone, note:

• How long you have felt tired, low or anxious, and whether it is getting worse.
• Weight changes you can't explain.
• Feeling cold or hot when others don't.
• Changes in your periods: heavier, lighter or irregular.
• Hair, skin, bowel and sleep changes.
• A racing heart, shaking or trouble sleeping.
• Whether anyone in your family has a thyroid condition.
• Whether you have been pregnant or had a baby in the last year.
• Any past thyroid test results, and any medicines or supplements you take.

Talk to a doctor if you have felt tired for a few weeks without knowing why, if low mood or anxiety has lasted two weeks or more, or if you notice several of the signs on this page together. If tiredness is the main thing, our guide on why you're always tired covers the other common reasons.

A Nari health counsellor can listen, help you put your symptoms in order, and book you with a Nari doctor. The doctor looks at your mood and your hormones together and prescribes the tests you need. Counsellors never give medical advice; medical decisions come from a Nari doctor.

Nari 1 is not an emergency service. If you are thinking of harming yourself, or you are in danger, call 112 now. For free mental health support at any hour, call Tele-MANAS on 14416 or 1-800-891-4416, a Government of India helpline.