Panic attacks and the Thyroid
The thyroid gland is one of the largest endocrine glands and is found in the neck right below the Adams apple. The thyroid gland produces hormones , including the hormone thyroid, which affect the way many other parts of the body and our metabolism function.
The relationship between panic attacks and the thyroid is not completely understood. In some cases, problems with the thyroid can cause panic attack like symptoms. Prior to mental health treatment for panic it is important to have a full medical work up to determine if there is an underlying medical condition causing or contributing to the panic. Panic attacks could be related to the thyroid, especially if you have a history of thyroid problems, or there are thyroid issues in your family.
One reason this is important to screen for these issues is because panic so often mimics real physical ailments. The clinician and patient must be certain there are no contributing physical factors to the panic. Therapists have to reassure their patients that there is no underlying physical cause in order for them to be able to proceed with evidenced based treatment. Evidenced based treatment consists of convincing the patient that their panic does signal danger, and successful treatment hinges on this.
Panic Attacks and the Thyroid: Hyperthyroidism and Hypothyroidism
Hyperthyroidism is a condition on which occurs when the thyroid gland overproduces some key hormones. Hyperthyroidism can produce heart palpitations, muscle weakness, insomnia, irritability and fatigue, all of which mimic mood disorders.
Hypothyroidism is a condition where the thyroid under produces these hormones and is also associated with panic. A case of phobia was reportedly linked to hyperthyroidism as far back as 1947. Some have documented onsets of panic related to the beginning of hyperthyroidism, as well as panic remitting when the hyperthyroidism is treated (Madaan 2008). Yet still other studies that have explored thyroid functioning in people with panic have found no abnormalities (Stein 1986). The research is somewhat confusing.
Panic Attacks and the Thyroid: Mood and Bipolar Disorder
About three years ago I worked with a child client who had been diagnosed with bipolar disorder. She had been medicated with strong anti psychotics which can cause terrible side effects. We later found out that she actually had an underlying medical condition affecting her thyroid, and that when treated for that, the mood symptoms disappeared. The thyroid gland is known to play a role in mood related disorders, and to sometimes mimic mood disorders. It is also important to screen for thyroid issues when bipolar disorder or depression is present.
Panic Attacks and the Thyroid. Is this a Genetic Syndrome?
Some Evidence from genetic studies suggests a possible syndrome in some families with panic disorder. This syndrome includes bladder problems, thyroid disorders, chronic headaches/migraine, and/or mitral valve prolapse. (Weissman 2008). This will effect a small group of people and is important to screen for if you have this cluster.
Since 1870, researchers have been conceptualizing panic as connected to other diseases. If you are suffering from panic, it may be important to get two medical opinions and to ensure that you have no underlying physical symptoms before seeking treatment. Below are some of the diseases that may be causing or contributing to panic that may need to be ruled out prior to treatment.
Panic attacks and the thyroid, other medical conditions to rule out by a doctor
• Pheochromocytoma or Tumor of the adrenal medulla ( rare) Urine sample
• Menieres disease/ evaluation of dizziness with an ear now and throat specialist
• Thyroid: Check for underlying thyroid conditions
• Evaluation of the level of TSH
• Serum calcium level ( hyperparathyroidism)
• Cardiac conditions ECG
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Madaan, Vishal Assessment of Panic Disorder Across the Life Span Focus 2008 6: 438-444
Weissman MM, Gross R, Fyer A, et al Interstitial Cystitis and Panic Disorder: A Potential Genetic Syndrome Arch Gen Psychiatry. 2004;61(3):273-279.
STEIN murray B. Panic disorder and medical illness Psychosomatics, Dec 1986; 27: 833 - 840.