Is it Mental Illness or Hashimoto’s Thyroiditis?

Hashimoto’s thyroiditis is a common cause of hypothyroidism that is often misdiagnosed as depression or other mental health conditions.

Updated September 2019

Imagine having all the symptoms of a major mental illness such as manic depression, paranoid schizophrenia, psychotic depression, or even a bipolar disorder. One day you wake up with overflowing physical energy, even feeling severely anxious, with a rapid heartbeat, profuse sweating, trembling hands, and diarrhea, and you can’t stop losing weight. Then soon enough, without warning, your energy plummets. You feel like a slug, are constipated, your hair starts falling out, you gain weight no matter how little you eat, and you are severely depressed. You may have difficulty swallowing, sound hoarse, and feel like you have swallowed something that wont go down. And then, suddenly, your old symptoms return, and you feel anxious, sweaty, trembling, and panicky. This cycle can repeat itself again and again.

While your symptoms resemble a mental health issue, they could be signs of Hashimoto’s thyroiditis, one cause of hypothyroidism. Hashimoto’s thyroiditis, also known as autoimmune thyroiditis or simply “Hashimoto’s, is caused by an autoimmune disorder. In this case, the body’s immune system sees the thyroid gland as a foreign body and begins to attack, damaging and killing thyroid cells along the way. As the cells are damaged or destroyed, they release their stored thyroid hormone, causing classic hyperthyroid symptoms such as anxiety, panic attacks, shaking hands, sweating, and a racing heart.

Each autoimmune attack causes more and more damage to the thyroid gland until, ultimately, the gland is no longer able to produce adequate thyroid hormones. Every cell in the body needs thyroid hormones, so a deficiency can wreak havoc on the entire system, causing depression, weight gain, severe fatigue, brain fog, memory loss, and even overall body aches.

With such a dramatic swing in symptoms, it’s easy to see how Hashimoto’s disease could be misdiagnosed as a mental illness like manic depression or bipolar disorder.

And it happens much too often. A 1987 study found that as many as 15% of patients admitted to a psychiatric hospital for depression actually were suffering from some level of hypothyroidism.

Learn more about Hashimoto’s here.

Symptoms of Hashimoto’s

At first, Hashimoto’s can produce little to no symptoms. But as the disease progresses, the body will cycle between hyperthyroid symptoms and hypothyroid symptoms, until ultimately the patient becomes permanently hypothyroid. Symptoms vary based on whether the thyroid is under attack or at rest, but can include:

  • Anxiety
  • Panic attacks
  • Insomnia
  • Unexplained weight gain or weight loss
  • Diarrhea or constipation
  • Feeling excessively cold or hot
  • Weakness and fatigue
  • Muscle and join pain or achiness
  • Hair loss
  • Irregular periods
  • Difficulty concentrating or thinking clearly, confusion, forgetfulness
  • Hoarseness, difficulty swallowing, or a tight feeling in the throat

Get the full list of thyroid disease symptoms here.

Getting the Right Diagnosis

Thyroid hormone lab tests such as the TSH, Free T4, Free T3 and Reverse T3 can diagnose hypothyroidism or hyperthyroidism, but to get a clear picture of a potential autoimmune thyroid disease, you must check for increased antibodies that are specific to thyroid proteins. These include thyroid peroxidase (TPO) and antithyroglobulin; however, it’s important to know that these antibodies can be at normal levels and a patient still have hashimoto’s disease. It can also be useful to check levels of thyroid stimulating immunoglobulin (TSI), which can be seen in Graves’ disease, another autoimmune thyroid disorder.

Get a FREE downloadable thyroid panel lab slip here.

Proper Treatment for Hashimoto’s

If lab tests or symptoms indicate Hashimoto’s, it is important to begin treatment as soon as possible to help avoid further damage to the thyroid gland. In addition to thyroid hormone replacement therapy, the following treatments options should be explored.

  • Supplements such as selenium can help lower antibody levels while strengthening the immune system
  • Treatment of any chronic bacterial or viral infections can also be important in managing autoimmune thyroid disease. Often, these infections can initiate the immune system dysfunction
  • Regulating the immune system can make a very positive difference in autoimmune disorders like Hashimoto’s. Medications including low-dose Naltrexone and gamma-globulin, can help balance immune system activity and reduce attacks.

Getting the Care You Deserve

The violent swings of Hashimoto’s disease can be very frightening, not only for the patient who has the autoimmune disease, but also for friends and family who watch their loved one struggling, but with proper diagnosis and treatment, the symptoms of Hashimoto’s can be resolved.

At Holtorf Medical Group, our physicians are trained to provide you with cutting-edge testing and innovative treatments to properly diagnose and treat your autoimmune thyroid disease, optimize your health and improve your quality of life. If you have been diagnosed with Hashimoto’s, but aren’t getting the treatment you need or if you have symptoms associated with thyroid dysfunction, call us at 877-508-1177 to see how we can help you!


1. Kent Holtorf, MD. “Understanding Local Control of Thyroid Hormones: (Deiodinases Function and Activity).”
2. Kent Holtorf, MD. “Thyroid Hormone Transport.”
3. Kent Holtorf, MD. “Diagnosis of Hypothyroidism: Are we getting what we want from TSH testing?”
4. Kent Holtorf, MD. “Why Doesn’t My Endocrinologist Know All of This?”

5. Dana L. Mincer; Ishwarlal Jialal. “Hashimoto Thyroiditis.”
6. LDN Trust. “Conditions that are helped by Low Dose Naltrexone (LDN).”

How HMG Has Helped Others: Patient Testimonial

After seeing 3 other doctors (over a 5 year period) for Hashimoto thyroid disease treatment, I finally found Dr. Holtorf (thank God!). I could write paragraphs on what I’d been through but the bottom line is that I finally found a doctor that is not only a good listener, compassionate & kind, but one who actually thinks “outside the box”.

For those of us who don’t respond in a conventional manner to medications, old school “by the book” endocrinologists have repeatedly patted us on the back & said, “Your TSH is fine”, just keep doing what you’re doing. In the meantime, I for one, was sleeping 16 hours a day, spent my life in a mind fog & was fatigued beyond belief (I even slept in my car during my lunchbreaks at work).

Dr.Holtorf immediately asked the right questions, patiently waiting through my confusion & tears, and made changes to my medication regime that truly turned things around for me.

I can’t say enough good things about him as a doctor & a caring person. – Ilene G.



Every Lyme/MSIDS patient I work with has messed up thyroid issues. In fact, one infected patient felt nearly well just by addressing the thyroid.

Notice the article talks about the importance of dealing with bacterial and viral infections. Often, when you deal with the infection(s), your many symptoms can just disappear; however, it’s important you partner with your ILADS-trained doctor to sleuth out your deficiencies and then supplement what your own body isn’t producing.

Most doctors are not privy to appropriate thyroid testing. Within this article there is a printable thyroid panel slip. The link will direct you to a great article explaining all the different elements in the panel as well as a downloadable slip you can take to your doctor. All of the required tests have a black X by them. I highly advise you to take advantage of this if you haven’t addressed your thyroid.

Also, please see another great read by Holtdorf on lies endocrinologists tell patients:  In the comment section I give a trick my doctor uses to determine if you need additional T3 as sometimes our bodies aren’t able to properly convert T4 into T3. Many feel this is a genetic issue.  Conventional medicine states our bodies will do this naturally; however, according to this article, 15% of the population can’t convert.  I’m one of them:  T3 is important because it delivers oxygen and energy to your cells, tissues, glands, and organs. More than 12 studies have shown the benefit of adding T3 to T4.

Many patients upon adding T3 were able to:

  • shed unwanted pounds
  • reduce cholesterol
  • have greater energy
  • have less brain fog
  • have less mood swings
  • be less depressed
  • regain supple skin
  • regain hair loss
  • reduce joint pain
The tiny thyroid hormone shouldn’t be neglected. Many thyroid symptoms look exactly like Lyme/MSIDS. Treat the thyroid and symptoms may disappear entirely.
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