The Trauma Recovery Institute

Getting to the root of Chronic Fatigue

Depression is a common symptom of hypothyroidism, yet many people become frustrated when their thyroid hormone medication does not relieve depression. This is because the effects of hypothyroidism on the brain are more complicated than people realize and thyroid hormone medication alone may not solve brain-based problems such as depression. The problem is many people suffer from hypothyroidism for years before receiving diagnosis and treatment, raising their likelihood of developing brain-based issues–sufficient thyroid hormone is vital to good brain health. Thyroid hormones facilitate function of the brain’s neurotransmitters, chemicals that communicate information throughout the bran and body. They also prevent brain inflammation and reduce the risk of developing an autoimmune reaction in the brain. When doctors in the standard health care model fail to properly manage hypothyroidism, they increase their patients’ risks for brain-based disorders.
Hypothyroidism and neurotransmitters
Neurotransmitters play a role in shaping who we are and how we perceive ourselves and the world around us. They influence our moods, memory and learning, self-esteem, anxiety levels, motivation, and more. I think this explains why some people who have been suffering for years with unresolved thyroid symptoms can become grouchy, angry, and pessimistic. That reflects not who they are necessarily, but instead their worsening brain function. As neurotransmitter function begins to fail due to thyroid hormone deficiency, the brain’s cells increasingly lose the ability to communicate with one another. This lack of activity causes neurons to die, creating accelerated brain degeneration in those pathways. When it comes to brain health, if you don’t use it you lose it—inactive neurons are swept up and discarded by the brain’s immune system. This is a scenario that cause a variety of symptoms, one of the more common being depression.
When thyroid hormone replacement fails to resolve your depression you may need to support specific neurotransmitter pathways. There is no scientifically valid test for this; it more involves learning the symptoms associated with each neurotransmitter.  For example, if your depression includes an inability to derive any joy from your hobbies, favorite foods, or other interests in your life that used to bring you happiness, you may have an issue with the serotonin pathway. If your depression includes poor motivation and constant self-doubt, the dysfunction may involve dopamine pathways. Depression with ongoing anxiety is common with GABA pathway issues. And depression with major loss of memory is common when acetylcholine pathways are impacted.  Addressing underlying mechanisms that cause neurotransmitter imbalances is not the same as taking an antidepressant. Antidepressants increase neurotransmitter levels by suppressing their clearance. They may have an effect for a short period of time but do not help your body’s ability to make them.
Neurotransmitter – Acetylcholine
Acetylcholine is the learning and memory neurotransmitter. Symptoms of poor acetylcholine activity include:
Loss of visual and photographic memory
Loss of verbal memory
Memory lapses
Impaired creativity
Diminished comprehension
Difficulty calculating numbers
Difficulty recognizing objects and faces
Slowness of mental responsiveness
Difficulty with directions and spatial orientation
Neurotransmitter –  Serotonin
Serotonin is the joy and well-being neurotransmitter. Symptoms of poor serotonin activity include:
Loss of pleasure in hobbies and interests
Feelings of inner rage and anger
Feelings of depression
Difficulty finding joy from life pleasures
Depression when it is cloudy or when there is lack of sunlight
Loss of enthusiasm for favorite activities
Not enjoying favorite foods
Not enjoying friendships and relationships
Unable to fall into deep restful sleep
Neurotransmitter –  GABA
GABA is the “calm and relaxed” neurotransmitter. Symptoms of poor GABA activity include:
Feelings of anxiousness or panic for no reason
Feelings of dread
Feelings of inner tension and inner excitability
Feelings of being overwhelmed for no reason
Restless mind
Hard to turn your mind off when you want to relax
Disorganized attention
Worry about things you never had thought of before
Neurotransmitter –  Dopamine
Dopamine is the “pleasure and reward” neurotransmitter. Symptoms of poor dopamine activity include:
Inability to self-motivate
Inability to start or finish tasks
Feelings of worthlessness
Feelings of hopelessness
Lose temper for minor reasons
Inability to handle stress
Anger and aggression while under stress
Desire to isolate oneself from others
Unexplained lack of concern for family and friends
When inflammation causes depression
Another mechanism to investigate if thyroid hormones did not resolve your depression is chronic inflammation. This is called the “cytokine model of depression” (cytokines are immune messengers). Until recently, the treatment of depression has focused primarily on antidepressants or thyroid hormones. An entirely new model has since emerged known as either the “cytokine model of depression” or “inflammatory based depression.” In this model chronic inflammation of the brain decreases the speed of communication between neurons. The most common symptom of slowed communication between neurons is brain fog, however depression is common as well. If you have both depression and brain fog, this may be a model to consider, especially if you also have an autoimmune condition such as Hashimoto’s, leaky gut, gluten sensitivity, or some other chronic inflammatory disorder.
Neurological autoimmunity with gluten sensitivity and Hashimoto’s
One of the first things I do when evaluating a Hashimoto’s patient is find where else they have autoimmunity. It’s rare that a person with Hashimoto’s only has the one autoimmune condition as they typically react to other tissues, such as joints, skin, or intestines. In fact, the most common autoimmunity that co-exists with Hashimoto’s is brain autoimmunity, specifically in the cerebellum. The cerebellum is an area at the back of the brain that helps support balance, maintains muscle tone in the neck and back, and lets you know where you are spatially in the environment. People with cerebellum autoimmunity typically notice vertigo, difficulty with balance, chronic neck and back weakness, nausea while driving or moving their head quickly, and so on.
We often see cerebellum autoimmunity in patients with Hashimoto’s because it is triggered by gluten sensitivity, something that seems nearly universal among those with Hashimoto’s hypothyroidism. This is because gluten proteins are structurally similar to cerebellar proteins. When a person with gluten sensitivity eats gluten the immune system is triggered to attack the gluten. Because cerebellar tissue is so similar to gluten, the immune system attacks the cerebellum too, which is called cross-reactivity. This explains why gluten sensitivity can cause cerebellum symptoms. Article Written by Datis Kharrazian
Don’t get depressed about brain disorders, get proactive, Consult a Functional Health Professional and work towards to new diet and lifestyle plan.
Before-and-after video: Hashimoto’s hypothyroidism and the brain
This is a video excerpt from a recent lecture for the Institute for Functional Medicine. In this video I show one of my patients who had gone for years with an undiagnosed hypothyroid condition. You can see the effect of her brain condition on her overall presence and then the difference after a few weeks of functional neurology therapy.

Datis Kharrazian: Developing the Clinical Eye to Discover the Causes of Fatigue
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