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Can Underactive Thyroid Cause Anxiety? Full Expert Guide

PBTT

Private Blood Tests Team

Clinical Team

24 Feb 202614 min read

Introduction

Anxiety can feel overwhelming — and when it appears alongside persistent fatigue, low mood, or brain fog, many people begin to wonder whether something deeper may be going on. One of the most commonly searched questions in UK health forums is: can underactive thyroid cause anxiety? The short answer is that thyroid hormone imbalance may indeed influence mood, stress response, and emotional wellbeing.

The thyroid gland plays a central role in regulating metabolism, energy, and nervous system function. When thyroid hormone levels are lower than expected — a state known as hypothyroidism — the effects can extend well beyond physical symptoms. Many individuals report changes in mood, heightened anxiety, and feelings of low motivation that overlap significantly with common mental health conditions.

This guide explores the relationship between thyroid function and anxiety, the connection between thyroid and depression, and how blood tests can provide helpful insight. If you have been experiencing unexplained mood changes, understanding the role of thyroid hormones may be a valuable step towards clarity. You may also wish to explore a thyroid blood test in London to measure your hormone levels directly.

What Is an Underactive Thyroid (Hypothyroidism)?

The thyroid is a small, butterfly-shaped gland located at the front of the neck. Despite its modest size, it has a significant influence on nearly every system in the body. The thyroid gland produces two key hormones — thyroxine (T4) and triiodothyronine (T3) — which help regulate metabolism, heart rate, body temperature, and energy levels.

When the thyroid gland does not produce sufficient amounts of these hormones, the result is hypothyroidism, commonly referred to as an underactive thyroid. This is one of the most prevalent endocrine conditions in the UK, particularly among women and individuals over the age of 40.

Common signs of an underactive thyroid may include:

  • Persistent tiredness and low energy
  • Unexplained weight gain
  • Sensitivity to cold
  • Dry skin and thinning hair
  • Constipation
  • Muscle aches and stiffness
  • Low mood or feelings of sadness
  • Difficulty concentrating or brain fog
  • What many people may not realise is that the thyroid gland and anxiety are closely connected. Similarly, the thyroid gland and depression may be linked through the same hormonal pathways. When thyroid hormone output falls below optimal levels, the impact on the nervous system can manifest as both physical and emotional symptoms.

    Can Underactive Thyroid Cause Anxiety?

    This is one of the most frequently asked questions about thyroid health — and the answer is that hypothyroidism may contribute to anxiety symptoms in some individuals. While anxiety is more commonly associated with an overactive thyroid (hyperthyroidism), research and clinical observation suggest that low thyroid anxiety is also a recognised concern.

    So, does hypothyroidism cause anxiety? The relationship is not always straightforward, but there are several ways in which reduced thyroid hormone levels may influence the nervous system:

  • Nervous system sensitivity — Thyroid hormones help regulate neurotransmitter activity, including serotonin and noradrenaline. When levels are low, the balance of these chemical messengers may be disrupted, potentially contributing to feelings of unease or worry
  • Stress response changes — Hypothyroidism may affect the body's ability to manage stress effectively, leading to heightened hypothyroidism stress responses even in everyday situations
  • Physical symptoms that mimic anxiety — Heart palpitations, breathlessness, and muscle tension can occur in hypothyroidism and may be mistaken for — or may intensify — anxiety symptoms
  • Fatigue-driven anxiety — Chronic exhaustion associated with low thyroid function can reduce resilience and make it harder to cope with daily demands, which may increase feelings of anxiety in hypothyroidism
  • Does low thyroid cause anxiety in every case? Not necessarily. The experience varies between individuals, and many factors contribute to anxiety. However, for those already experiencing mood changes alongside physical thyroid symptoms, the hormonal component is well worth exploring.

    Can hypothyroidism cause anxiety that feels persistent or difficult to manage? It is possible. Some individuals describe a background sense of unease that does not respond well to standard relaxation techniques — which may suggest that the underlying cause is hormonal rather than purely psychological.

    Anxiety Caused by Thyroid vs Primary Anxiety

    Understanding the difference between anxiety caused by thyroid imbalance and primary anxiety disorder is an important step in making sense of your symptoms. While the two can feel remarkably similar, there are some patterns that may help distinguish them.

    Hormone-Related Anxiety Patterns

    Anxiety thyroid imbalance may present with certain characteristics:

  • Symptoms that appear gradually alongside other hypothyroid signs (fatigue, weight changes, cold sensitivity)
  • Thyroid anxiety in the morning — some individuals notice that anxiety feels more pronounced upon waking, which may relate to cortisol and thyroid hormone fluctuations during the night
  • Mood changes that seem disproportionate to life circumstances
  • Anxiety that is accompanied by physical sluggishness rather than restless energy
  • A sense of being emotionally flat or numb alongside anxious thoughts
  • Primary Anxiety Patterns

    A hypothyroidism anxiety disorder distinction may also be suggested by:

  • Anxiety that has been present since adolescence or early adulthood, without clear hormonal triggers
  • Racing thoughts, hypervigilance, and restlessness as dominant features
  • Anxiety that responds well to cognitive behavioural strategies or relaxation techniques
  • No accompanying physical signs of thyroid dysfunction
  • Hypothyroidism stress can also make existing anxiety worse. If you are already prone to anxious feelings, reduced thyroid function may lower your threshold for coping with everyday pressures, creating a cycle that can feel difficult to break without understanding the underlying factors.

    It is also worth noting that the two conditions can coexist. An individual may have a pre-existing tendency towards anxiety that is then amplified by thyroid hormone changes.

    Thyroid and Depression: Are They Linked?

    Just as many people ask whether can a thyroid problem cause anxiety, an equally important question is whether can a thyroid problem cause depression. The evidence strongly suggests that thyroid hormones play a meaningful role in mood regulation, and that thyroid disease and depression are frequently observed together.

    Can thyroid disease cause depression? The hormonal mechanisms are well documented. Thyroid hormones influence the production and activity of neurotransmitters — including serotonin, dopamine, and gamma-aminobutyric acid (GABA) — that are directly involved in mood stability. When these hormones are insufficient, the neurochemical environment may shift in ways that contribute to low mood.

    Does thyroid problems cause depression in all cases? No — but the association is strong enough that thyroid function is routinely considered when individuals present with persistent mood changes. Thyroid and depression share several overlapping symptoms, which can make it difficult to determine the primary cause without appropriate testing.

    Key points about thyroid issues and depression:

  • Thyroid disease and depression may share symptoms such as fatigue, poor concentration, and loss of motivation
  • Thyroid problems and depression can coexist, with one potentially worsening the other
  • Thyroid issues and depression may both respond to changes in hormone levels, which is why testing can be informative
  • The connection between the thyroid gland and depression is supported by a growing body of research
  • Understanding whether mood changes are related to thyroid function can help individuals make more informed decisions about their wellbeing and seek appropriate support.

    Thyroid Disease and Anxiety: Why It Happens

    To understand why thyroid disease and anxiety are connected, it helps to consider the broader role that thyroid hormones play in the body. The thyroid does not simply regulate metabolism — it influences the speed and efficiency of virtually every cell in the body, including brain cells.

    When thyroid function is impaired, several changes may occur that contribute to thyroid stress and anxiety:

  • Neurotransmitter disruption — Reduced thyroid hormone availability may lower serotonin production, which can influence mood, sleep, and emotional resilience
  • Cortisol dysregulation — The thyroid and adrenal systems are closely linked. Underactive thyroid anxiety may be partly driven by changes in cortisol patterns, which can heighten the body's stress response
  • Autonomic nervous system changes — Thyroid hormones help regulate the balance between the sympathetic (fight-or-flight) and parasympathetic (rest-and-digest) nervous systems. Imbalances may contribute to underactive thyroid stress, where the body feels simultaneously exhausted and on edge
  • Inflammation — Some forms of hypothyroidism are associated with autoimmune inflammation, which has been independently linked to mood changes
  • Can thyroid disease cause anxiety that fluctuates over time? Yes — thyroid hormone levels can vary, and symptoms may come and go or change in intensity. This variability can be confusing and may lead individuals to question whether their experience is "real" or significant. Thyroid issues and anxiety should always be taken seriously, regardless of how symptoms present.

    Underactive thyroid anxiety is a genuine and recognised pattern. If you are experiencing persistent worry, nervousness, or emotional instability alongside physical symptoms such as fatigue or cold sensitivity, thyroid function may be a contributing factor worth investigating.

    Hypothyroidism or Depression? Understanding the Overlap

    One of the most challenging aspects of thyroid-related mood changes is the significant overlap between hypothyroidism or depression symptoms. The two conditions can look remarkably similar, which is why many individuals go through extended periods of uncertainty before the underlying cause is identified.

    Shared symptoms may include:

  • Persistent fatigue and low energy
  • Difficulty concentrating or making decisions
  • Loss of interest in activities previously enjoyed
  • Changes in appetite or weight
  • Sleep disturbances
  • Feelings of hopelessness or emotional flatness
  • Thyroid mood swings anger may also be a feature for some individuals. Hormonal fluctuations can affect emotional regulation, leading to irritability, frustration, or sudden mood changes that feel out of character. This can be distressing and may strain relationships if the underlying cause is not understood.

    The critical difference is that hypothyroidism-related mood changes are driven by a measurable hormonal imbalance, which means that identifying low thyroid levels through a blood test can provide clarity. Without testing, it can be extremely difficult to distinguish between the two conditions based on symptoms alone.

    What Symptoms May Suggest a Thyroid Blood Test?

    If you are experiencing a combination of the following symptoms, a thyroid blood test may provide helpful information:

  • Persistent fatigue that does not improve with rest
  • Cold sensitivity — feeling cold when others are comfortable
  • Mood changes — including low mood, anxiety, or emotional instability
  • Brain fog — difficulty thinking clearly, poor memory, or reduced concentration
  • Anxiety with physical symptoms — such as a tight chest, shallow breathing, or a sense of dread that appears without clear cause
  • Unexplained weight gain or difficulty losing weight
  • Dry skin, thinning hair, or brittle nails
  • Muscle aches or joint stiffness
  • No single symptom confirms a thyroid problem, but a pattern of several of these signs may suggest that thyroid function is worth investigating. You can explore comprehensive thyroid testing options to find the right panel for your needs.

    How Thyroid Blood Tests Help

    Thyroid blood tests provide a clear, objective measurement of hormone levels in the blood. They are one of the most reliable ways to assess whether the thyroid gland is functioning within expected ranges.

    The key markers typically measured include:

  • TSH (Thyroid Stimulating Hormone) — Produced by the pituitary gland, TSH signals the thyroid to produce hormones. Elevated TSH levels may suggest that the thyroid is underperforming and the pituitary is working harder to compensate
  • Free T4 (Thyroxine) — The primary hormone produced by the thyroid gland. Low T4 levels alongside elevated TSH may indicate hypothyroidism
  • Free T3 (Triiodothyronine) — The active form of thyroid hormone. T3 is converted from T4 and is responsible for many of the thyroid's effects at the cellular level
  • These markers together provide a comprehensive picture of thyroid function. A single test result should be considered within the context of overall symptoms and individual circumstances.

    It is important to note that thyroid blood tests measure hormone levels — they do not provide a diagnosis. Results should be reviewed alongside individual symptoms and shared with appropriate healthcare services for full interpretation.

    When Should You Seek Further Support?

    While many thyroid-related symptoms are manageable and develop gradually, there are circumstances where seeking further support is advisable:

  • If anxiety or low mood is significantly affecting your daily life, relationships, or work
  • If physical symptoms such as extreme fatigue, significant weight changes, or persistent cold sensitivity are worsening
  • If you have a family history of thyroid conditions and are experiencing new or changing symptoms
  • If self-care strategies are not providing relief
  • In these situations, seeking medical advice from appropriate healthcare services is an important step. If symptoms are severe — such as chest pain, difficulty breathing, or thoughts of self-harm — accessing urgent medical care is essential.

    Understanding your thyroid hormone levels through a blood test can provide valuable information that may help guide next steps and support informed conversations with appropriate healthcare services.

    Comparison Table

    The following table compares symptoms that may be linked to thyroid dysfunction, anxiety, or both:

    SymptomMay Be Linked to ThyroidMay Be Linked to AnxietyOverlap
    Fatigue
    Low mood
    Cold intolerance
    Racing thoughts
    Mood swings
    Weight changes
    Muscle tension
    Brain fog
    Sleep disturbance
    Irritability

    Benefits of Private Thyroid Testing

    Private thyroid testing offers several practical advantages for individuals who wish to take a proactive approach to understanding their hormonal health:

  • Clear hormone measurement — Receive precise readings of TSH, T4, and T3 levels in a patient-friendly format that is easy to understand
  • Fast results — Private testing typically provides results within a few working days, reducing the waiting and uncertainty that can accompany thyroid concerns
  • Confidential service — Your results are provided directly to you in a professional and confidential setting, giving you full control over how you use the information
  • Structured appointments — Book a convenient time at a CQC-registered clinic with no lengthy waiting lists, and attend your appointment knowing exactly what to expect
  • Whether you are exploring thyroid function for the first time or monitoring an existing concern, private testing provides a straightforward and accessible route to obtaining the information you need.

    If you would like to book a thyroid blood test, Private Blood Tests London offers comprehensive thyroid panels at our clinic. You can also explore our full range of thyroid function testing to find the right option for your needs.

    Taking an Informed Approach to Thyroid and Mood

    The question of whether can underactive thyroid cause anxiety is one that many people across the UK are asking — and it is a valid and important question. Thyroid hormones play a fundamental role in mood regulation, stress response, and emotional wellbeing. When levels are lower than expected, the effects can extend beyond physical symptoms to influence how you think and feel on a daily basis.

    Understanding the connection between thyroid function and mental wellbeing is an empowering step. It does not replace the need for appropriate support, but it does provide a foundation of knowledge that can help guide informed decisions about your health.

    Private Blood Tests London is here to support your understanding of thyroid health and mood through clear, reliable hormone testing. Take an informed step towards clarity — and gain the insight you need to feel more confident about your wellbeing.

    Frequently Asked Questions

    Can underactive thyroid cause anxiety?

    Yes, an underactive thyroid may contribute to anxiety in some individuals. Thyroid hormones influence neurotransmitter activity and nervous system function. When these hormones are lower than expected, the resulting imbalance may manifest as feelings of anxiety, worry, or emotional unease. The experience varies between individuals, and a thyroid blood test can help determine whether hormone levels are within expected ranges.

    Does low thyroid cause anxiety?

    Low thyroid levels may contribute to anxiety symptoms, although the relationship is not universal. Reduced thyroid hormone production can affect serotonin and other neurotransmitters involved in mood regulation, which may increase susceptibility to anxiety. If you are experiencing anxiety alongside other hypothyroid symptoms such as fatigue and cold sensitivity, thyroid testing may provide helpful insight.

    Can a thyroid problem cause depression?

    Thyroid problems — particularly hypothyroidism — may be associated with low mood and depressive symptoms. Thyroid hormones play a role in neurotransmitter production and brain function. When levels are insufficient, mood regulation may be affected. The link between thyroid and depression is well recognised, and testing can help clarify whether hormonal factors may be contributing.

    What is the link between thyroid and depression?

    The link between thyroid and depression relates to the role that thyroid hormones play in brain chemistry. T3 and T4 influence the production of serotonin, dopamine, and other mood-related neurotransmitters. When thyroid function is reduced, these chemical messengers may be produced in lower quantities, potentially contributing to persistent low mood, lack of motivation, and emotional flatness.

    Can hypothyroidism cause anxiety disorder?

    Hypothyroidism may contribute to anxiety symptoms that can resemble an anxiety disorder. However, it is important to distinguish between anxiety driven by hormonal imbalance and a primary anxiety disorder. If anxiety symptoms are accompanied by physical signs of hypothyroidism — such as fatigue, weight gain, or cold intolerance — a thyroid blood test may help determine whether hormonal factors are involved.

    Why do I get thyroid anxiety in the morning?

    Some individuals notice that anxiety feels more pronounced in the morning. This may relate to natural fluctuations in cortisol and thyroid hormone levels, which are typically at their highest upon waking. If thyroid function is impaired, the body's ability to manage this morning hormonal surge may be compromised, potentially leading to heightened anxiety, restlessness, or a sense of dread upon waking.

    Can thyroid issues cause mood swings?

    Yes, thyroid issues may contribute to mood swings. Fluctuations in thyroid hormone levels can affect emotional regulation, leading to irritability, frustration, or sudden changes in mood. Some individuals also report thyroid mood swings anger — episodes of disproportionate irritability or frustration that feel out of character. These patterns may improve once thyroid levels are identified and understood.

    Is anxiety caused by thyroid permanent?

    Anxiety caused by thyroid imbalance is not necessarily permanent. Many individuals find that once thyroid hormone levels are identified and appropriate support is accessed, anxiety symptoms may improve. The key step is understanding whether thyroid function is a contributing factor, which can be determined through a thyroid blood test. Seeking medical advice from appropriate healthcare services is recommended for ongoing management.

    How do I know if anxiety is thyroid-related?

    It can be difficult to distinguish thyroid-related anxiety from other causes based on symptoms alone. However, certain patterns may suggest a thyroid connection — such as anxiety appearing alongside fatigue, cold sensitivity, weight changes, or brain fog. A thyroid blood test measuring TSH, T4, and T3 levels provides the most reliable way to assess whether thyroid function may be contributing to your symptoms.

    What blood test checks thyroid levels?

    A thyroid function test typically measures TSH (Thyroid Stimulating Hormone), Free T4 (Thyroxine), and Free T3 (Triiodothyronine). These three markers together provide a comprehensive picture of how the thyroid gland is functioning. Private Blood Tests London offers thyroid blood tests that measure all three markers, with results typically available within a few working days.

    Can thyroid disease cause both anxiety and depression?

    Yes, thyroid disease may contribute to both anxiety and depression in some individuals. The hormonal mechanisms that affect mood regulation can influence emotional wellbeing in multiple ways. Some people experience predominantly low mood, others experience anxiety, and some experience both simultaneously or alternately. Testing thyroid hormone levels can help determine whether thyroid function may be a contributing factor.

    When should I get a thyroid blood test?

    You may wish to consider a thyroid blood test if you are experiencing persistent fatigue, unexplained mood changes, anxiety, cold sensitivity, weight changes, or brain fog — particularly if these symptoms have developed gradually or do not respond to standard self-care measures. If you have a family history of thyroid conditions, proactive testing may also be beneficial. Private Blood Tests London offers convenient thyroid testing with fast, clear results.

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