Dr. Aaron Hartman explains why thyroid symptoms get dismissed as anxiety or depression. Most new patients arrive shocked their symptoms are real, not psychological. He notes treatment-resistant depression often improves with TSH below 2 mIU/L, a target rarely used in standard practice.
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Gosh, I couldn't agree more. You know, I think it's a pervasive and essentially ubiquitous issue in the world of thyroid. Even in the construct that medicine views hypothyroid symptoms as very nonspecific in general, and that's what's reiterated in all of these studies. Hey, look, just because someone has this constellation of symptoms doesn't mean they have a thyroid issue. When in fact, I actually find that if you look deep enough and they have 5 or 6 of these symptoms, Most, most of the time it is a thyroid issue. Um, but there's a couple dynamics that I see over and over and over again, and I witnessed this firsthand because the people that come to Modern Thyroid Clinic have gone everywhere else. Like, we're not people's first stop. We're like the last ditch effort because we're expensive and we're cash pay and it's a pain, et cetera. So, you know, a couple things are number one, the mental health issue, right? Like, people are told, oh, well, you have depression, you have anxiety, go see a psychiatrist. In all honesty, the foundation of Modern Thyroid Clinic— when I started my practice, I was a psychiatric functional medicine PA who never marketed myself as a thyroid person, treated a handful of treatment-resistant thyroid patients, treatment-resistant depression, people with thyroid dysfunction, changed their lives. They took my information, spread it across the internet, across thyroid advocacy platforms, And they actually built Modern Thyroid Clinic without me ever intentionally doing it. I remember when my first person flew in from out of state, I was like, I think I'm doing the wrong thing. Like, I think psychiatry is not my shtick. I think I need to be in the niche of thyroid. So mental health is pervasive. Um, research shows that labs need to be extraordinarily tightly controlled when looking at TSH alone. Um, psychiatric studies show for treatment-resistant depression, their TSH needs to be below 2. No medical kind of construct identifies that in terms of real-life treatment. And then second, you know, it's, it's blaming the patient sort of situation. Eat less, exercise more, right? Like, that's what I was told, sent on my way. This isn't a thyroid problem, this is a lifestyle problem. But these women cannot lifestyle their way out of this. Like, this is a biochemical issue and it's so pervasive. I'm not exaggerating when I tell you that 90 to 95% of patients that are new to me come to see me on the day we review their labs for the first time. Well, they tell me one of two things. Either one, it's, so you're telling me all of this is not in my head? Or, so you're telling me I'm not crazy? Which speaks volumes about the level of gaslighting and just gross kind of negligence that these people are experiencing.
