Hello doctor, I am doing research on diagnosis and treatment of mental illnesses. I have already interviewed couple of psychiatrists and now would like to focus on asking some questions to endocrinologists. My questions are: 1) “In thyroid disorders mainly in hyperthyroidism a paranoid syndrome may occur” Why is this happening? 2) What is the connection between low ferritin level and thyroid? 3) What does an elevated level of homocysteine mean to an endocrinologist? Thank you for your help and time.
Hi. 1) Yes, paranoid syndrome is frequently seen in association with patients having hyperthyroidism, reason being distractive over activity, anxiety, emotional instability, exaggerated insensitivity to noise, fluctuating depression and other unexplained medical symptoms. All these things can lead to paranoid symptoms. 2) Low ferritin or iron level decreases de-iodination activity which slows down conversion of T4 to T3. Low ferritin decreases the activity of enzyme thyroid peroxidase which is dependent on iron. Hence, it causes increase in concentration of circulating TSH (Thyroid Stimulating Hormone). 3) Raise in homocysteine level is not considered to be good. It could be genetic and due to other causes. In genetic cause it can cause short life span of the person as it causes atherosclerosis and more effect is seen on cardiovascular system. High level causes damage to arterial wall and plaque formation, may also cause aggregation of platelets, clot formation and blockage of an artery. It is more dangerous in case when coronary artery supplying the heart gets affected as this can cause myocardial infarction (commonly known as heart attack). Hope this answer helps you. For further queries, get back to an endocrinologist online -->