Thyroid-Stimulating Hormone Suppression Therapy and Its Association with Anxiety, Depression, Hypomania, and Quality of Life in Differentiated Thyroid Cancer

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Objective: This study aimed to investigate the impact of thyroid-stimulating hormone (TSH) suppression therapy on psychological outcomes and quality of life in patients with differentiated thyroid carcinoma (DTC), with particular focus on anxiety, depression, hypomania, and related hormonal parameters. Methods: A total of 87 adult patients with DTC receiving levothyroxine therapy were evaluated. Participants were grouped according to their TSH levels: <0.1, 0.1-0.5, and 0.6-4.2 mIU/L. Psychometric evaluations included the Beck Anxiety Inventory, Beck Depression Inventory, Hypomania Checklist-32, and Quality of Life Short Form (SF-36) Quality of Life Scale. Thyroid function tests and clinical parameters were recorded. Comparative, correlational, and multivariable regression analyses were performed. Results: No significant differences were found in psychometric scores or SF-36 subdomains among the TSH-based groups. However, a weak positive correlation was identified between TSH levels and anxiety scores (r = 0.175, P = .044), while T3 levels were inversely correlated with depression scores (r = −0.216, P = .045). These exploratory associations did not remain statistically significant in multivariable linear and logistic regression analyses. No independent associations were identified between TSH categories or thyroid hormone levels and psychological outcomes. Conclusion: The TSH suppression therapy does not appear to significantly affect quality of life or mood-related symptoms in a categorical manner. Although these associations were attenuated in regression analyses, subtle relationships among TSH, T3, and psychological parameters may still exist, suggesting that psychological outcomes are influenced by multiple clinical and psychosocial factors. These findings support the need for individualized treatment strategies that consider both oncologic control and patient well-being. Cite this article as: Selimzade A, Kocaman BB, Muradov I, et al. TSH suppression therapy and its association with anxiety, depression, hypomania, and quality of life in differentiated thyroid cancer. Endocrinol Res Pract. Published online August 1, 2026. doi: 10.5152/erp.2026.26918.

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