Enhanced Well-Being Associated with Thyrotoxicosis: A Neglected Effect of Thyroid Hormones?

CONTEXT: Thyrotoxicosis may be associated with a better sense of well-being than in the euthyroid state, though this is not widely recognised. EVIDENCE ACQUISITION: A comprehensive literature search in PubMed and Google Scholar, was performed to identify studies investigating factors influencing well-being, mood, and psychological features associated with elevated thyroid hormones. RESULTS: Enhanced well-being associated with thyrotoxicosis has been described, although the evidence is observational and anecdotal. CONCLUSIONS: Enhanced well-being associated with thyrotoxicosis is probably experienced in a minority of patients and may explain why some seek overtreatment with thyroid hormones and report significant improvement on larger than physiological thyroid hormone replacement regimens. It may also explain why some patients with hyperthyroidism (usually due to Graves’ disease) are reluctant to adhere to anti-thyroid medication.