Introduction:
Attention deficit hyperactivity disorder (ADHD) is a childhood neuropsychiatric disorder often associated with cognitive deficits and high heritability rates (76-80%). Emerging evidence suggests a role for thyroid hormones in the pathophysiology of ADHD, including dysfunctions ranging from hypo- to hyperthyroidism. This study aims to investigate thyroid hormone levels (T3, T4, TSH) in children with ADHD and ADHD-NOS (unspecified), and to assess their relationship with symptom severity.
Methods:
A cross-sectional and retrospective study was conducted at the Department of Child and Adolescent Psychiatry, Abant İzzet Baysal University. Clinical records of 205 patients (2012–2013) were evaluated, including 99 with ADHD and 106 with ADHD-NOS. T3, T4, and TSH levels were analyzed in 81 patients. Symptom severity was assessed by validated scales such as T-DSM-IV-S and SCARED, and data were statistically analyzed with Pearson correlations and parametric tests.
Results:
T4 levels were significantly higher in the ADHD group compared to ADHD-NOS (p=0.006). A negative correlation was observed between the total number of psychiatric diagnoses and T4 levels (p=0.001), suggesting that lower T4 levels are associated with increased comorbidities. Furthermore, elevated TSH levels correlated positively with total scores and hyperactivity subscores (p=0.037).
Discussion:
Our findings indicate that T4 and TSH levels may play an important role in the manifestation of ADHD symptoms. Elevated T4 in ADHD suggests potential thyroid dysfunction in children with more severe symptoms. Previous studies have reported inconsistencies in thyroid hormone levels in patients with ADHD, possibly due to variations in sampling methods and in the assessment of generalized thyroid hormone resistance (GRTH).
Conclusion:
TSH and T4 levels may be associated with ADHD symptom severity and psychiatric comorbidities, suggesting that thyroid function assessment may be useful in the management of children with ADHD. Future studies in larger, multicenter samples are needed to validate these findings and explore therapeutic implications.
Keywords: ADHD, ADHD-NOS, thyroid hormones, TSH, T4, psychiatric comorbidities.
Reference :
ÖZTURK, Yusuf; HANGÜL, Zehra; DEMIR, Nuran; TUFAN, Ali Evren. The relations between thyroid hormones and clinical characteristics of Turkish children and adolescents with ADHD and ADHD-NOS: a preliminary study. Psychiatria Danubina, v. 36, no. 3-4, p. 333-339, 2024. Available at: https://doi.org/10.24869/psyd.2024.333. Accessed on: 27 Jan. 2025.
