The Relationship Between Thyroid Function, Mental Health and Physical Activity - A Narrative Review
DOI:
https://doi.org/10.12775/QS.2026.61.73001Keywords
Thyroid function, Hypothyroidism, Hyperthyroidism, Autoimmune thyroid disease, Physical activity, Exercise, Mental healthAbstract
Background: Thyroid hormones play a key role in metabolic, cardiovascular, neuromuscular, and central nervous system regulation. Consequently, thyroid dysfunction may impair physical performance, mental health, and overall quality of life. Physical activity has been proposed as a supportive strategy that may beneficially influence both thyroid-related outcomes and psychological well-being.
Aim: This narrative review aimed to summarize current evidence regarding the interrelationships between thyroid function, mental health, and physical activity, with emphasis on potential mechanisms and clinical implications.
Materials and Methods: A narrative review of the literature was conducted using recent clinical studies, cohort studies, randomized trials, and meta-analyses addressing thyroid disorders, exercise, depression, anxiety, and related endocrine mechanisms.
Results: Both hypothyroidism and hyperthyroidism are associated with reduced exercise tolerance, fatigue, mood disturbances, and lower quality of life, with autoimmune thyroid diseases adding further psychological burden. Moderate physical activity improves mood, functional capacity, and metabolic health, while excessive exercise and low energy availability may disrupt hormonal balance. These relationships are multidirectional and involve hormonal, inflammatory, and behavioral mechanisms.
Conclusions: Thyroid function, mental health, and physical activity are closely interconnected. Moderate, individualized exercise may represent an important adjunctive strategy in patients with thyroid disorders. Integrated multidisciplinary care and further prospective studies are needed to clarify causal mechanisms and optimize management strategies.
References
1. Gavriilidou, M., Chorti, A., Psomiadou, A., Koidou, E., Papaioannou, M., & Papavramidis, T. (2025). Thyroid Gland Disorders and Physical Activity: Can They Affect Each Other?. Cureus, 17(3), e81489. https://doi.org/10.7759/cureus.81489
2. Lee, J., Baek, H. S., Jo, K., Kim, M. H., Lee, J. M., Chang, S. A., & Lim, D. J. (2025). The Impact of Physical Activity on Thyroid Health: Insights From Representative Data in Korea. The Journal of clinical endocrinology and metabolism, 110(3), e717–e727. https://doi.org/10.1210/clinem/dgae178
3. Skrzypiec-Spring, M., Pokrywka, A., Szeląg, A., & Zembroń-Łacny, A. (2025). Autoimmune Thyroid Diseases and Physical Activity and Sports-More Unknowns than Facts. Biomedicines, 13(10), 2352. https://doi.org/10.3390/biomedicines13102352
4. Al Qaderi, A. H., Osman, A. A., Manasrah, H., Ali, M. Z., & Al Qaderi, N. (2026). Exploring the Connection Between Thyroid Health and Psychiatric Disorders: A Comprehensive Review With a Focus on Schizophrenia and Bipolar Disorder. Cureus, 18(1), e102146. https://doi.org/10.7759/cureus.102146
5. Nuguru, S. P., Rachakonda, S., Sripathi, S., Khan, M. I., Patel, N., & Meda, R. T. (2022). Hypothyroidism and Depression: A Narrative Review. Cureus, 14(8), e28201. https://doi.org/10.7759/cureus.28201
6. Ittermann, T., Völzke, H., Baumeister, S. E., Appel, K., & Grabe, H. J. (2015). Diagnosed thyroid disorders are associated with depression and anxiety. Social psychiatry and psychiatric epidemiology, 50(9), 1417–1425. https://doi.org/10.1007/s00127-015-1043-0
7. Siegmann, E. M., Müller, H. H. O., Luecke, C., Philipsen, A., Kornhuber, J., & Grömer, T. W. (2018). Association of Depression and Anxiety Disorders With Autoimmune Thyroiditis: A Systematic Review and Meta-analysis. JAMA psychiatry, 75(6), 577–584. https://doi.org/10.1001/jamapsychiatry.2018.0190
8. Zhao, T., Chen, B. M., Zhao, X. M., & Shan, Z. Y. (2018). Subclinical hypothyroidism and depression: a meta-analysis. Translational psychiatry, 8(1), 239. https://doi.org/10.1038/s41398-018-0283-7
9. Sundus, H., Khan, S. A., Zaidi, S., Chhabra, C., Ahmad, I., & Khan, H. (2025). Effect of long-term exercise-based interventions on thyroid function in hypothyroidism: A systematic review and meta-analysis of randomized controlled trials. Complementary therapies in medicine, 92, 103196. https://doi.org/10.1016/j.ctim.2025.103196
10. Oumali, N. A., Abrari, K., Shafia, S., Hosseini, S. H., & Akhoundzadeh, K. (2026). Comparative effects of voluntary and forced exercise on cognitive performance, thyroid function, and hippocampal integrity in a rat model of post-traumatic stress disorder. IBRO neuroscience reports, 20, 391–398. https://doi.org/10.1016/j.ibneur.2026.02.015
11. Almas, S. P., Werneck, F. Z., Coelho, E. F., Teixeira, P. F. S., & Vaisman, M. (2023). Endurance training improves heart rate on-kinetics in women with subclinical hypothyroidism: a preliminary study. Journal of endocrinological investigation, 46(1), 51–57. https://doi.org/10.1007/s40618-022-01882-8
12. Vuletić, M., Kaličanin, D., Barić Žižić, A., Cvek, M., Sladić, S., Škrabić, V., Punda, A., & Boraska Perica, V. (2024). Occupational Physical Activity and Regular Exercise Are Inversely Correlated with Thyroid Function in Patients with Hashimoto's Thyroiditis. Diseases (Basel, Switzerland), 12(11), 281. https://doi.org/10.3390/diseases12110281
13. Tian, L., Lu, C., & Teng, W. (2024). Association between physical activity and thyroid function in American adults: a survey from the NHANES database. BMC public health, 24(1), 1277. https://doi.org/10.1186/s12889-024-18768-4
14. Schuch, F. B., Vancampfort, D., Richards, J., Rosenbaum, S., Ward, P. B., & Stubbs, B. (2016). Exercise as a treatment for depression: A meta-analysis adjusting for publication bias. Journal of psychiatric research, 77, 42–51. https://doi.org/10.1016/j.jpsychires.2016.02.023
15. Stubbs, B., Vancampfort, D., Hallgren, M., Firth, J., Veronese, N., Solmi, M., Brand, S., Cordes, J., Malchow, B., Gerber, M., Schmitt, A., Correll, C. U., De Hert, M., Gaughran, F., Schneider, F., Kinnafick, F., Falkai, P., Möller, H. J., & Kahl, K. G. (2018). EPA guidance on physical activity as a treatment for severe mental illness: a meta-review of the evidence and Position Statement from the European Psychiatric Association (EPA), supported by the International Organization of Physical Therapists in Mental Health (IOPTMH). European psychiatry : the journal of the Association of European Psychiatrists, 54, 124–144. https://doi.org/10.1016/j.eurpsy.2018.07.004
16. Kandola, A., Ashdown-Franks, G., Hendrikse, J., Sabiston, C. M., & Stubbs, B. (2019). Physical activity and depression: Towards understanding the antidepressant mechanisms of physical activity. Neuroscience and biobehavioral reviews, 107, 525–539. https://doi.org/10.1016/j.neubiorev.2019.09.040
17. Yang, W., Wong, S. H., Sum, R. K., & Sit, C. H. (2021). The association between physical activity and mental health in children with special educational needs: A systematic review. Preventive medicine reports, 23, 101419. https://doi.org/10.1016/j.pmedr.2021.101419
18. Mountjoy, M., Sundgot-Borgen, J. K., Burke, L. M., Ackerman, K. E., Blauwet, C., Constantini, N., Lebrun, C., Lundy, B., Melin, A. K., Meyer, N. L., Sherman, R. T., Tenforde, A. S., Klungland Torstveit, M., & Budgett, R. (2018). IOC consensus statement on relative energy deficiency in sport (RED-S): 2018 update. British journal of sports medicine, 52(11), 687–697. https://doi.org/10.1136/bjsports-2018-099193
19. Baweja, R., Eisele, C., Breitzig, M. T., Free, M. F., Kalyoncu, A., Singh, B., Frye, M. A., Waschbusch, D. A., Liao, D., & Saunders, E. F. H. (2026). Thyroid and depression: Insights from a retrospective real world clinical cohort. Psychoneuroendocrinology, 188, 107809. Advance online publication. https://doi.org/10.1016/j.psyneuen.2026.107809
20. Fan, T., Luo, X., Li, X., Shen, Y., & Zhou, J. (2024). The Association between Depression, Anxiety, and Thyroid Disease: A UK Biobank Prospective Cohort Study. Depression and anxiety, 2024, 8000359. https://doi.org/10.1155/2024/8000359
21. Samuels, M. H., Kolobova, I., Niederhausen, M., Janowsky, J. S., & Schuff, K. G. (2018). Effects of Altering Levothyroxine (L-T4) Doses on Quality of Life, Mood, and Cognition in L-T4 Treated Subjects. The Journal of clinical endocrinology and metabolism, 103(5), 1997–2008. https://doi.org/10.1210/jc.2017-02668
22. Kuś, A., Kjaergaard, A. D., Marouli, E., Del Greco M, F., Sterenborg, R. B. T. M., Chaker, L., Peeters, R. P., Bednarczuk, T., Åsvold, B. O., Burgess, S., Deloukas, P., Teumer, A., Ellervik, C., & Medici, M. (2021). Thyroid Function and Mood Disorders: A Mendelian Randomization Study. Thyroid : official journal of the American Thyroid Association, 31(8), 1171–1181. https://doi.org/10.1089/thy.2020.0884
23. Li, Z., Mao, Y., Wen, X., Chen, G., & Zhou, S. (2025). Associations of physical activity type, intensity, and frequency with subclinical hypothyroidism: a cross-sectional analysis of NHANES 2007-2012. Frontiers in public health, 13, 1499070. https://doi.org/10.3389/fpubh.2025.1499070
24. Mennitti, C., Farina, G., Imperatore, A., De Fonzo, G., Gentile, A., La Civita, E., Carbone, G., De Simone, R. R., Di Iorio, M. R., Tinto, N., Frisso, G., D'Argenio, V., Lombardo, B., Terracciano, D., Crescioli, C., & Scudiero, O. (2024). How Does Physical Activity Modulate Hormone Responses?. Biomolecules, 14(11), 1418. https://doi.org/10.3390/biom14111418
25. Gacek, M., Wojtowicz, A., & Kędzior, J. (2025). Physical Activity, Nutritional Behaviours and Depressive Symptoms in Women with Hashimoto's Disease. Healthcare (Basel, Switzerland), 13(6), 620. https://doi.org/10.3390/healthcare13060620
26. Ahmad, A. M., Serry, Z. H., Abd Elghaffar, H. A., Ghazi, H. A., & El Gayar, S. L. (2023). Effects of aerobic, resistance, and combined training on thyroid function and quality of life in hypothyroidism. A randomized controlled trial. Complementary therapies in clinical practice, 53, 101795. https://doi.org/10.1016/j.ctcp.2023.101795
27. Loh, H. H., Lim, L. L., Yee, A., & Loh, H. S. (2019). Association between subclinical hypothyroidism and depression: an updated systematic review and meta-analysis. BMC psychiatry, 19(1), 12. https://doi.org/10.1186/s12888-018-2006-2
28. Wildisen, L., Feller, M., Del Giovane, C., Moutzouri, E., Du Puy, R. S., Mooijaart, S. P., Collet, T. H., Poortvliet, R. K. E., Kearney, P., Quinn, T. J., Klöppel, S., Bauer, D. C., Peeters, R. P., Westendorp, R., Aujesky, D., Gussekloo, J., & Rodondi, N. (2021). Effect of Levothyroxine Therapy on the Development of Depressive Symptoms in Older Adults With Subclinical Hypothyroidism: An Ancillary Study of a Randomized Clinical Trial. JAMA network open, 4(2), e2036645. https://doi.org/10.1001/jamanetworkopen.2020.36645
29. Milo, T., Maimon, L., Cohen, B., Haran, D., Segman, D., Danon, T., Bren, A., Mayo, A., Cohen Rappaport, G., McInnis, M., & Alon, U. (2024). Longitudinal hair cortisol in bipolar disorder and a mechanism based on HPA dynamics. iScience, 27(3), 109234. https://doi.org/10.1016/j.isci.2024.109234
30. Petrowski, K., & Kahaly, G. J. (2025). Stress and Thyroid Function-From Bench to Bedside. Endocrine reviews, 46(5), 709–735. https://doi.org/10.1210/endrev/bnaf015
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Copyright (c) 2026 Łukasz Muraszewski, Emilia Muraszewska, Patrycja Kwitowska, Eryk Ubysz, Kornelia Nieradka, Dominika Krakowiak
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