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Volume 14
Issue 17
10.3390/jcm14175959
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Systematic Review

Is There a Link Between TSH Levels and Schizophrenia? A Systematic Review and Meta-Analysis

by
Elisa Gatta
1,2,
Francesco Dondi
3,
Ilenia Pirola
1,2,
Andrea Delbarba
1,
Virginia Maltese
1,
Pietro Bellini
3,
Massimiliano Ugoccioni
4,
Irene Silvestrini
4,
Mario Rotondi
4,5,
Francesco Bertagna
2,3 and
Carlo Cappelli
1,2,*
1
Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili, 25121 Brescia, Italy
2
Centro per la Diagnosi e Cura delle Neoplasie Endocrine e delle Malattie della Tiroide, University of Brescia, 25121 Brescia, Italy
3
Nuclear Medicine, University of Brescia, ASST Spedali Civili, 25121 Brescia, Italy
4
Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy
5
Laboratory for Endocrine Disruptors, Unit of Internal Medicine and Endocrinology, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2025, 14(17), 5959; https://doi.org/10.3390/jcm14175959 (registering DOI)
Submission received: 17 July 2025 / Revised: 16 August 2025 / Accepted: 22 August 2025 / Published: 23 August 2025
(This article belongs to the Section Endocrinology & Metabolism)
Versions Notes

Abstract

Background: Thyroid dysfunction and psychiatric disorders often coexist, raising interest in their potential interplay. In particular, the relationship between thyroid-stimulating hormone (TSH) levels and schizophrenia has been investigated, though findings remain inconsistent. We performed a systematic review and meta-analysis to clarify whether TSH levels differ in patients with schizophrenia compared with healthy controls. Methods: A systematic search of PubMed/MEDLINE, Scopus, and Web of Science was conducted up to May 2025. Eligible studies were selected based on predefined criteria according to the PICO framework: What are the TSH levels in first-episode, drug-naïve patients diagnosed with schizophrenia compared with healthy subjects, and do TSH levels influence different psychiatric phenotypes? PRISMA guidelines were followed. Study quality and risk of bias were assessed using QUADAS-2. Results: Of 2068 records screened, 35 studies met the inclusion criteria. Quality assessment revealed a generally unclear risk of bias, with few studies showing a high risk. The meta-analysis included 3669 patients and 1391 controls from ten Asian, eight European, and three North American studies. TSH levels were similar between patients and controls (SMD = –0.059 mIU/L; 95% CI: –0.260 to 0.141), with substantial heterogeneity (I2 = 84%, p < 0.001). Conclusions: This meta-analysis found no significant association between TSH levels and schizophrenia, despite decades of research and methodological diversity.
Keywords: thyroid; thyroid hormones; schizophrenia thyroid; thyroid hormones; schizophrenia

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MDPI and ACS Style

Gatta, E.; Dondi, F.; Pirola, I.; Delbarba, A.; Maltese, V.; Bellini, P.; Ugoccioni, M.; Silvestrini, I.; Rotondi, M.; Bertagna, F.; et al. Is There a Link Between TSH Levels and Schizophrenia? A Systematic Review and Meta-Analysis. J. Clin. Med. 2025, 14, 5959. https://doi.org/10.3390/jcm14175959

AMA Style

Gatta E, Dondi F, Pirola I, Delbarba A, Maltese V, Bellini P, Ugoccioni M, Silvestrini I, Rotondi M, Bertagna F, et al. Is There a Link Between TSH Levels and Schizophrenia? A Systematic Review and Meta-Analysis. Journal of Clinical Medicine. 2025; 14(17):5959. https://doi.org/10.3390/jcm14175959

Chicago/Turabian Style

Gatta, Elisa, Francesco Dondi, Ilenia Pirola, Andrea Delbarba, Virginia Maltese, Pietro Bellini, Massimiliano Ugoccioni, Irene Silvestrini, Mario Rotondi, Francesco Bertagna, and et al. 2025. "Is There a Link Between TSH Levels and Schizophrenia? A Systematic Review and Meta-Analysis" Journal of Clinical Medicine 14, no. 17: 5959. https://doi.org/10.3390/jcm14175959

APA Style

Gatta, E., Dondi, F., Pirola, I., Delbarba, A., Maltese, V., Bellini, P., Ugoccioni, M., Silvestrini, I., Rotondi, M., Bertagna, F., & Cappelli, C. (2025). Is There a Link Between TSH Levels and Schizophrenia? A Systematic Review and Meta-Analysis. Journal of Clinical Medicine, 14(17), 5959. https://doi.org/10.3390/jcm14175959

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