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A bidirectional relationship of metabolic syndrome and depression exists, and there has been discussion of classifying depression as metabolic syndrome type II.18 Hyperglycemia contributes to elevation of advanced glycation end products, pro-oxidant, cytotoxic substances that induce inflammation.19 Thyroid pathologies such as hypothyroidism, thyro-stress, and Hashimotos thyroiditis also have been linked to an increased predisposition toward anxiety and depression and shouldnt be overlooked.20 A complete thyroid profile is recommended to determine whether an imbalance exists, and, if so, corrective measures should be taken

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