Thyroid Disease and Bipolar Disorder

Well, at least now I’m dealing with a concrete reason for the weight gain.

After donating yet more blood to a handful of vials, it seems my thyroid has decided to quit functioning at optimum capacity.  Not that this really comes as a surprise – thyroid disease runs in my family.

In an odd way I am very relieved.

At least I no longer have to fight with my two psychiatrists about my suspicion something is going on medically that is causing the weight gain.  We’ve got it!  Hard, empirical data.  Why they never counted the rising numbers on my scale as heavily as the lab results numbers is hard to believe.  (Sorry, couldn’t resist.)

I’m not going to bore everyone with a lot of facts, stats, etc about thyroid and Bipolar, but there are two items I found of particular interest. First, I just can’t resist this little snippet from NIMH’s Bipolar information page:

People with bipolar disorder are also at higher risk for thyroid disease, migraine headaches, heart disease, diabetes, obesity, and other physical illnesses.10, 11 These illnesses may cause symptoms of mania or depression. They may also result from treatment for bipolar disorder.

Let’s read that last sentence again.  Yup – I’ll never know whether the treatment caused or had a hand in the thyroid disease or not.

The second is from Journal of Thyroid Research [Volume 2011 (2011), Article ID 306367, 13 pages doi:10.4061/2011/306367]  Thyroid Functions and Bipolar Affective Disorder by Subho Chakrabarti  

There is now more or less incontrovertible evidence that, apart from their developmental effects on the CNS, thyroid hormones have major effects on the metabolic activity of the mature brain. Mood disorders are intimately associated with suboptimal thyroid function. Although comparatively less investigated, increasing evidence has shown that HPT axis dysfunction is relevant to the aetiopathogenesis, course, treatment, and outcome of bipolar disorder. Hypothyroidism either overt or more commonly subclinical appears to the commonest abnormality found among patients with bipolar disorder. It is also likely that the prevalence of thyroid dysfunction is greater in patients with rapid cycling and more refractory forms of the disorder. Lithium has potent anti-thyroid effects and can induce hypothyroidism among patients on this treatment; alternatively, it can exacerbate a preexisting hypothyroid state. Even minor perturbations of the HPT axis in the normal range have the potential to affect the outcome of bipolar disorder. Awareness of this fact is required among clinicians, and patients should be carefully monitored and managed for HPT axis dysfunction.

(Bold added by me.)

I urge everyone out there to have your GP check your thyroid panel during your regular physical.  I am a bad example of a good patient – I have physicals every two years instead of annually.  If I hadn’t stormed my psychiatrists’ offices with my weight gain complains, I would never have had yet more blood work done for some time and my thyroid problem would have gone undiagnosed for another year at least.

Do it – ask for the test – and don’t back down if they tell you it’s only your T4 that’s out of whack.  Insist on follow-up.  That deficient T4 number could be a huge culprit in what ails you.  Insisting on follow-up could wind up saving you a while lot of heartache (and a lot of money when you really don’t have to buy that new wardrobe.)

I am *so* glad you got this figured out! I’m lucky that my GP always tests my thyroid function at physical time. When I saw him last week about my shoulder’s torn rotator cuff, he ruled out a steroid injection because he said they “can mess with your moods.” Gotta love him.

Hi, Candida – thanks for the link! I have my appointment with the prescribing GP tomorrow and I’m going to ask him if he’s familiar with any of this research. I hope all is well with you – Vivien

I am so glad to hear you have the thyroid problem sorted out! I hope your weight comes off easily now. I too have an under-active thyroid, which was diagnosed many years before the bipolar so we don’t know which came first although I would suspect the bipolar. Thyroid disease does not run in my family (with the exception of a distant great-aunt) so maybe I have a little cause and effect going on? Regardless, I have two conditions to attend to now, both of which constantly demand my attention. I can only go two days of missing my thyroid supplement or my moods start to dip and I become very tired all the time. I am so glad you posted this – I never knew there was a connection!

Monday – how are you? Thanks for sharing – I didn’t know you have a thyroid problem, too. Mind if I pick your brain when I get a bit further into my own treatment? I hope all is going well on your end. 🙂

I’ve come across this site and wanted to comment on the thyroid/bipolar connection. I’m searching for answers for my daughter who is suffering with acute anxiety and depression. Her grandmother, aunt, brother and father all suffer/suffered with bipolarity. As a mother, I was always trying to find answers for my son so started a survey of people who were suffering with bipolarity. Over 20 something years, if the person being queried would answer, I found that 100% of all persons asked had family members who had either thyroid problems and/or autoimmune conditions. Why the medical community won’t research this is beyond me. Over a period of time I would ask psychiatrists why my findings were mute. They, to a doctor, said that it was ‘anecdotal.’ Welp, if you hear something enough, it stops being an anecdote and becomes science. I would like to know if any of your readers have autoimmune conditions. My son was on Lithium and gained 150lbs. AND, he, his grandmother and father all have/had issues with their thyroid.

Hi, Ginger: The thyroid issue is a messy one. What I’ve personally come across is the med messing with either the thyroid itself or skewing thyroid test results. I was on two meds for a while. One caused weight gain and the one I am still on causes a skew in the thyroid blood work. But, that’s not to say had I stayed on the med causing weight gain longer, it wouldn’t have wrecked my thyroid (’cause that was one of the other, lovely side effects).

Thanks for the comment – I hope others will join the conversation. If you find any new info, pls feel free to post a follow up. I’d love to hear about anything you may dig up 🙂

I never in my wildest dreams would I think the two had anything to do with one another. I found out I was bi-polar 7 years ago and hypothyroid 1 year ago. I have never had a weight problem except the last year, I have gained 40 lbs and can not get it off…it is so discouraging. I’m glad to hear of this link, as I have always struggled with my moods….maybe now I can sit and talk with the Dr and figure out the goals that need to be set.

Jessica, every time I would mention to my son’s psychiatrist that I’d done a survey of those with bipolar familial conditions and the 100% connection with thyroid, he would tell me, “That’s all anecdotal.” When something is anecdotal 100% of the time, I’d call it science! ! Yes, I think bipolar disorders stem from the thyroid. Maybe you could get your doctor to look into this. Someone in the medical community certainly needs to. Do you have any auto-immune conditions? Also, are you on lithium? This cause a tremendous weight gain.

It’s great that you havebeen able to establish a link between thyroid and bipolar. but tell me how serious is this ailment….my husband wants to divorce me, is it that bad?

I am sad that I got to know that I am a bipolar recently. I was hospitalized for a major manic episode. Still dealing with my fresh marriage related issues and the straiin it has put on my husband. This blog is encouraging though. I also have Hypothyroidism, i am on 50mcg daily. I am sure when I get off the Valporate (Depakote), the optimum thyroid level will keep my mood swings in check 🙂

Hi, Sonia. Right after diagnosis is one of the hardest times. It’s difficult enough dealing with the fallout that brought you to being diagnosed, and on top of that you have to cope with having a disorder.

Marital issues are not uncommon. Especially when things arise as a result of behavior during a manic episode. Many of us go to counseling – individual and couples – to help keep it all together. It does work for a lot of us. Also, educating your spouse is necessary. I speak from experience. It can work out positively!

Thanks for commenting! I’m glad you find the blog encouraging! Feel free to comment on anything at all – the community here is very supportive and helpful.

Good luck!!

Sorry about your hard times! I hate to tell you, but if u truly are bipolar u will probably be on depakote the rest of your life, along with an antipressant.

I’m both bipolar II and hypothyroid. It’s a handful! The addition of a tiny bit of T4 (levothyroxine) to my synthroid (which is only T3) made a huge difference for me. It improved my mood immensely and lifted the fatigue and weakness I was experiencing. (My TSH and all those numbers were fine, btw…I asked to try the T4 b/c I still felt so lousy) Good luck and hang in there.

research shows it’s best to get thyroid levels annually if taking lithium. my thyroid levels have drifted. there is no way to no if that is natural or because of the lithium. thankfully my levels haven’t gone completely catiwampus.

3 months after being put on Lithium, my weight went out of control and, ta daaaa…. under active thyroid. 6 years later thyroid has gotten worse. Now doc’s talking tests for diabetes. While I’m grateful for lithium, it’s changed my life, it’s unfortunately two-fold – a medicine and a menace

Forgive me if I’m wrong but I believe it’s my T3 level that’s at 6 and my docs use the old ranges where 5 is within the normal range. So they call it ‘subclinical’. However I seem to have a lot of the symptoms except weight gain – but they refuse to treat!

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