For so many years, endocrinologists and GPs have been running scared of adequate thyroid hormone dosing - citing all the nasty signs and symptoms of hyperthyroidism.
It seems to take psychiatrists, cardiologists, and others to seek out and research whether that really is the case in humans who simply take a high dose of thyroid hormones.
Don't miss that this is only a "literature review" - not new research.
Prog Neuropsychopharmacol Biol Psychiatry. 2016 Jun 11. pii: S0278-5846(16)30080-X. doi: 10.1016/j.pnpbp.2016.06.001. [Epub ahead of print]
Elevated levels of circulating thyroid hormone do not cause the medical sequelae of hyperthyroidism.
Kelly T1, Denmark L2, Lieberman DZ3.
1George Washington University, Department of Psychiatry and Behavioral Sciences, 2120 L St NW, Suite 600, Washington, DC 20037(1); The Depression & Bipolar Clinic of Colorado, 400 East Horsetooth Road, Suite 300, Fort Collins, Colorado 80525(2). Electronic address: TamKelly@comcast.net.
2The Depression & Bipolar Clinic of Colorado, 400 East Horsetooth Road, Suite 300, Fort Collins, Colorado 80525(2).
3George Washington University, Department of Psychiatry and Behavioral Sciences, 2120 L St NW, Suite 600, Washington, DC 20037(1).
Clinicians have been reluctant to use high dose thyroid (HDT) to treat affective disorders because high circulating levels of thyroid hormone have traditionally been equated with hyperthyroidism, and understood as the cause of the medical sequelae of hyperthyroidism, such as osteoporosis and cardiac abnormalities. This conclusion is not supported by (HDT) research.
A literature review of research related to the morbidity and mortality of HDT treatment was performed.
There exists a large body of research involving the use of HDT treatment to prevent the recurrence of differentiated thyroid cancer and to treat affective disorders. A review of this literature finds a lack of support for HDT as a cause of osteoporosis, nor is there support for an increase in morbidity or mortality associated with HDT. This finding contrasts with the well-established morbidity and mortality associated with Graves' disease, thyroiditis, and other endogenous forms of hyperthyroidism.
The lack of evidence that exogenous HDT causes osteoporosis, cardiac abnormalities or increases mortality compared with the significant morbidity and mortality of hyperthyroidism requires an alternative cause for the medical sequelae of hyperthyroidism. One possibility is an autoimmune mechanism.
High circulating levels of thyroid hormone is not the cause of the sequela of hyperthyroidism. The reluctance to using high dose thyroid is unwarranted.
Copyright © 2015. Published by Elsevier Inc.
bipolar; etiology; hyperthyroidism; iatrogenic; morbidity; sequelae
PMID: 27302764 [PubMed - as supplied by publisher]
Psychiatrists are uniquely qualified to do the risk-benefit analyses of high dose thyroid for the treatment of the bipolar I, bipolar II and bipolar NOS. Other specialties do not have the requisite knowledge of the risks of alterative medications or of the mortality and morbidity of the bipolar disorders to do a full risk benefit analysis.