Bipolar Disorder and Cellular Hypothyroidism

[Andyb1205]

Recently came across this. Quite interesting, though I can’t access the full article.

“Multiple lines of evidence suggest the hypothesis that high dose thyroid therapy corrects for cellular hypothyroidism found in bipolar disorders. Evidence indicates that bipolar disorders are associated with mitochondrial dysfunction which results in low cellular adenosine 5′-triphosphate (ATP) levels. Transport of thyroid hormones into cells is energy intensive and dependent on ATP except in the pituitary gland. Inadequate ATP levels makes it difficult to get thyroid hormone into cells leading to cellular hypothyroidism. This creates a condition where the blood and pituitary levels of thyroid hormone are normal but low in other tissues. High dose thyroid therapy produces a gradient that is sufficient for thyroid hormone to diffuse into cells correcting cellular hypothyroidism. If this hypothesis is correct there are number of implications. The two most important are: On average patients suffering from a bipolar disorder die 10–20 years earlier than the general population. The medical sequelae associated with bipolar disorders cause far more deaths than suicide. If high dose thyroid corrects for cellular hypothyroidism it could well decrease the medical morbidity and mortality associated with bipolar disorders that are the result of cellular hypothyroidism. Thus high dose thyroid would be a first treatment that decreases the considerable medical morbidity and mortality associated with the bipolar disorders. This would stand in stark contrast to most psychiatric medications that can that increase morbidity and mortality. It would also reinforce the safety of HDT. The second implication is thyroid hormone blood levels in patients suffering from a bipolar disorder do not accurately reflect the true thyroid status.”

sciencedirect.com/science/a...

[Andyb1205]

More.

“TSH was suppressed; and T4 levels went to around 150% of normal, Whybrow reported. In the randomized trial, the dose was 300 mcg daily, with a starting dose and weekly increases of 100 mcg.

You’re asking yourself: “How come these patients don’t just become hyperthyroid, if you’re giving them supraphysiologic doses of thyroid hormone?” Of course that’s a key question. Whybrow and Bauer and colleagues have found that patients with rapid cycling bipolar disorder “respond differently to the hormone and tolerate it better than healthy individuals.” In other words, despite their TSH of less than 0.1, patients who respond do not develop tachycardia, palpitations, tremor, GI hypermotililty, or weight loss.”

psychiatrictimes.com/bipola...

[Marz in reply to Andyb1205]

amazon.co.uk/Science-Thyroi...

You may find the above book interesting. I have not read it ...

[greygoose in reply to Andyb1205]

despite their TSH of less than 0.1, patients who respond do not develop tachycardia, palpitations, tremor, GI hypermotililty, or weight loss.”

Again this idea that TSH affects the heart! And no mention of T3. Whilst I would not dispute that bi-polar is connected to hypothyroidism, one cannot take seriously a study that contains such antiquated ideas.

[Andyb1205 in reply to greygoose]

In his defence he’s a psychiatrist, one error doesn’t discredit the important point he’s making. We know that what he said is extended to countless hypothyroid patients who can more than tolerate a low, and even suppressed, TSH. And those patients who do require very large amounts of thyroid hormone, to get them in the cells.

Elsewhere he does cite the use of large doses of T3, referring to old but important studies, that the Psychiatrist Kelly cites in his book.

He also points out that thyroid augmentation, T4 and T3, is even in official bipolar treatment guidelines. Yet Psychiatrists hesitate to use what is not only a far safer alternative to many other medications, but backed up by clinical trials and science. For Bipolar patients, this means lower doses and by extension reduced need for additional psychiatric medications, in effect, stabilizing mood with great reduction in side effects.

[Marz in reply to Andyb1205]

Apologies - I did not take on board the author of your opening post. I must not rush 😊

[Andyb1205 in reply to Marz]

No need at all! I was replying to greygoose, though I understand the concern. Too many thyroid patients and more have suffered because of the dogmatic adherence to the TSH test.

What these studies show though is just so important. Thyroid hormones are so important that at the end of the day, there should be more doctors willing to give patients a trial and evaluate the clinical response.

[greygoose in reply to Andyb1205]

That is not just one error. That is a basic fault the whole structure. But, as I said, I'm not disputing that people with bi-polar are hypo, and need T3. Had bi-polar been invented in the 60s, when I was a teenager, I'm pretty sure I would have been diagnosed with it. But, I very much doubt I would have been treated with T3, when it was exactly that that I needed!

[MissGrace]

This is really interesting. I wonder if the same isn’t true for a lot of others too who aren’t bipolar? This forum is full of people gasping for an increase in medication and often being denied it. Leads me to think that synthetic Levo isn’t that effective for some and they struggle to convert it - do they need an awful lot to get a decent T3 level and feel better too?

The ‘normal’ ranges were made up of ‘normal’ people producing their own tailor-made, unique T3 and T4 from their own thyroid made from their own DNA. Don’t think a synthetic formula is the same! It might chemically be the same, but I think there may be more too it than that.

I don’t understand that If you take the pill, even the progesterone-only pill, there is a choice of many, if one doesn’t suit, you try another. With Levo, you can pretty much have Levo, or Levo. The only difference is the type of cr*p they bulk up the tablet with. If it doesn’t suit. Tough - it must be in you head! There are alternatives, but the vast majority are not allowed to find the medication that suits. All we can have is Levo, and then they often starve us of the amount we might need to get truly well. Grrr! 🤸🏿‍♀️🥛

[Marz in reply to MissGrace]

amazon.co.uk/Science-Thyroi...

I have not read the above book. could be interesting ...

[greygoose in reply to MissGrace]

The ‘normal’ ranges were made up of ‘normal’ people producing their own tailor-made, unique T3 and T4 from their own thyroid made from their own DNA.

That's just the problem, they weren't entirely made up of 'normal' people, there were a lot of undiagnosed hypos in the mix.

[MissGrace in reply to greygoose]

Hence the inverted commas around ‘normal’ in my post. There were probably undiagnosed hypers, pituitary failures and all sorts of other things too. I guess one person’s ‘normal’ is another’s aberration! 🤸🏿‍♀️🥛

[greygoose in reply to MissGrace]

Absolutely.

[Zelda123]

I’ve got bipolar as it runs in my family and thyroid issues. If this is the case why won’t the drs help me.. I’ve deteriorated since being overactive can’t get my energy levels back I’m under active now and on thyroxine 50mg. They won’t give me a increase because even though my TSH is high my thyroid hormone is 6 ..