Thyroid hormone levels in patients with bipolar disorder: a systematic review and meta-analysis.

[helvella]

Bipolar has been frequently mentioned on the forum. I think many suspect (or are sure) there are links between bipolar and thyroid hormones.

This paper, whilst a meta-analysis, seems to confirm links. Which is unlikely to surprise many.

Thyroid hormone levels in patients with bipolar disorder: a systematic review and meta-analysis.

Liu S 1, 2 , Chen X 2 , Li X 2 , Tian L 1, 2

BMC Endocrine Disorders, 18 Nov 2024, 24(1):248

doi.org/10.1186/s12902-024-... PMID: 39551764 PMCID: PMC11572511

Abstract

Purpose

To investigate the difference in blood (serum/plasma) thyroid hormone (TH) levels, including thyroid-stimulating hormone (TSH), thyroxine (T4), triiodothyronine (T3), free thyroxine (FT4), and free triiodothyronine (FT3), in bipolar disorder (BD) during different mood episodes (depression and mania) compared with healthy control (HC) and between manic episodes (BD-M) and depressive episodes (BD-D).

Methods

As of September 1, 2024, the electronic databases PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, China Science and Technology Journal Database, Wanfang Database, and Clinical Trials. Gov were systematically searched with no language limitations. Standardized mean differences (SMD) with 95% confidence interval (CI) were summarized using a random effects model. The chi-squared-based Q test and the I2 test assessed the size of heterogeneity.

Results

The 21 studies included a total of 3696 participants, Of the 2942 BD patients, 1583 were in depressive episodes 1359 were in manic episodes. The status of measuring blood TH levels included 2 studies in plasma and 19 in serum. Combined with the results of the sensitivity analyses, we obtained the following relatively reliable results: serum T3 (SMD: -0.63, 95%CI: -1.09 to -0.17) and FT3 (SMD: -0.42, 95%CI: -0.83 to -0.00) levels decreased significantly in BD-D compared to HC; serum T3 (SMD: -0.91, 95%CI: -1.49 to -0.32) levels decreased significantly and serum FT4 (SMD: 0.37, 95%CI: 0.14 to 0.60) levels increased significantly in BD-M than in HC; serum T3 (SMD: 0.87, 95%CI: 0.24 to 1.49) and FT3 (SMD: 0.27, 95%CI: 0.13 to 0.42) levels demonstrated a significant elevation in BD-M compared to BD-D. In the group of euthyroidism, apart from serum FT4 (SMD: 0.21, 95%CI: -0.15 to 0.58) levels showed no significant difference between BD-M and HC, other results above remained consistent.

Conclusion

Serum T3 and FT3 levels decreased significantly in BD-D compared to HC. Serum T3 levels decreased significantly and serum FT4 levels increased significantly in BD-M compared to HC. Serum T3 and FT3 levels increased significantly in BD-M than in BD-D. The temporality of changes in TH levels and BD progression demands further longitudinal studies to illustrate.

Open access here:

europepmc.org/article/MED/3...

[arTistapple]

Very interesting. I like the way they separated the manic and depression phases. As you say not a surprising outcome to many and affirming our own observations re: issues/hyper/hypo/Hashimotos.

I don’t know enough about Graves.

[helvella Administrator]

Exclusion criteria were as follows: (1) reviews, conference abstracts, letters, and other non-primary studies; (2) non-human research, such as animal experiments; (3) the object of studies accompanied by other mental illness (such as schizophrenia); (4) rapid cycling BD; (5) studies during pregnancy or lactation; (6) treatment-induced changes in TH levels, such as lithium; (7) data or full text was not available.

[HandS]

Thank you for sharing this. My experience of supporting my adult daughter in both in patient and community mental health settings tells me that MH ‘treatment’ has never left the dark ages.

When I query physical symptoms in relation to their prescribed meds I get told “we’re not medical”.

Also, it appears to be standard practice that MH diagnoses can be changed to suit the drug of the day.

I’ve had 20 years of trying to make sense of anything the MH profession does or says. I think many ‘medical’ doctors experience the same feeling.

Will they ever join the dots 🤷‍♂️