Bipolar Disorder

[StumperDan]

Anybody else live with Bipolar Disorder and under active thyroid.

My life is my conditions and thier management.

Currently trying to drop back to some sort of stability, but certain physical are not helping. Extremely dry scalp, hairline, getting further down face. Dry areas on face. Feet and hands ice blocks and worse in colder weather. I've just had the second of two extremely bad dry eye periods, it's now returning - Ophthalmologist diagnosed keratoconjunctivitis and a heap of eye drops and gels. I have painful osteoarthritis feet, knees, hips; I am waiting for an op on my back, fusion L4 & 5, my left arm has damaged and trapped nerves - very, very painful. Constant streaming nose. GERD which is getting worse, swallowing issues, other unpleasant issues. My life is currently in 100% constant pursuit of sleep and to be pain free. I was previously running marathons with high training miles with Bipolar & thyroid in check. Levels of Lithium check regularly, 125 levo that goes up and down from 150, consistently conflicting advice from Dr, Endocrinologist & Rheumatologist. Dr's at no point in 15 years, have coordinated an overview or looked for any connections with above. They never read notes/correspondence from consultants, no suggestions, no understanding of someone's life rapidly crumbling. MH service is zero, nothing- 12 - 18 months wait for any meaningful Biploar therapy, meds in out, up and down. I take a stack of meds with a list of do's and dont's, timings, increasing/decreasing doses, manufacturer changes, titration/weaning. It's without doubt a FT occupation to try and manage the above conditions and another the meds. Dr insists I have annual reviews (MH, General & Meds) - If I mention my conditions, I am dismissed because this appointment isnt for that!I know more about my conditions than the practice nurses, its just box ticking. Yet, I have to wait two weeks for a 10 minute appointment and only allowed to discuss one symptom. Rarely my appointed, or indeed rarely the same Dr. Physically, pain and mobility deteriating, mentally struggling with Bipolar and holding all of this together. Is there anybody at all that lives with Bipolar and UAT got similar issues, that has been through it and found successful solutions. I cannot cope with anymore unnecessary confrontation with practice managers or receptionists, with secretaries, with meaningless appointments. Any help from anyone with the identical issues, would be immensely and gratefully received.

Iam safe;;;;;;

but, increasingly I am in places I am uncomfortable with, through the immense frustration and mental workload in an attempt to step back into some sort of normality and life.

Thanks for reading and take care.

Dan

[HandS]

Hi: sorry you are experiencing so much difficulty in getting the medical and MH suppprt you need. These two health sectors operate independently of each other, leaving patients to try and navigate sometimes unfathomable “pathways” to treatment, as well as ever more complex prescribing. I know many people and families struggle with this.

As you say, no ‘professional’ will understand the impact of chronic health conditions on your life and you are your best advocate.

Lithium has well documented complications with thyroid function -do your MH prescribers monitor your thyroid tests ? Or do you see an Endocrinologist?

[StumperDan in reply to HandS]

Thanks for your kind help, no - I barely get by nowadays getting the correct prescriptions at the correct time. MH services look at me blank and astonishment if I suggest someone could look at any connections to any of my pain meds. There just isnt the opportunity. When I feel a little better, I am going to write to the ceo the MH trust. Lots of donts but no do's from them and vague promises but lack of consistent communication often prevents meaningful or no progress, I feel, and my anxiety hinders, that it would be difficult to have a go at my sole MzH contact. She has been as professional as she can under horrific conditions. Their internal departments don't talk to each other, you can just feel and sense thier own frustration with their predicament. I've probably seen in excess of 50 therapists. I have seen a private Endo and it looks like I will have do so again. Thankyou again for your kind help.

[traveltime]

I can’t help specifically, also not a medic, but there’s a lot going on in the world of ketogenic diet (therapies) for bipolar/mental health and a mass of other health areas. I mostly know of USA contacts but searches for metabolicmind.org and Matt bazsucki may help?

[StumperDan in reply to traveltime]

Thanks for your kind response, I fasted earlier this year, having read up on lots of options, I lost 3 stone in just under 4 months. I needed to, in order to aid recovery from pending back op. I've slipped a little of late but I remain on fruit, cereal & egg sandwiches. My big issue is a can't exercise, not even take the dog out, the more I push myself the longer I will be laid up. I have had a peep at keto and I will have a pop. I am 6"1' and my fighting weight is just under 16 stone. Thanks for your kind response and help.

[greygoose]

Hi StumperDan, welcome to the forum.

Sounds to me as if you're under-medicated for your thyroid. Bi-polar is often listed as a hypo symptom. The brain needs a lot of T3 and if it doesn't get it, all sorts of brain symptoms can make themselves felt.

Do you get copies of your blood test results? It is your legal right to have print-outs of them. So, if you haven't got a copy of your latest results ask at reception and then post the results on here and let's have a look. Hypothyroidism is an evil disease that affects your whole body causing symptoms that doctors often misdiagnose as other diseases. So, let's start with that, shall we?

[StumperDan in reply to greygoose]

Hi Grey Goose, many thanks for your kind help and response. I am going get a base start fir me, I will get Medicheck bloods and srart there. Thanks again.

[greygoose in reply to StumperDan]

You're welcome.

[radd]

Welcome Dan,

Sorry to hear you are experiencing all these problems.

You probably know lithium can cause hypothyroidism, and then hypothyroidism can effect neurological function so it can all turn into a self driving circle. However, your symptoms sound as if you are very much under- medicated with thyroid meds. Much of this forum is occupied by members whose Levothyroxine-mono-therapy meds aren’t adequate because they have a genetic need for additional T3. This could be your problem in which case no matter what dose they prescribe of Levo it will never bring about your well being.

Much of thyroid hormones success relies upon the complexities of synthesis (if any gland is left), transport, and regulation. A large part of the regulation depends upon three enzymes called deiodinases:D1, D2, D3, with D2 being the primary enzyme responsible for intracellular conversion of T4 to T3 in the brain.

Most of the biological effects of thyroid hormone in the body are due to the action of T3 but it is the brain that requires most and has more receptors than anywhere else in the body. These regulate the action of serotonin, noradrenaline, GABA, etc, so insufficient amounts can result in neurotransmitter abnormalities and neurological change. Psychiatrists sometimes treat persistent depression or bipolar with T3 meds.

There are genetic differences that can influence how these dieodinases work, and a common impairment to D2 means a subset of hypothyroid people require additional T3 meds to restore normal functioning of their brain, muscle and heart.

If you post your recent thyroid hormone labs including the ranges (numbers in brackets) members will comment.

[StumperDan in reply to radd]

Wow, thanks for your time and knowledge with your post, really appreciate it. I took bloods with Medicheck, I was impressed with them and their help. That was circa 10 years ago. The results went to the private Endo who did manage to communicate with Dr. He was not happy though. I do think it wise to get some bloods done and start with that as a base. Thanks again for your kind help.

[radd in reply to StumperDan]

Dan,

If you are getting a thyroid panel it might be prudent to include thyroid auto-antibodies TPOAb as you appear so symptomatic. TPOAb are involved in a whole host of conditions and unmanaged high levels create damaging chronic inflammation felt all over the body including the brain.

There are many research papers in pubmed concerning the role of thyroid antibodies in neuropsychiatry, and even authors proposing autoimmune thyroiditis as a possible endophenotype for bipolar disorder in those genetically dispositioned. Lithium known to interact with thyroid function is also thought by some to induce autoimmunity by its influence on cellular and humoral immunity.

What is accepted is long term elevated autoimmune antibodies predispose us to other conditions including the possibility of the autoimmune attack extending to the nervous system. This may be identified by positive TPOAb binding to neurological tissue. triggering autoimmunity in the brain.

You likely know the brain has two types of cells: neurons (intelligence/emotions/etc) and microglia (immune cells). Both auto-antibodies and hypothyroidism create havoc within the gut and a direct gut-brain connection has been evidenced by research showing G.I. immune cells (enteric glial) triggering the brains (astroglial) immune cells. A common example frequently shown on this forum is when members find eating gluten results in brain fog generated by brain inflammation.

A good read for further understanding on the autoimmunity side is ‘Why Isn’t My Brain Working” by Datis Kharrazian (clinical research scientist professor, renowned in the functional medicine world).

[MEguylol]

who diagnosed you with bipolar and what are or were your symptoms of bipolar?

[StumperDan in reply to MEguylol]

I am 59 years old, I've lived with Bipolar since my late teens if not longer. As I mentioned I have been in and around stable, but since I've had to stop running my elated and depressive episodes come quicker and are deeper and higher. The lack of consistent if not any MH treatment, including medication and therapy, serves only to elevate my symptoms including crippling anxiety, which in turn is magnified by constant battles with medical admin, appointments, travel arrangements etc etc - further still, my pain has worsened this year which tends to leave me isolated leading into depression and the associated issues of withdrawal from most of life's traditional activities. Converse to this, if pain management settles and I can fit back into some sort of normality, I tend to then drift/shoot up into an elevated state. It's a vicious vicious circle (s) and cannot break them unless someone (qualified, regularly accessable & understanding) My back op may not be successful, it won't solve my shoulder and arm pain, which worryingly worsens weekly - it's unexplained at the mo. I was dx UAT circa 10 years ago, Mum was too in her 60's.

[StumperDan]

Yes, thank you, but it's only the private Endo that did try to set up communication with Phych & Doc. Doc wasn't for connecting up with them. It's all done via a receptionist with no chat about the background. Very dismissive. Appreciate your note.