I'll highlight one sentence from this short and simple paper:
Thyroid function should be investigated in all patients presenting with mania or psychotic symptoms.
Hypothyroidism Presenting as Acute Mania
Published online by Cambridge University Press: 01 August 2024
Abstract
Aims
In patients presenting with acute mania & psychosis, it is important to rule out organic cause of their symptoms. Neuropsychiatric problems include affective disorders, disturbances in cognition and psychosis. Mania is commonly associated with hyperthyroidism, But hypothyroidism is a medical condition commonly encountered in a variety of the clinical settings. Patients with severe hypothyroidism may present with psychosis and less commonly with symptoms of mania. We report a case of 37 year old male presenting with acute mania & psychosis, in context of severe hypothyroidism.
Thyroid dysfunction is known to have a significant impact on mental health. Hypothyroidism, in particular, has been linked to mood disorders and acute psychosis. Though most commonly associated with depression, hypothyroidism has been linked to psychosis since the late 1800s, in reports of delusions and hallucinations in patients with myxedema. More recent literature highlights the incidence and coexistence of hypothyroidism and psychiatric disorders, describing possible mechanisms contributing to the pathophysiology of these disorders. The link between hypothyroidism and mania, however, is less clear, with few reports in the literature. We present a case report of a 37 year old male presenting with acute onset mania with psychosis and previously undiagnosed severe hypothyroidism.
Link to EuropePMC entry which has onward link to journal:
Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
I was completely off my trolly by the time I actually got some appropriate help. It came in terrible waves of rage, then uncontrollable weeping, then some relief where I thought mmm that’s a bit odd and it would start up again in that cycle I had little ability to reflect at that stage because I was so poorly it was a case of getting through each moment and the awful torrent of symptoms the mood changes/ mania or whatever it was were only one aspect of my purgatory, other symptoms were manifold.
I wonder how many end up in this state being misdiagnosed as having mental disorders. I presume some must die as a consequence. I hope it is exceptionally rare. .
I feel pretty certain many hypos suffer this by degrees. However not wanting to be ‘written off’ by the medical ‘profession’, I also think many of us weather this, in an attempt to avoid said ‘written off’. In so doing we totally overload an already overloaded system. Your description of particularly “that’s a bit odd and it would start up again in that cycle …” Oh dear, strikingly familiar. Those moments of sanity making a liar of the rest. I do still get this (not optimally medicated) but fortunately not the extremes.
Our medical profession and medical care is so lacking. It does make you wonder how strong we actually are to ‘weather’ this on our own, sometimes for decades.
Interesting finding helvella. Not at all surprised. Also not surprised by brush off from GPs re this presentation (by degrees) but perhaps not quite so vivid. So many people crying out for help and GPs entirely unversed and unable to help. Shocking really.
I have been the same. Without a thyroid and medication altered. i.e. very very low FT3.
I have never been a bad tempered person but when very very low FT3 I know it's that because I feel a rage that I have never felt before. I also feel weird in the head.
All is resolved when I take my next NDT s pill. This usually happens around lunchtime when I am running low. Not often because I managed to work it out.
Sadly, I can totally relate to this and then when all calms down the wonder of why you acted in a particular way. Or the bad impulsive decisions that make you thinkWHY!
My husband many many years ago worked as a psychiatric nurse and he said that majority of the female patients were all on thyroid medication. Very sad.
If you look at the pictures of women in sanatorium from past centuries, it is so obvious that they had thyroid problems. Huge goites, protruding eyes, no eyebrows, wild hair. Locked away with no treatment until they died, so so sad.
lots of people who don’t have thyroid disease suffer from mania or Bi-polar
I filled in the Cambridge LongTerm conditions survey you posted on the board @helvella and they want to interview me the beginning of Feb via Microsoft. I am quite looking forward to it and will post what happened on the board afterwards
Thavk yoi for this information. I have a neighbour who worked in various psychiatric departments in my local area. When I mentioned hypothyroidism to her several years ago, she said that it’s one of the first things that they test for when assessing patients. It’s very sad to think that this is not routinely implemented by every health authority. I’m sure that lots of patients suffer needlessly from being misdiagnosed. It’s a very difficult battle to fight especially when you’re being gaslighted by most of the medical profession.
I’m so lucky that I have benefitted from this and other forums to advocate for correct treatment. It’s been a life saver!
Thank you for all that you and the admins do. Your research, advice and support is invaluable and I will be forever grateful to you all for guiding me down the right path to recovering my health.
I suspect there is something of a gap between GPs, and all forms of psychological service, who might have little appreciation of these issues and this specific association. And psychiatrists who will more likely have come across Dr Richard Asher, and others.
Dr Richard Asher - Myxoedematous madness
A short introduction and onward link to Dr Asher's paper.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
B12 levels and hypothyroidism
