Hpt Axis Dysfunction And Outcome Of Bipolar Disorder
In conclusion, several HPT axis abnormalities, which may have an important bearing on outcome, have been documented during acute-phase treatment of bipolar disorder. Similar findings during maintenance-phase treatment with lithium are consistent with the well-known anti-thyroid effects of lithium. Therefore, lithium-induced changes in thyroid function, even within the normal range, are detrimental to its prophylactic efficacy, especially with regard to depressive symptoms . The presence of HPT dysfunction during lithium-treatment further underlines the need for regular monitoring of thyroid functions and rapid correction of any abnormalities that arise during such treatment. It may also explain why T4 supplementation can enhance treatment-response in some patients with refractory mood disorders on lithium treatment.
Considerations For Taking Iodine
Iodine is a complicated topic, so please refer to an earlier article I wrote, which was focused on iodine. This article includes more research information, as well as the results of my Root Cause Rebels survey on using iodine versus using selenium. Find out which intervention had the greatest effect. You might be surprised!
To summarize although iodine serves as fuel for our thyroid and is very important in iodine deficiency induced hypothyroidism, Hashimotos is a different mechanism.
Adding iodine is like pouring gas into an engine thats on fire thats essentially whats happening in Hashimotos. Adding iodine to the mix before putting out the fire and fixing the engine may result in further damage to the thyroid. In those with a predisposition to autoimmunity, this has been documented time and time again, in both animal and human studies. My approach is, lets fix the engine first , and then add the fuel once we know that the engine is no longer on fire. Please read the article linked above and also check out my book, Hashimotos: Root Cause. I have an entire chapter on the iodine controversy that references numerous studies.
Are Menstrual Problems Common
When menstrual problems occur, it may be easy to think that other women don’t experience them.
However, according to the National Institutes of Health menstrual irregularities occur in about 14% to 25% of women of childbearing age.
These figures differ by the cause or nature of irregularity.
For example, if a woman has severe menstrual cramps, she might be included in the tally of women with endometriosis rather than among women with menstrual problems.
Moreover, many women do not report their menstrual problems to their healthcare providers.
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Why Hashimotos Is Mistaken For Bipolar Disorder
Could eight medications, six hospitalizations, and a dozen electroconvulsive treatments under anesthesia all have been the result of misdiagnosed Hashimotos? If so, how many other people are enduring the same kind of misguided treatment?
Its possible her bipolar symptoms were symptoms of Hashimotos, and unfortunately such a mistake is common today given the medical misunderstanding of Hashimotos. When autoimmune Hashimotos flares up, the immune system attacks and destroys the thyroid gland. As the thyroid tissue is destroyed, it spills excess thyroid hormone into the bloodstream. This causes symptoms that can easily be confused with the manic episode of bipolar disorder, such as hyperactivity, irritability, and an inability to sleep.
When the immune attack dies down, more thyroid tissue is lost and the person returns to a hypothyroid state that frequently includes depression and fatigue, which can look like the depressive state of bipolar disorder. Also for someone who has gone a period of time without sleeping much and operating on overdrive, a crash it to be expected.
Thyroid Health And Menstruation
Jacobson et al. confirmed that circulating thyroid hormone concentrations are associated with subtle differences in menstrual cycle function outcomes.
Both hypothyroidism and hyperthyroidism can lead to menstrual disturbances.
Women with hyperthyroidism usually have decreased menstrual flow, but anovulatory cycles are also very common. Although heavier menstrual flows may occur, they are not quite common in hyperthyroidism. Since today, hyperthyroidism is spotted and diagnosed earlier than before, menstrual irregularities are less common than they used to be.
On the other hand, hypothyroidism is usually associated with increased menstrual bleeding, and disorders in homeostasis may contribute to the problem. Both hyper- and hypothyroidism are associated with reduced fertility, and the outcome of the pregnancy is more often abnormal than it is in euthyroid women.
Ajmani et al. carried out a study on the role of thyroid dysfunction in patients with menstrual disorders.
They enrolled 100 women into their research and found that in subjects with menstrual disorders, 44% had thyroid conditions. Of these, 20% had subclinical hypothyroidism, 14% had overt hypothyroidism, while 8% had overt hyperthyroidism. Scientists concluded that thyroid dysfunction is a significant causative etiology of menstrual abnormalities.
As you can see, hypothyroidism is more commonly associated with menstrual problems than hyperthyroidism.
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Prevalence Of Circulating Antithyroid Antibodies In Patients With Mood Disorders
Several studies have surveyed the prevalence of circulating antithyroid antibodies in psychiatric populations . Gold et al. were the first to hypothesize that the so-called symptomless autoimmune thyroiditis may be not symptomless. Their hypothesis was based on the finding that the majority of patients admitted to a psychiatric hospital for depression and thyroid dysfunction had circulating AbM . It must be said, however, that patients had been diagnosed with subclinical, mild, or overt hypothyroidism, but no other evidence of thyroiditis was mentioned. Moreover, the overall prevalence of AbM in their patients was 9/100, which may be similar to the prevalence reported for the general population, especially if such low titers are considered positive.
Table;1 Prevalence studies of thyroid antibodies in patients with mood disorders
The manic episode claimed to represent the first case of bipolar disorder due to Hashimotos encephalopathy , was associated with hyperthyroidism and pathological EEG. The patient responded to psychiatric treatment, carbimazole and short-term treatment with high doses of prednisolone.
In the subsequent cases of mania reported in association with autoimmune thyroiditis, most attention was drawn to the hypothyroid status of the patient rather than to autoimmunity.
Thyroid And Bipolar Resources
An excellent book for the lay reader is;Thyroid Power;by;Richard Shames, M.D. and Karilee Shames, R.N., PH.D.
It describes how fatigue, weight gain, depression, high cholesterol, low sex drive, and a host of other difficulties are often due to low thyroid. It also explains how to talk to your doctor about misconceptions about hypothyroidism, and what is really normal.
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Thyroid Hormone Resistance And Also Disorder Of Thyroid Hormone Transport Or Metabolism
These are conditions that are rare and very difficult to diagnose properly.;In these conditions sometimes because of genetic variation your body might become resistant to thyroid hormone.;This is similar to what we see in Type II Diabetes where the body becomes resistant to the lin hormone.
The second condition is where there is a problem with either too high levels of thyroid binding protein or low levels of thyroid-binding protein.;The thyroid hormone in the bloodstream is present in the bound form.;Thyroid hormone is bound to thyroid binding protein, so if there is a significant difference in the levels of these thyroid-binding proteins it can interfere with optimal levels.;Some of this condition is attributable to high cortisol levels and also is estrogen levels .;;
Thyroid Disease Symptoms With Normal Thyroid Test Results
The conventional way of determining thyroid dysfunction is measuring TSH.;But with just one thyroid hormone level being checked we miss the chance of complete evaluation of thyroid.
And thus;thyroid dysfunction often goes unnoticed;and thats the reason people have suffered for several years before finally someone checks their thyroid completely and discovers the underlying cause of the problem.;
Below I am going to talk about the reasons why are maybe experiencing thyroid disease symptoms with normal thyroid test results.;;your thyroid tests might be normal but why are you still feeling the symptoms:;
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Hpt Axis Dysfunction In Rapid Cycling Bipolar Disorder And Mixed Affective States
Rapid cycling usually affects about 9 to 20% of all patients with bipolar disorder . This subpopulation is characterized by more severe morbidity and a refractory clinical course. More women, than men, suffer from rapid cycling .
Mixed affective states have also been associated with reduced thyroid functioning in certain studies. In a study of first-episode manic and mixed types of bipolar disorder, 33% of the patients in mixed episodes had elevated TSH levels, in comparison with 7% of patients experiencing pure mania . In similar vein, Chang et al. found significantly lower T4 levels and elevated TSH levels in patients with mixed mania, compared with those with pure mania. These differences were not associated with exposure to lithium. Others have reported that patients with mixed states have a higher rate of positive anti-thyroid antibody titres, than other unipolar or bipolar subgroups, apparently unrelated to lithium treatment . However, not all studies have been able to confirm the association of overt or subclinical thyroid dysfunction with mixed manic episodes . Thus, the question of HPT dysfunction in mixed affective states remains an unresolved one .
Gut Detox And Adrenal Support
Immediately she started to notice improvement in how she felt. After following the diet for several months, I put her on a gut detoxification program with a hypoallergenic detox protein powder. I started her on adrenal adaptogen herbs and nutrients as her salivary adrenal panel showed an increase in cortisol and night. This means she was more awake and night when she should be tired, which indicates a dysfunction in the brains sleep-wake cycle. Adrenal adaptogens address this.
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Testing For Thyroid Problems
Many doctors rely on one lab test to determine whether or not patients have a healthy, functioning thyroid gland. However, most only test for the amount of TSH in the bloodstream. Other thyroid hormone tests are available, such as Free T4, Free T3, Reverse T3, and TPO .
I dont want to get too scientific, but each of these tests checks for certain levels of hormones that all work together to create a healthy thyroid. Without testing for all of them, you cant be sure whether or not you have a thyroid disorder. While many people dont want to get tested for all of these due to the number of blood tests it requires, its important to rule out all thyroid problems before beginning treatment for bipolar.
One treatment of thyroid disease has been known to help reduce the symptoms of mental illness. The most common treatment is Synthroid a synthetic T4 hormone. However, treating patients with T3 hormone has been effective in treating bipolar symptoms.
T3 has helped reduce symptoms of depression with fewer side effects than antidepressants. Many doctors automatically prescribe synthetic T4 hormone without getting to the underlying cause of the thyroid disorder. By testing for all hormones, as mentioned before, your doctor may find that a prescription for T3 hormone may fix both your thyroid problems and your bipolar symptoms better than Synthroid.
Thoughts On Thyroid Dysfunction Can Be Mistaken For Mental Illness
I watched as my mother suffered symptoms of hypothyroidism for years. She was misdiagnosed, and treated for other illnesses. She finally presented with a goiter, which made her miserable.
As I got older, I seemed to parrot my mothers symptoms, and after much online research, I became more and more convinced that I, too, had thyrhoid problems. Unfortunately, I was more convinced than my doctors were. By aggregating them to no end, I finally got my Internist to order a test, which proved me correct. I think one of their issues, was the fact that I lost, instead of gained weight. Soon after this, I was tested for other things, and found to be almost devoid of B12. After these things were treated, I began to regain my mental faculties, which had deteriorated alarmingly. .
I believe this article should be widely circulated to doctors, to inform them, , of these truths.
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More Info About Hyperthyroidism And Menstrual Problems
Studies have connected hyperthyroidism with menstrual irregularities as well. These are the problems that may occur when hypothyroidism is undiagnosed or improperly managed:
- Delayed puberty or late menstruation Unlike hypothyroidism, which causes early onset of the first period hyperthyroidism can delay the start of puberty. Girls with hyperthyroidism may get their first period at 15 or older
- Light menstrual periods Hyperthyroid women tend to have periods that are lighter than normal
- Shorter menstrual periods While hypothyroidism can prolong your periods, hyperthyroidism can shorten them. Bear in mind that a short period isnt automatically better
- Sporadic menstrual periods Hyperthyroid women may find that their periods dont occur at a normal rate. They may have a period one month and a pause of month or two before the next period
- Absent menstrual periods Besides sporadic menstruations, women with hyperthyroidism may experience a complete absence of their periods for a certain period of time
Reasons For Thyroid Disease Symptoms With Normal Thyroid Test Results
Inside:;Research-Backed reasons why people have a thyroid function test normal values but still have thyroid disease symptoms. Whats the underlying reason for thyroid symptoms. What can affect false thyroid test results?
Thyroid problems are very prevalent these days, especially in middle-aged women.;Their prevalence is increasing day by day and many women suffer from terrible thyroid symptoms on a daily basis.
Hypothyroidism/Hashimotos disease come with a range of symptoms and oftentimes these symptoms can have multiple underlying reasons.;
There is a large number of women that we are seeing who have all thyroid disease symptoms with normal thyroid test results.;
So I get this question very commonly: Can my thyroid tests be false? ;or Can my thyroid test results be normal and I can still have hypothyroidism?
The Answer to these questions is not simple and a little complicated.
So to answer this question first we need to understand some basics about thyroid hormone production in our body.;
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Little Known Things About Your Thyroid That Can Affect Your Mental Health
Ever wondered if your thyroid gland is playing a role in your depression, anxiety or psychosis? Problems with your Thyroid gland can mimic a number of psychiatric disorders ranging from depression, anxiety and even psychosis. It is thus extremely important that mental health professionals be aware of some important but little known facts.
Problems with your Thyroid gland can mimic a number of psychiatric disorders ranging from depression, anxiety and even psychosis. It is thus extremely important that mental health professionals be aware of some important but little known facts.
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Could Hashimotos Flare
My patient Jeanette, 42, had been diagnosed seven years earlier by her family physician with bipolar disorder. She had manic episodes of staying up late at night, buzzing with energy and working on various projects, and shopping to excess, spending money she and her husband didnt have. After these energy surges she then would crash and fall into fatigue and depression. A friend suggested she might have bipolar disorder and she brought this up with her family doctor, who prescribed her two psychiatric drugs and referred her to a psychiatrist. However her diagnosis was never re-evaluated and she eventually ended up on eight different medications, including lithium and drugs for depression, anxiety, panic attacks, and insomnia.
During her seven years of treatment she had also been hospitalized six times for complications due to her medications or for manic episodes. During the last hospitalization she had her gallbladder removed and was diagnosed with high blood sugar and Hashimotos, an autoimmune thyroid disease, and placed on thyroid hormone medication. Prior to seeing me she received twelve or thirteen electroconvulsive treatments under anesthesia during a six-month period, as prescribed by her psychiatrist.
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When To See The Doctor
A major mistake that most women make is that they often wait for problems to go away on their own and avoid consulting their healthcare provider. When sudden changes in menstrual period and flow occur, it’s a sign that something is wrong, and you should see the doctor in order to determine the cause of these irregularities and prevent potential complications in the future.
If these problems happen frequently, your doctor may want to evaluate thyroid hormone levels. In cases then thyroid conditions are to blame for menstrual irregularities proper management of those diseases could normalize your cycle as well.
You should also see your doctor if you have:
- Intense or increased menstrual cramps
- A thyroid condition and treatment, but menstrual irregularities still occur
- Heavy menstrual bleeding lasting for more than 24 hours
- Menstrual periods that last seven days or longer
- Menstrual periods that come in a shorter timeframe than what is considered normal
- Periods that stopped for about three months or longer and you are not pregnant
The Connection Between Bipolar Disorder And The Thyroid
Though the correlation between bipolar disorder and thyroid disease is complicated, understanding that there is a connection between the two can help you better treat your symptoms. You may find that one thyroid medication may diminish symptoms of both bipolar and thyroid disease without a complicated mix of antidepressants, anticonvulsants, and mood stabilizers.
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