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Ask the Mental Health Expert Archives 2001-2004

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Hypothyroid with Bipolar Disorder

Q. I have been diagnosed with hypothyroid as well as mild bipolar disorder. Since my thyroid levels are still out of balance, could the bipolar be a result of the hypothroid?

A. It's possible, but by no means certain, that low thyroid function itself could cause a bipolar-like mood disorder. The research literature has not really provided final answers on this question. More likely, low thyroid function (hypothyroidism) would be an aggravating factor in a patient who already had true bipolar disorder, especially of the rapidly-cycling type (more than 4 mood swings per year). If you have a strong family history of bipolar disorder, this makes it even more likely that you would eventually have developed bipolar symptoms, even with normal thyroid function.

It's probably also likely that until your thyroid function is back to normal, medications for bipolar disorder are not going to be entirely effective. Depression tends to be especially persistent, in my experience, when even mild hypothyroidism is allowed to continue. Also-one medication for bipolar disorder, lithium, can actually cause or worsen hypothyroidism.

This doesn't mean lithium can't be used, but thyroid supplements must be provided to compensate for its effects. The bottom line: getting your thyroid function back to normal is a high priority. A psychiatrist with experience treating bipolar disorder, perhaps working in consultation with an endocrinologist, would be the best source of information and advice for you.

February 2001

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