Thyroid Hormone for Rapid-Cycling Bipolar Disorder?

Thyroid Hormone for Rapid-Cycling Bipolar Disorder?

Thyroid Hormone for Rapid-Cycling Bipolar Disorder?

Thyroid Hormone for Rapid-Cycling Bipolar Disorder? Not a good Idea.

 

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Dr.Guttler’s comments:

  1. Making Bipolar patients thyrotoxic from an overdose of T4 with TSH <0.1 is a short term solution at best.
  2. Long term effects of excess T4 thyroid hormone builds over time beyond 3 months of the study.
  3. heart,bone and other bad effects for long term excess thyroid hormone has been well studied in thyroid cancer patients to be detremental.
  4.  please stop doing this and others Do Not Try this on their Bipolar patients.

T4, but not T3, is effective.

https://www.jwatch.org/na46981/2018/06/29/thyroid-supplementation-treating-rapid-cycling-bipolar

Rapid-cycling bipolar disorder is common and refractory to treatment. Thyroid medications, predominately levothyroxine (L-T4) for bipolar depression, have been tested but mostly in open-label studies. These researchers conducted a double-blind, randomized, placebo-controlled study of L-T4 and triiodothyronine (T3) in euthyroid patients with rapid-cycling bipolar disorder (≥4 episodes/year) who were receiving therapeutic levels of lithium.

The original study was powered for 60 patients, but only 32 patients were studied (mean age, 36; 22 women). Doses, adjusted weekly, were increased until treatment goals were met (L-T4: free T4 index, 4.5–7.5 units or thyroid-stimulating hormone, <0.1 units; T3: T3-resin uptake, 0.65–1.36 units). At baseline, eight patients had histories of hypothyroidism, and seven were on supplementation.

During a minimum follow-up of 3 months (medians across groups, 15.6–16.6 weeks), the L-T4 group spent significantly less time depressed or in mixed states and more time in euthymia than the placebo group; time in the manic phase did not differ between groups. T3 produced no significant findings, but the authors noted a pattern of effects similar to that with L-T4. Adverse effects included hot flashes/sweating with L-T4 and mild tremor with both L-T4 and T3. Response was not related to baseline thyroid status.

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