Lithium and Bipoler – Low Thyroid ?

[rontherider]

Hello Dr Mariano,

My sister has been a bipoler patient for last 15 years. She is stable now and taking the following medications.

(Lithium Carbonate) 400mg 2 tablets at bedtim
Aripiprazole 15 mg morining 2 tablets

My questions is, can this be a result of low thyroid harmone ? What test can she have done to check if she is a candidate for thyroid replacement therapy.

Ron

[hardasnails1973]

@rontherider 1909 wrote:

Hello Dr Mariano,

My sister has been a bipoler patient for last 15 years. She is stable now and taking the following medications.

(Lithium Carbonate) 400mg 2 tablets at bedtim
Aripiprazole 15 mg morining 2 tablets

My questions is, can this be a result of low thyroid harmone ? What test can she have done to check if she is a candidate for thyroid replacement therapy.

Ron

Lithium binds with iodine which lowers t-4 production.
When dealing with bi polarism Dr M nicely pointed out that one needs more t4 then t3 to feel more stabilized. It is noted that in clincal studies that people on lithium are more likely to have hypothyroid symptoms. When dealing with lithium it also binds with inositol which is an important nutrient for membrane stabilization. Had a recent patient she was on lithium and a boat load of other psycho drugs. When asked about the past. She was diagnosed with hypothyroidism at the same time bipolarism was diagnosed. We speculate that if the treating dr would have properly taken care of the thyroid then her bipolarism may have also been treated.

[DrMariano2]

@rontherider 1909 wrote:

My sister has been a bipoler patient for last 15 years. She is stable now and taking the following medications.

(Lithium Carbonate) 400mg 2 tablets at bedtim
Aripiprazole 15 mg morining 2 tablets

My questions is, can this be a result of low thyroid harmone ? What test can she have done to check if she is a candidate for thyroid replacement therapy.

Generally, a mental illness is generally a highly complex condition with multiple simultaneous underlying causes. Mental function is highly preserved, with multiple redundant systems. It takes multiple simultaneous problems to disable these systems enough to cause a mental illness. Many times, the there are several underlying issues to which the body/mind can compensate and a person can feel fairly well. However, once such a person will have a predisposition to a mental illness once additional problems occur. Once additional problems occur, the person’s capacity to compensate collapses and the person develops a mental illness.

Bipolar disorder has multiple underlying causes. One of them is suboptimal thyroid hormone signaling. If this is severe enough, it may be recognized as hypothyroidism.

Lithium, itself, can block thyroid hormone release from the thyroid gland. This is one reason thyroid levels need to be monitored while on treatment with Lithium. Lithium is not a strong anti-inflammatory agent. This is one reason it does not address rapid cycling bipolar disorder.

Generally, if using FDA Approved treatments for bipolar disorder, one will need at least 3 or more to fully stabilize a person with bipolar disorder. A good response to one or two medications is excellent. With aging and other health related changes, e.g if diabetes or cardiovascular disease occurs – both naturally and as a side effect of treatment, then additional measures may need to be taken to maintain stability.

TSH, Free T3, Total T4 are a minimal panel to help determine if a person needs thyroid hormone. It is important to correlate this with the history and exam. There are other causes of thyroid hormone signaling problems, such as systemic illness, infection, etc., which may complicate or limit thyroid treatment, even if thyroid treatment is needed.

[Houston1970]

Try four,
depakote er 1000mg
3grains armor
the lowest clinical dose of Testoserone
30 mg of Adderal

the good doc is correct the basic problem from my experience is their are few neuroenndocrinoloigists. Psychiatry and Endocronolgy are synergistic, if you stabilise on a first line mood stabiliser your stable but will still fell like crap, hormones help you feel better but for me can’t give you the stability needed to deal with high performance stress. I went to UCSd had a 4.0 and burned out by junior year. Oddly the alleged world class shrink though I was dillusional until I threw my transcript in his face. The dumbass probably could not organic chem so he problem had ochem envy. You see unlike the good man here he was so dogmatic that the patient was actual cosidered a nut untill proven innocent. I gurantee there is not one psych patient who feels on four psych meds.

Complex problems need an open mind, perservance and an integrative approach proof means feeling well. Because we are not rational minds if you used math to walk you would be shocked at the results systems need errors to work in a nonlinear world it’s called evololution

[Author]

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