Is Hyperthyroidism a Cause of Bipolar?

Hyperthyroidism is a condition in which the thyroid produces excess hormones. A large number of people with hyperthyroidism also have comorbid psychological conditions, the most common of which are mood issues. Evidence has shown strong associations between hyperthyroidism and depression and anxiety. Some evidence even suggests a link between hyperthyroidism and mania.

However, little research exists into the relationship between hyperthyroidism and bipolar. Further, there is little evidence demonstrating that hyperthyroidism increases the risk of bipolar. It has been well established that the thyroid affects mood and that proper regulation of the thyroid can alleviate mood issues. Research has shown that for people with depression and anxiety, symptoms of the psychological condition subside in almost equal proportion to the reduction of thyroid hormone secretion when properly treated.

This is not the case for those with bipolar, however. Rather than experiencing a proportionate reduction in symptoms, individuals with bipolar often continue to have symptoms after the thyroid production has been stabilized. This poses the questions: what is the relationship between the two, and what impact does the thyroid have on bipolar?

In an effort to answer these questions, Li-Yu Hu of the Department of Psychiatry at Yuli Veterans Hospital in Taiwan recently conducted a longitudinal study on over 42,000 Taiwanese residents, half of whom had a diagnosis of hyperthyroidism. The participants included in the study received medical care between the years of 2000 and 2010. According to national Health Insurance records, the participants with hyperthyroidism were much more likely to have bipolar than the participants without hyperthyroidism. Further, women with hyperthyroidism, participants with asthma, and those with alcohol abuse issues were even at greater risk of developing bipolar.

Existing psychological research has provided support for asthma and alcohol use as being risk factors for mental health problems. However, in this study, Hu believes that perhaps asthma, which is an inflammatory condition, could be physiologically related to immune activation and thus, bipolar. Also, women may be more vulnerable to mood problems and in particular, bipolar, because the hyperthyroidism combined with the natural production of estrogen could act as an increased metabolic liability.

Although the reason for the increased prevalence of bipolar in hyperthyroidism participants is unclear, the results presented here provide evidence of a clear risk relationship. “Based on our data,” added Hu, “We suggest that more attention should be focused on female patients, patients with alcohol use disorders, and those with asthma following a diagnosis of hyperthyroidism.”

Reference:
Hu, L.-Y., Shen, C.-C., Hu, Y.-W., Chen, M.-H., Tsai, C.-F., et al. (2013). Hyperthyroidism and risk for bipolar disorders: A nationwide population-based study. PLoS ONE 8(8): e73057. doi:10.1371/journal.pone.0073057

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  • AmyH

    AmyH

    September 20th, 2013 at 3:46 AM

    Many years ago I was diagnosed with an over active thyroid and I was also very depressed but the doctors then said that was very unusual, that typically under active thyroid and depression went hand in hand and that made me feel kind of crazy because I knew what I was feeling and they were basically telling me I was wrong. I am glad that I got the right physical diagnosis and I do have that under control now but at least now I have some little validation that the other wasn’t all in my head, that it wasn’t strange to be depressed with this physical issue too, and I wish that the doctors I had seen had of been a little more open minded about the whole thing instead of just trying to tell me otherwise.

  • Caldwell

    Caldwell

    September 21st, 2013 at 10:07 AM

    I suppose that in ceryain situations you bcould say that the two things go hand in hand but of course not every single time. Not eveyr single person who has an over active thyroid is going to exhibit symptoms of bipolar disorder, and not everyone with bipolar is going to show signs of having an over active thyroid. It could merely be coincidental that in some cases these two things happen to present in the same patient at the same time. Doesn’t mean that this is always going to happen, just in certain cases.

  • p

    p

    October 22nd, 2014 at 3:12 PM

    I believe that hyperthyroidism can cause mania. It happened to me. I’ve never had an issue before. My thyroid medication was too high and caused a variety of psychological issues. Once they regulated the medication all of the psychological symptoms disappeared. I would assume I would still have issues if there was more going on other than an out of whack thyroid. I’ve also been reading tons of articles and there is an association between thyroid disregulation and depression. I have not experienced that, but the other was pretty frightening.

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