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.”
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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