"However, his rapid cycling between depression and mania did not improve, and withdrawing from lithium made him wildly manic. He was referred to Whybrow's Malignant Bipolar Illness Clinic at the University of Pennsylvania, in Philadelphia. There a high dose of thyroxine the hormone created in the thyroid gland, which controls how much energy the body uses was added to the lithium the patient was given."
"Whybrow and Bauer's treatment has since been replicated in many bipolar patients suffering from rapid cycling and other variants of severe and intractable bipolar illness. Many, but not all, of these patients are pre-menopausal women, where their bipolar disorder is driven by oestrogen-thyroid hormone interaction in the brain. In bipolar disease, too little thyroxine is circulating, and when a woman is pre-menopausal, the oestrous cycle fosters rapid cycling."
A 41-year-old doctor developed severe rapid-cycling bipolar symptoms years after thyroid nodule removal, alternating between weeks of lethargy and periods of manic erratic behavior. Standard lithium treatment failed and withdrawal provoked extreme mania. Addition of high-dose thyroxine to lithium promptly stopped rapid mood cycling and produced long-term stability. The combined treatment has been replicated in many patients with rapid-cycling or intractable bipolar illness. Many affected patients are pre-menopausal women whose bipolar disorder is driven by oestrogen–thyroid hormone interactions in the brain. In such cases low circulating thyroxine and lithium-induced thyroid-axis collapse can be reversed by high-dose thyroxine, helping about 75% improve.
Read at www.theguardian.com
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