Treatment with T3 triiodothyronine thyroid hormone for treatment resistant depression with bipolar illness.

[Suzanne River]

Hi, I am new to this forum.... I have had a recent experience with a remarkable change in mood after my internist doubled the dose of T3 which she had started me on because I had a deficiency. About the time I began the higher dose I went from feeling extremely depressed to feeling optimistic, serene, grounded, and even, dare I say it, happy ? ! ?? I am trying to figure out if T3 is a magic bullet for me or if the mood shift was just a coincidence. I would be grateful to hear of anyone's experience with this,,,,, or any other related issues. Thank you !

[Merry]

Hi Suzanne,

I was just reading the latest edition of bp Magazine, and there's an article on research done by the Depression and Bipolar Clinic of Colorado. Researchers studied patient records of people with bp II or bp NOS who had on average been unsuccessfully treated with 14 medications. After starting T3 treatment, 84% had improved symptoms, and a third experienced full remission. No switch to hypomania for any of the folks studied on T3. So they conclude that T3 appears "helpful as an add-on treatment for people with bipolar II disorder who experience treatment-resistant depression, or for people with what's known as bipolar disorder not otherwise specified (NOS) who also have treatment-resistant depression."

I think I'll mention this to my psychiatrist. Thanks for sharing your experience.

[Chocoholic99]

As a result of the article, I brought this up with my psychiatrist, who thought it was worth a try - he has used with other patients with various results. I took it in the AM, once on full dose, started sleeping 4 -6 pm and then only 3 hours 5 - 7 am, when I had been sleeping through the night. We've pulled it out for a month, and may try again in a month, taking it at a different time of day. I didn't switch to hypomania.
However, what works for some doesn't work for others and vice versa.

[joecol]

People suffering from anxiety, panic, stress and depression should consult a specialist and only then should use the medicine, as there can be various reasons behind the disorder. Medicines used to cure such disorders are habit forming and should be used for small duration. As per my personal experience, I have used Xanax and it helped me in getting over my panic and anxiety disorder. You can have all necessary information about this on http://www.xanax-effects.com Along with medicine, the concerned person should take a break from his/her regular schedule, go out and take good sleep.

[Chocoholic99]

It would be nice if meds could be used only for short durations but serious illness has to be treated seriously.
Some diseases have no cures, only meds that might be able to manage some of the symptoms. Someone with diabetes would not be told to "take a break" from their medications. Someone with serious mental illness who "takes a break" from their meds could end up ending their life. I am pleased to hear that you have been able to get over your panic and anxiety disorder.

Some people with mental illness live with it every day of their life, with no breaks.

[Sarah]

The relationship between thyroid and bipolar is really interesting. I have also benefited from taking T3 - I am not saying it has cured my bipolar, but it has helped with my symptoms and it turns out that many people with bipolar disorder are also hypothyroid. According to Drs Goodwin and Jamison in their textbook "Manic-Depressive Illness: Bipolar Disorders and recurrent Depression": “Thyroid dysfunction associated with bipolar disorder is a significant problem”.

People who have a thyroid gland that is not functioning properly are more likely to have bipolar disorder, panic disorder, OCD, major depression, and/or a whole range of other mood disorders than the population in general. Research such as the STEP-BD clinical study has shown that the connection between thyroid problems and bipolar disorder is far more common amongst women than men.

Also, Bipolar II or “soft bipolar” is more strongly connected to thyroid disorders than Bipolar I. There is also a link between rapid cycling and hypothyroidism. (Hypothyroidism, which means an under-active thyroid is the most frequent manifestation of thyroid dysfunction.)

The way I see it, ALL people suffering from bipolar disorder should also be carefully screened by their doctor(s) for the other mental and physical health complications that commonly occur along with bipolar, for example substance abuse, anxiety disorders, heart disease, diabetes and so forth. However, based on the information above, it is particularly important that ALL WOMEN WITH BIPOLAR II ALWAYS BE CHECKED FOR AN UNDER-ACTIVE THYROID. As I said, I am not cured of bipolar, but both my physical health and mooods are much better now that I take T3.

[Chocoholic99]

Sarah -
I agree with you re testing thyroid. In my case, I had had been told all my life that I had a normal thyroid - and that it was my understanding that T3 might also be benefit even for people with a functioning thyroid. Most people never get to a p-specialist and someone with bipolar may spend 8 years before they get a correct diagnosis.

I'm not sure why you refer to Bipolar II as the "soft bipolar"? There is nothing soft about rapid cycles several times a day (before we sorted out some of the issues) Now the daily rapid cycles are more under control, but my meds have to be adjusted about 6x time per year, as the seasons/light changes/life/etc. Even now, I still feel like I carry a heavy blanket all the time that I can't get lifted off.

[Sarah]

Sorry - did not mean to offend with use of the expression "soft bipolar" or to minimize the dificulties involved. I have seen Bipolar II referred to as "soft bipolar" and understood this to be an alternative term, but certainly did not mean to suggest there is anything trivial about it.

The whole issue of what is a "normal" thyroid is really confused and I personally believe it might make sense to diagnose based on symptoms as well as blood tests because there is so much controversy about what the correct range should be. If people will forgive a long post, I can share what I have learned through doing some research:

Usually when someone has have blood work done, the doctor will base treatment decisions on what the lab where your blood was tested has flagged as “out of range” versus “normal” in their report. Currently, the majority of US labs report the "normal" reference range for the Thyroid Stimulating Hormone (TSH) as being between 0.5 – 5.0.

However, as long ago as January 2003, American Association of Clinical Endocrinologists, started advising doctors that a more accurate range would be a range of TSH level from 0.3 - 3.0. This means that based on the latest medical evidence, millions of Americans have low thyroid function in the TSH range of 3.0 – 5.0 but are not getting identified in the lab reports relied on by their family doctor. Using the updated range would put 20% of the population as hypothyroid, as opposed to just 5% as measured now. Some experts even believe the correct range should be even narrower, at 0.4 - 2.5. (You can read a simple description of the research on About.com’s Thyroid Testing webpage.)

THIS MEANS YOU COULD BE HYPOTHYROID, DESPITE WHAT A BLOOD TEST SAYS.

On top of the confusion around testing ranges, studies have shown that many people with bipolar disorder, particularly those who are in depressive episodes, have “subclinical” low levels of thyroid hormone – they do not meet the “official” diagnosis of hypothyroid with a TSH of over 5.0, but their TSH is still at the low end of the scale.

From what I can figure out, it boils down to this: thyroid malfunction is a very important complication in bipolar disorder, but is commonly overlooked. It is really important that anyone diagnosed with bipolar have their thyroid function tested immediately. Even if thyroid function level is low but “normal” (that is, if TSH is in the range of 2.5 – 5.0), or definitely low by even the out-dated standard (TSH over 5.0), then starting thyroid supplementation immediately is likely to be highly beneficial (but this a personal opinion - I am not a doctor.)