Association between bipolar affective disorder and thyroid dysfunction

Krishna, Vinay; Thunga, Ravish; Unnikrishnan, Bhaskaran; Kanchan, Tanuj; Bukelo, Mario Joseph; Mehta, Rajesh; Venugopal, Anand

doi:10.1016/j.ajp.2012.08.003

Cited by 32 publications

(21 citation statements)

References 22 publications

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“…Despite the presence of elevated T4 concentrations TSH levels tend to be normal in depressive patients, but circadian variation of TSH concentration is impaired (339–342) and the response to TRH test is blunted (323). Both total and free T3 concentrations are reduced in MD (175, 176, 343), but elevated in bipolar I disorder (237, 344). Concomitantly, rT3 concentrations are temporarily increased in both MD and manic disorder; however, not in bipolar I disorder (334, 345, 346).…”

Section: Thyroid Allostasis In Various Physiological and Pathologicalmentioning

confidence: 98%

Thyroid Allostasis–Adaptive Responses of Thyrotropic Feedback Control to Conditions of Strain, Stress, and Developmental Programming

Hoermann²,

et al. 2017

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The hypothalamus–pituitary–thyroid feedback control is a dynamic, adaptive system. In situations of illness and deprivation of energy representing type 1 allostasis, the stress response operates to alter both its set point and peripheral transfer parameters. In contrast, type 2 allostatic load, typically effective in psychosocial stress, pregnancy, metabolic syndrome, and adaptation to cold, produces a nearly opposite phenotype of predictive plasticity. The non-thyroidal illness syndrome (NTIS) or thyroid allostasis in critical illness, tumors, uremia, and starvation (TACITUS), commonly observed in hospitalized patients, displays a historically well-studied pattern of allostatic thyroid response. This is characterized by decreased total and free thyroid hormone concentrations and varying levels of thyroid-stimulating hormone (TSH) ranging from decreased (in severe cases) to normal or even elevated (mainly in the recovery phase) TSH concentrations. An acute versus chronic stage (wasting syndrome) of TACITUS can be discerned. The two types differ in molecular mechanisms and prognosis. The acute adaptation of thyroid hormone metabolism to critical illness may prove beneficial to the organism, whereas the far more complex molecular alterations associated with chronic illness frequently lead to allostatic overload. The latter is associated with poor outcome, independently of the underlying disease. Adaptive responses of thyroid homeostasis extend to alterations in thyroid hormone concentrations during fetal life, periods of weight gain or loss, thermoregulation, physical exercise, and psychiatric diseases. The various forms of thyroid allostasis pose serious problems in differential diagnosis of thyroid disease. This review article provides an overview of physiological mechanisms as well as major diagnostic and therapeutic implications of thyroid allostasis under a variety of developmental and straining conditions.

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Section: Thyroid Allostasis In Various Physiological and Pathologicalmentioning

confidence: 98%

Thyroid Allostasis–Adaptive Responses of Thyrotropic Feedback Control to Conditions of Strain, Stress, and Developmental Programming

Hoermann²,

et al. 2017

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“…An association between the thyroid economy and bipolar disorder—and particularly rapid cycling—is evident from clinical and research studies. Patients with bipolar disorder are more likely to have thyroid abnormalities than healthy individuals . Thyroid dysfunction is also associated with poor treatment response in bipolar depression and mixed states .…”

Section: Introductionmentioning

confidence: 99%

“…Patients with bipolar disorder are more likely to have thyroid abnormalities than healthy individuals. 8,9 Thyroid dysfunction is also associated with poor treatment response in bipolar depression 10 and mixed states. 11 In an early study of 30 patients with rapid cycling, 23% were found to have grade I hypothyroidism, while 27% had grade II and 10% grade III.…”

mentioning

confidence: 99%

Adjunctive thyroid hormone treatment in rapid cycling bipolar disorder: A double‐blind placebo‐controlled trial of levothyroxine (L‐T₄) and triiodothyronine (T₃)

et al. 2018

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“…Researchers also found that hyperthyroidism may increase the risk of developing BD [19]. Higher tri-iodothyronine (T3) hormone was found in BD patients [20]. A recent study in BD found that using total tri-iodothyronine (TT3) as an adjunctive treatment could augment and accelerate treatment response to medicines, such as antidepressants and lithium, especially for treatment-resistant bipolar II depression [21].…”

Section: Introductionmentioning

confidence: 99%

Correlation between Intrinsic Brain Activity and Thyroid-Stimulating Hormone Level in Unmedicated Bipolar II Depression

et al. 2019

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Background/Aims: Although abnormalities of amplitude of low-frequency fluctuations (ALFF) and hormone levels of hypothalamus-pituitary-thyroid axis have been reported in patients with bipolar disorder (BD), the association between abnormal ALFF and serum thyroid hormone levels remains unknown. Method: A total of 90 patients with unmedicated BD II depression and 100 healthy controls (HCs) underwent resting-state functional magnetic resonance imaging, and then routine band (0.01–0.1 Hz), slow-5 band (0.01–0.027 Hz), and slow-4 band (0.027–0.073 Hz) ALFF analysis were performed. Additionally, serum thyroid hormone levels including free tri-iodothyronine (FT3), total tri-iodothyronine (TT3), free thyroxin (FT4), total thyroxin (TT4), and thyroid-stimulating hormone (TSH) were detected. The correlation between abnormal serum thyroid hormone levels and ALFF values in patients with BD II depression was calculated. Results: Compared with the HCs, patients with BD II depression showed decreased ALFF in bilateral precuneus (PCu)/posterior cingulate cortex (PCC) in routine and slow-4 frequency bands, decreased ALFF in the right PCu, and increased ALFF in the right middle occipital gyrus (MOG) in the slow-5 frequency band. Additionally, patients with BD II depression showed lower TSH level than HCs, and TSH level was positively correlated with ALFF values in the bilateral PCu/PCC in the routine frequency band. Conclusions: These findings suggest that patients with BD II depression display intrinsic activity abnormalities, mainly in the PCu/PCC and MOG, which are associated with specific frequency bands. Moreover, altered intrinsic activity in the PCu/PCC may be related to TSH levels in bipolar II depression.

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Association between bipolar affective disorder and thyroid dysfunction

Cited by 32 publications

References 22 publications

Thyroid Allostasis–Adaptive Responses of Thyrotropic Feedback Control to Conditions of Strain, Stress, and Developmental Programming

Thyroid Allostasis–Adaptive Responses of Thyrotropic Feedback Control to Conditions of Strain, Stress, and Developmental Programming

Adjunctive thyroid hormone treatment in rapid cycling bipolar disorder: A double‐blind placebo‐controlled trial of levothyroxine (L‐T₄) and triiodothyronine (T₃)

Correlation between Intrinsic Brain Activity and Thyroid-Stimulating Hormone Level in Unmedicated Bipolar II Depression

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Association between bipolar affective disorder and thyroid dysfunction

Cited by 32 publications

References 22 publications

Thyroid Allostasis–Adaptive Responses of Thyrotropic Feedback Control to Conditions of Strain, Stress, and Developmental Programming

Thyroid Allostasis–Adaptive Responses of Thyrotropic Feedback Control to Conditions of Strain, Stress, and Developmental Programming

Adjunctive thyroid hormone treatment in rapid cycling bipolar disorder: A double‐blind placebo‐controlled trial of levothyroxine (L‐T4) and triiodothyronine (T3)

Correlation between Intrinsic Brain Activity and Thyroid-Stimulating Hormone Level in Unmedicated Bipolar II Depression

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Adjunctive thyroid hormone treatment in rapid cycling bipolar disorder: A double‐blind placebo‐controlled trial of levothyroxine (L‐T₄) and triiodothyronine (T₃)