# Bipolar & Lithium - Hyperthyroidism?



## Dear Prudence (Sep 21, 2014)

Hello there. I'm new here & wanted to see if anyone had anything to say about this.

I'm a 33 year old female who was diagnosed with Bipolar Disorder seven years ago. I have been through all the meds there & back, but Lithium has been a constant. I have lab work done every 6 - 12 months to check my thyroid among other things & they have always been normal. The most recent test came back with different results though. She only tests two things & they were:

TSH .005 (.3 - 4.1)
Free T4 1.6 (.76 - 1.46)

After seeing such a low TSH, she wanted to retest in case it was an error. So, a week later I did it again & it came back:

TSH .005 (.3 - 4.1)
Free T4 1.54 (.76 - 1.46)

Does this indicate Hyperthyroidism? I read Lithium can cause Hypothyroidism which is why I'm surprised by the results. Also, is it normal for Free T4 to change like that?

As far as symptoms go, I sleep 11 hours a night & still feel like I could go to bed at anytime. I have major anxiety, but am also diagnosed with Generalized Anxiety Disorder. I feel like I have no motivation. I'm sometimes really aware of my heart beating & feel like it is beating hard & too fast. I especially feel it when I lay down in bed at night. I have shortness of breath, especially when I bend over. My hands sometimes shake & I feel like I'm STARVING all the time. Also, my skin has been breaking out more than usual.

Does this sound like Hyperthyroidism? It is hard to tell about symptoms because of my other disorders. I have an appointment with a Nurse Practitioner next Tuesday & don't know what to expect. Thank you for any insight you may have!


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## joplin1975 (Jul 21, 2011)

You do appear to be hyperthyroid. A free t3 test would be really helpful, as would testing your antibodies (I think you might want to start with TSI, TPO, and thyroglobulin & thyroglobulin AB). You might also request an ultrasound of your thyroid.


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## creepingdeath (Apr 6, 2014)

Just googled:

Lithium can be associated with the development of hyperthyroidism also.

check out the link:

http://thyroid.about.com/od/relatedconditions1/a/lithium_bipolar.htm


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## Lovlkn (Dec 20, 2009)

> Does this indicate Hyperthyroidism? I read Lithium can cause Hypothyroidism which is why I'm surprised by the results. Also, is it normal for Free T4 to change like that?


You are definitely hyper. Request the testing that Joplin 1975 listed and post the lab's with ranges.


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## Dear Prudence (Sep 21, 2014)

Thank you so much for the replies & link. Any advice on what to say to request those tests? I'm a very timid person & don't usually speak up, especially in situations like that. Also, is being irritable a symptom of Hyperthyroidism? I forgot to list that as something I'm experiencing, but it can also be the sign of a Bipolar episode. Between my disorders, side effects of the medicines I take & possible Hyperthyroidism, things can get very confusing.


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## Andros (Aug 26, 2009)

TSI
Normally, there is no TSI in the blood. If TSI is found in the blood, this indicates that the thyroid stimulating immunoglobulin is the cause of the of a person's hyperthyroidism.
http://labtestsonline.org/understanding/analytes/thyroid-antibodies/tab/test
(Copy and paste into your browser)

Trab
http://www.ncbi.nlm.nih.gov/pubmed/17684583
(Copy and paste into your browser)

Understanding the Thyroid: Why You Should Check Your Free T3
http://breakingmuscle.com/health-medicine/understanding-thyroid-why-you-should-check-your-free-t3
(Copy and paste into your browser)

Grave's psychotic
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1324966/
(Copy and paste into your browser)

bipolar/thyroid disease
http://www.psycheducation.org/thyroid/introduction.htm
(Copy and paste into your browser)

(hyperthyroid)
http://ajp.psychiatryonline.org/article.aspx?articleID=140934

http://www.drrichardhall.com/Articles/hashimoto.pdf
(Copy and paste into your browser)

It does sound hyper. You need a FREE T3 test and.................................

Did you know that hyperthyroid can mimic bipolar? Yes it can.

Information above which could be helpful to you and your doc.

Welcome to the board!


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## webster2 (May 19, 2011)

Ask to have a complete set of thyroid tests done including the Frees to get a better picture of what is going on. I have had to come out and say that I work to pay for my insurance, my insurance covers these tests so let's get on with it. I have not been refused. Don't be timid, you want to feel well. Take someone with you, if it will help. Discuss with them ahead of time what you want to say and what you want to come away with. It is also good practice for when you are with the doctor to have said these things before. Take a list to remind you of what you want to talk about.

I seriously thought I was bipolar when I was hyperthyroid (untreated) for 2 years. It was blown off as menopause. If you are bipolar and hyper at the same time, you must feel terrible. Oh boy, irritable, is mild for what I felt like! I had such awful mood swings and could not reign in my emotions, nearly lost my job & marriage. I hope that you will get definitive answers and the correct treatment soon. Hang in there!


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## Dear Prudence (Sep 21, 2014)

Thanks so much for the replies & helpful links!

I do think I actually have Bipolar Disorder because it went untreated for seven years before I was diagnosed seven years ago. I've had at least one (usually two) blood test(s) a year to check my thyroid for the past seven years & they always came back normal. So this Hyperthyroidism is a recent thing.

I did want to ask if vertical ridges in your fingernails are a sign of Hyperthyroidism? I read that they can mean iron deficiency, poor digestion and absorption of food & poor protein metabolism. Does that stuff have a connection to your thyroid? I tried googling this stuff, but everything is so overwhelming. I was hoping one of you had an answer.


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## creepingdeath (Apr 6, 2014)

Thyroid disease does cause vertical ridges on your nails hypo or hyper.

They can also be caused by other conditions also.

Can also be apart of getting older.

check out topic I posted awhile back by clicking on link below.

http://thyroidboards.com/forums/topic/10790-nail-beading-ridges/?hl=ridges


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## Dear Prudence (Sep 21, 2014)

Sorry, I should've searched the forums for ridges. Some of my nails are worse than others too, but I think that is the only sign something is wrong with them. I will definitely bring it up at my appointment.

I have another question about lab results. Obviously, I need to ask for a copy, but how do you get it? Do you make an appointment to discuss the results or do they call you or what? Some of the reports are long so I don't see them reading that to you over the phone. I will be super anxious to find out the results.


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## creepingdeath (Apr 6, 2014)

If you are in the United States by law you have the right to copies of any lab work or studies.

You should be able to either have your Doctor print them out and you can pick them up or have them send them to you in the mail or via email.

Don't be afraid to stand up for your rights.

Remember these Medical professionals work for you.


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## joplin1975 (Jul 21, 2011)

You can just go to your doctor's office (you usually need to show ID) and request a copy.


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## Dear Prudence (Sep 21, 2014)

Thanks. Hopefully they can send them to me because the office is 30 minutes away & I have a lot of anxiety driving. It seems like they are important to have though so I will pick them up if I have to. Thanks again for all your help. You guys really know what you are talking about & are super friendly too.


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## Dear Prudence (Sep 21, 2014)

Well, my appointment is finally in two days. I'm writing down things to discuss & was wondering if you guys could tell me what to say as to WHY I'm requesting Free T3, TSI, TPO, Thyroglobulin & Thyroglobulin AB?


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