EXPLORING THE INTRIGUING INTERPLAY BETWEEN THYROID DISEASES AND BIPOLAR DISORDER
Keywords:
thyroid diseases, hypothyroidism, hyperthyroidism, bipolar disorder, treatment interactions, shared risk factorsAbstract
Thyroid diseases, which include hypothyroidism and hyperthyroidism, and bipolar disorder are two separate yet interrelated areas of mental and endocrine health. Research has revealed a link between both illnesses, suggesting that thyroid dysfunction may impact the onset and prognosis of bipolar disorder, and vice versa. This review digs into the complex relationship between thyroid diseases and bipolar disorder, with an emphasis on therapeutic interactions, common risk factors, and the probable dysfunction of the Hypothalamic-Pituitary-Thyroid (HPT) axis in bipolar disorder. The purpose of this review is to thoroughly investigate the multidimensional association between thyroid illnesses (hypothyroidism and hyperthyroidism) and bipolar disorder. Among the objectives are: (1) Therapy Implications: Looking into the bidirectional effects of medications like lithium-induced hypothyroidism and the possible use of levothyroxine in bipolar therapy; (2) Shared Risk variables: Investigating the genetic, autoimmune, inflammatory, environmental, and gender-related variables that contribute to thyroid illness and bipolar disorder co-occurrence; and (3) HPT Axis Dysfunction: Investigating the possible involvement of HPT axis dysfunction in bipolar illness, as well as the consequences for mood regulation and symptom severity. The complex link between thyroid disorders and bipolar illness emphasizes the importance of ongoing studies in this area. Shared risk factors and bidirectional treatment impacts provide exciting opportunities for further investigation into the relationships between these illnesses. The possibility of HPT axis disruption in bipolar illness provides fresh insights into mood control mechanisms. As our understanding grows, targeted treatment therapies addressing both thyroid dysfunction and bipolar symptoms may develop, eventually improving the well-being of those dealing with these linked issues.
References
Ahmed, O.M., El-Gareib, A.W., El-Bakry, A.M., Abd El-Tawab, S.M., Ahmed, R.G. (2008): Thyroid hormones states and brain development interactions. – International Journal of Developmental Neuroscience 26(2): 147-209.
Aldinger, F., Schulze, T.G. (2017): Environmental factors, life events, and trauma in the course of bipolar disorder. – Psychiatry and Clinical Neurosciences 71(1): 6-17.
Bauer, M., Whybrow, P.C. (2021): Role of thyroid hormone therapy in depressive disorders. – Journal of Endocrinological Investigation 44(11): 2341-2347.
Bauer, M., Glenn, T., Pilhatsch, M., Pfennig, A., Whybrow, P.C. (2014): Gender differences in thyroid system function: relevance to bipolar disorder and its treatment. – Bipolar Disorders 16(1): 58-71.
Bauer, M., London, E.D., Rasgon, N., Berman, S.M., Frye, M.A., Altshuler, L.L., Mandelkern, M.A., Bramen, J., Voytek, B., Woods, R., Mazziotta, J.C. (2005): Supraphysiological doses of levothyroxine alter regional cerebral metabolism and improve mood in bipolar depression. – Molecular Psychiatry 10(5): 456-469.
Bauer, M., Heinz, A., Whybrow, P.C. (2002): Thyroid hormones, serotonin and mood: of synergy and significance in the adult brain. – Molecular Psychiatry 7(2): 140-156.
Bobo, W.V. (2017): The diagnosis and management of bipolar I and II disorders: clinical practice update. – In Mayo Clinic Proceedings, Elsevier 92(10): 1532-1551.
Bocchetta, A., Traccis, F., Mosca, E., Serra, A., Tamburini, G., Loviselli, A. (2016): Bipolar disorder and antithyroid antibodies: review and case series. – International Journal of Bipolar Disorders 4: 1-18.
Boukouaci, W., Oliveira, J., Etain, B., Bennabi, M., Mariaselvam, C., Hamdani, N., Manier, C., Bengoufa, D., Bellivier, F., Henry, C., Kahn, J.P. (2018): Association between CRP genetic diversity and bipolar disorder comorbid complications. – International Journal of Bipolar Disorders 6(1): 1-6.
Carmaciu, C.D., Anderson, C.S., Lawton, C.A. (2003): Thyrotoxicosis after complete or partial lithium withdrawal in two patients with bipolar affective disorder. – Bipolar Disorders 5(5): 381-384.
Carvalho, A.F., Firth, J., Vieta, E. (2020): Bipolar disorder. – New England Journal of Medicine 383(1): 58-66.
Chen, M., Jiang, Q., Zhang, L. (2021): The prevalence of bipolar disorder in autoimmune disease: a systematic review and meta-analysis. – Ann Palliat Med 10(1): 350-361.
Chakrabarti, S. (2011): Thyroid functions and bipolar affective disorder. – Journal of Thyroid Research 14p.
Czarnywojtek, A., Zgorzalewicz-Stachowiak, M., Czarnocka, B., Sawicka-Gutaj, N., Gut, P., Krela-Kazmierczak, I., Ruchala, M. (2020): Effect of lithium carbonate on the function of the thyroid gland: mechanism of action and clinical implications. – Journal of Physiology & Pharmacology 71(2): 191-199.
Dehghan, A., Dupuis, J., Barbalic, M., Bis, J.C., Eiriksdottir, G., Lu, C., Pellikka, N., Wallaschofski, H., Kettunen, J., Henneman, P., Baumert, J. (2011): Meta-analysis of genome-wide association studies in> 80 000 subjects identifies multiple loci for C-reactive protein levels. – Circulation 123(7): 731-738.
Gutman, D.A., Nemeroff, C.B. (2003): Persistent central nervous system effects of an adverse early environment: clinical and preclinical studies. – Physiology & Behavior 79(3): 471-478.
Jacobson, E.M., Huber, A., Tomer, Y. (2008): The HLA gene complex in thyroid autoimmunity: from epidemiology to etiology. – Journal of Autoimmunity 30(1-2): 58-62.
Jain, A., Mitra, P. (2020a): Bipolar affective disorder. – StatPearls Publishing 13p.
Jain, A., Mitra, P. (2020b): Catatonic schizophrenia. – StatPearls Publishing 8p.
Kato, T. (2019): Current understanding of bipolar disorder: Toward integration of biological basis and treatment strategies. – Psychiatry and Clinical Neurosciences 73(9): 526-540.
Kawahara, K., Hohjoh, H., Inazumi, T., Tsuchiya, S., Sugimoto, Y. (2015): Prostaglandin E2-induced inflammation: Relevance of prostaglandin E receptors. – Biochimica et Biophysica Acta (BBA)-Molecular and Cell Biology of Lipids 1851(4): 414-421.
Kelly, T. (2016): A hypothesis on the mechanism of action of high-dose thyroid in refractory mood disorders. – Medical Hypotheses 97: 16-21.
Kelly, T. (2015): An examination of myth: a favorable cardiovascular risk-benefit analysis of high-dose thyroid for affective disorders. – Journal of Affective Disorders 177: 49-58.
Kelly, T., Lieberman, D.Z. (2009): The use of triiodothyronine as an augmentation agent in treatment-resistant bipolar II and bipolar disorder NOS. – Journal of Affective Disorders 116(3): 222-226.
Kember, R.L., Hou, L., Ji, X., Andersen, L.H., Ghorai, A., Estrella, L.N., Almasy, L., McMahon, F.J., Brown, C., Bućan, M. (2018): Genetic pleiotropy between mood disorders, metabolic, and endocrine traits in a multigenerational pedigree. – Translational Psychiatry 8(1): 12p.
Khan, M., Jose, A., Sharma, S. (2023): Physiology, Parathyroid Hormone. – StatPearls Publishing 6p.
Kuś, A., Kjaergaard, A.D., Marouli, E., Del Greco M, F., Sterenborg, R.B., Chaker, L., Peeters, R.P., Bednarczuk, T., Åsvold, B.O., Burgess, S., Deloukas, P. (2021): Thyroid function and mood disorders: a Mendelian randomization study. – Thyroid 31(8): 1171-1181.
Lai, S., Zhong, S., Zhang, Y., Wang, Y., Zhao, H., Chen, G., Chen, F., Shen, S., Huang, H., Jia, Y. (2021). Association of altered thyroid hormones and neurometabolism to cognitive dysfunction in unmedicated bipolar II depression. – Progress in Neuro-Psychopharmacology and Biological Psychiatry 105: 10p.
Lambert, C.G., Mazurie, A.J., Lauve, N.R., Hurwitz, N.G., Young, S.S., Obenchain, R.L., Hengartner, N.W., Perkins, D.J., Tohen, M., Kerner, B. (2016): Hypothyroidism risk compared among nine common bipolar disorder therapies in a large US cohort. – Bipolar Disorders 18(3): 247-260.
Lazarus, J.H., Kirov, G., Harris, B.B. (2013): Effect of lithium on the thyroid and endocrine glands. – In Lithium in Neuropsychiatry, CRC Press 11p.
McKnight, R.F., Adida, M., Budge, K., Stockton, S., Goodwin, G.M., Geddes, J.R. (2012): Lithium toxicity profile: a systematic review and meta-analysis. – The Lancet 379(9817): 721-728.
Mishra, K.K., Sawant, N., Garg, S. (2022): Management of psychiatric disorders in patients with endocrine disorders. – Indian Journal of Psychiatry 64(Suppl 2): S402-S413.
Nefzi, R., Abid, Y., Ouanes, S., Johnson, I., Ghachem, R. (2015): Lithium Associated Hyperthyroidism. – European Psychiatry 30: 1p.
Ortiga‐Carvalho, T.M., Chiamolera, M.I., Pazos‐Moura, C.C., Wondisford, F.E. (2011): Hypothalamus‐pituitary‐thyroid axis. – Comprehensive Physiology 6(3): 1387-1428.
Parial, S. (2015): Bipolar disorder in women. – Indian Journal of Psychiatry 57(Suppl 2): 16p.
Plans, L., Barrot, C., Nieto, E., Rios, J., Schulze, T.G., Papiol, S., Mitjans, M., Vieta, E., Benabarre, A. (2019): Association between completed suicide and bipolar disorder: a systematic review of the literature. – Journal of Affective Disorders 242: 111-122.
Rosenblat, J.D., McIntyre, R.S. (2015): Are medical comorbid conditions of bipolar disorder due to immune dysfunction? – Acta Psychiatrica Scandinavica 132(3): 180-191.
Salvador, J., Gutierrez, G., Llavero, M., Gargallo, J., Escalada, J., López, J. (2021): Endocrine disorders and psychiatric manifestations. – Endocrinology and Systemic Diseases 34p.
Shine, B., McKnight, R.F., Leaver, L., Geddes, J.R. (2015): Long-term effects of lithium on renal, thyroid, and parathyroid function: a retrospective analysis of laboratory data. – The Lancet 386(9992): 461-468.
Soheili-Nezhad, S., Sprooten, E., Tendolkar, I., Medici, M. (2023): Exploring the Genetic Link Between Thyroid Dysfunction and Common Psychiatric Disorders: A Specific Hormonal or a General Autoimmune Comorbidity. – Thyroid 33(2): 159-168.
Vigo, D., Thornicroft, G., Atun, R. (2016): Estimating the true global burden of mental illness. – The Lancet Psychiatry 3(2): 171-178.
Wiersinga, W.M. (2016): Clinical relevance of environmental factors in the pathogenesis of autoimmune thyroid disease. – Endocrinology and Metabolism 31(2): 213-222.
Yatham, L.N., Kennedy, S.H., Parikh, S.V., Schaffer, A., Bond, D.J., Frey, B.N., Sharma, V., Goldstein, B.I., Rej, S., Beaulieu, S., Alda, M. (2018): Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder. – Bipolar Disorders 20(2): 97-170.
Young, A.H., Grunze, H. (2013): Physical health of patients with bipolar disorder. – Acta Psychiatrica Scandinavica 127: 3-10.
Yu, M.G., Flores, K.M., Isip-Tan, I.T. (2017): Acute mania after levothyroxine replacement for hypothyroid-induced heart block. – Case Reports 3p.
Zader, S.J., Williams, E., Buryk, M.A. (2019): Mental health conditions and hyperthyroidism. – Pediatrics 144(5): 7p.
Zhao, Y., Wang, N., Chen, J., Guan, Q., Yuan, X., Shen, Y., Zhang, X., Hao, W., Zhang, R., Zhai, D. (2022): Association between early-onset affective disorders and hypothyroidism in a larger number of psychiatric drug-free patients. – Journal of Affective Disorders 299: 31-36.
Zhao, S., Zhang, X., Zhou, Y., Xu, H., Li, Y., Chen, Y., Zhang, B., Sun, X. (2021): Comparison of thyroid function in different emotional states of drug-naïve patients with bipolar disorder. – BMC Endocrine Disorders 21: 1-7.
Zhong, S., Chen, G., Zhao, L., Jia, Y., Chen, F., Qi, Z., Huang, L., Wang, Y. (2019): Correlation between intrinsic brain activity and thyroid-stimulating hormone level in unmedicated bipolar II depression. – Neuroendocrinology 108(3): 232-243.
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