Naturopathic doctors have long used thyroid-balancing strategies in managing mood disorders. Naturopathic doctors are trained experts in detecting hormone imbalances and interactions between hormones. Thyroid problems can come from many different sources; pituitary, primary thyroid problems, thyroid conversion problems, and even thyroid hormone receptor resistance. Furthermore, naturopathic doctors have more than just one thyroid medicine at their disposal and prescribe T4, T3, combinations of T4 and T3, and other natural substances that help the body better utilize hormones.
Why worry about thyroid?
1. More patients with bipolar disorder are overtly hypothyroid than the general population.
2. Even slightly low thyroid function leads to poor treatment response.
3. Some medications alter thyroid function such as lithium and possibly Seroquel.
4. Thyroid hormone replacement repeatedly shows positive results in bipolar disorder ever since its first report in the early 1900’s.
5. High-dose thyroid is an effective mood stabilizer, and helps prevent further mood episodes.
How do you use thyroid hormone?
At Fountainhead clinic we first test for thyroid problems by ordering a full array of thyroid labs including: TSH, T4, T3, fT4, fT3, and T3 uptake. If these tests are positive, the patient has overt hypothyroidism and needs thyroid medication. We consider a TSH cutoff value of greater than 2.0 to be problematic. We also find body temperature an accurate measure of very subtle subclinical thyroid dysfunction when TSH is normal. Patients measure their body temperature using a basal body thermometer, on waking, 10 AM, 3 PM, and 8PM. Thyroid problems are considered if mid-day temperature readings never reach 98.6.
If you would like to purchase a reliable thermometer click here.
If we use thyroid, it is a tool to aid response to other therapies, both natural and conventional. We find without thyroid balance patients respond poorly and rarely achieve happy, stable moods.
When indicated, we use high-dose thyroid therapy and have found surprisingly good results. Patients who have rapid cycling bipolar disorder benefit with or without other mood stabilizers.
What about the risks?
At Fountainhead Clinic, we discuss the risks of high dose thyroid with all patients. The two largest risks are osteoporosis and heart arrhythmias. Recent studies indicate the osteoporosis risk is very minimal but we still take precautions by giving extra nutrients that support bone health. With arrhythmias, we occasionally have patients tested to ensure this is not happening.
What form of thyroid do you use?
Most commonly we will use USP thyroid, also known as Armour thyroid. This form of thyroid contains 38 mcg of T4, 9 mcg of T3, and trace amounts of T2 per grain. We find the combination of T4, T3, and T2 often works far better than T4 therapy alone.
Occasionally, we prescribe sustained release T3 using Wilson’s Protocol. This option is selected if the patient has normal TSH but low body temperatures, or if high dose thyroid is risky (osteoporosis risk, or cardiovascular disease risk).
Is there research supporting the use of thyroid hormone in bipolar disorder?
Yes, see the research article below.
Thyroid Review Article to bring to your physician Click Here.