Well, at least now I’m dealing with a concrete reason for the weight gain.

After donating yet more blood to a handful of vials, it seems my thyroid has decided to quit functioning at optimum capacity.  Not that this really comes as a surprise – thyroid disease runs in my family.

In an odd way I am very relieved.

At least I no longer have to fight with my two psychiatrists about my suspicion something is going on medically that is causing the weight gain.  We’ve got it!  Hard, empirical data.  Why they never counted the rising numbers on my scale as heavily as the lab results numbers is hard to believe.  (Sorry, couldn’t resist.)

I’m not going to bore everyone with a lot of facts, stats, etc about thyroid and Bipolar, but there are two items I found of particular interest. First, I just can’t resist this little snippet from NIMH’s Bipolar information page:

People with bipolar disorder are also at higher risk for thyroid disease, migraine headaches, heart disease, diabetes, obesity, and other physical illnesses.10, 11 These illnesses may cause symptoms of mania or depression. They may also result from treatment for bipolar disorder.

Let’s read that last sentence again.  Yup – I’ll never know whether the treatment caused or had a hand in the thyroid disease or not.

The second is from Journal of Thyroid Research [Volume 2011 (2011), Article ID 306367, 13 pages doi:10.4061/2011/306367]  Thyroid Functions and Bipolar Affective Disorder by Subho Chakrabarti  

There is now more or less incontrovertible evidence that, apart from their developmental effects on the CNS, thyroid hormones have major effects on the metabolic activity of the mature brain. Mood disorders are intimately associated with suboptimal thyroid function. Although comparatively less investigated, increasing evidence has shown that HPT axis dysfunction is relevant to the aetiopathogenesis, course, treatment, and outcome of bipolar disorder. Hypothyroidism either overt or more commonly subclinical appears to the commonest abnormality found among patients with bipolar disorder. It is also likely that the prevalence of thyroid dysfunction is greater in patients with rapid cycling and more refractory forms of the disorder. Lithium has potent anti-thyroid effects and can induce hypothyroidism among patients on this treatment; alternatively, it can exacerbate a preexisting hypothyroid state. Even minor perturbations of the HPT axis in the normal range have the potential to affect the outcome of bipolar disorder. Awareness of this fact is required among clinicians, and patients should be carefully monitored and managed for HPT axis dysfunction.

(Bold added by me.)

I urge everyone out there to have your GP check your thyroid panel during your regular physical.  I am a bad example of a good patient – I have physicals every two years instead of annually.  If I hadn’t stormed my psychiatrists’ offices with my weight gain complains, I would never have had yet more blood work done for some time and my thyroid problem would have gone undiagnosed for another year at least.

Do it – ask for the test – and don’t back down if they tell you it’s only your T4 that’s out of whack.  Insist on follow-up.  That deficient T4 number could be a huge culprit in what ails you.  Insisting on follow-up could wind up saving you a while lot of heartache (and a lot of money when you really don’t have to buy that new wardrobe.)