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Euthyroid hyperthyroxinemia and rapid cycling affective disorder: case report.

R D Alarcón, J R Shirriff, E E Kern

    The Journal of Clinical Psychiatry
    |February 1, 1985
    PubMed
    Summary

    Rapid cycling bipolar disorder may elevate thyroid hormone (T4) levels, challenging the idea that hypothyroidism causes this condition. This suggests euthyroid hyperthyroxinemia could play a role in bipolar disorder progression.

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    Area of Science:

    • Endocrinology
    • Psychiatry
    • Thyroid Hormone Regulation

    Background:

    • Rapid cycling bipolar illness presents significant clinical challenges, characterized by frequent mood episodes.
    • A case study highlights a 32-year-old woman experiencing 19 affective episodes and 6 hospital admissions over 34 months.

    Observation:

    • Persistent hyperthyroxinemia (elevated thyroxine levels) was consistently observed during manic episodes.
    • Diagnostic work-up excluded primary thyroid dysfunction, identifying oral contraceptives, appetite suppressants, and the psychiatric condition itself as potential contributors to high T4.

    Findings:

    • The study questions the hypothesis that underlying thyroid hypofunction (underactive thyroid) is the primary driver of rapid cycling bipolar disorder.
    • Elevated T4 levels in the absence of overt thyroid disease (euthyroid hyperthyroxinemia) were noted.

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    Implications:

    • Bipolar disorder itself may contribute to increased T4 levels.
    • Further research is needed to understand the role of euthyroid hyperthyroxinemia in the pathogenesis and progression of rapid cycling bipolar disorder.