Bipolar OR Hypothyroidism--PLEASE HELP

[Osc]

(I am a  bipolar patient in India.The medical knowledge and diagnostic abilities of doctors here in india are ok but not as good as the west)

I was diagnosed as bipolar a year and a half ago. I received treatment there after, but have not shown much inprovement. Now i have read alot about hypothyroidism, its symtoms etc.; and now i feel that there are high chances that I may have hypothyroidism. ( Its bad that my psychiatrist never mentioned hypothyroidism and getting its possibility ruled out).

Now i have taken a blood test for Ultra TSH, Free T4 and Free T3 levels. the levels show withing the normal lab ranges (but i have read that these normal ranges change from lab to lab), but my T3 level is on the lower side.

I will be meeting a endocrinologist , but i am scared that he will just look at the report and say that have normal thyroid levels. Somehow after knowing the symptoms of hypothyroidism, i feel that i have more chances of being hypothyroid than bipolar. And another thins is that i would be at a better position if i actually have hypothyroid as it is much easier to keep in control and bipolar is a really bad illness to have(from my experience).

Then I am stuck between my psychiatrist and the endocrinologist.
-What should i do if the endocrinologist says i have normal thyroid levels and that i am not
hypothyroid???
-How should i make sure that I am definitely do not have hypothyroidism and that I definitely am bipolar
-Which other illnesses (like hypothyroidism) I should rule out before i am definitely diagnosed as bipolar.

Your help/advice would be greatly appreciated. i am in great need of help!!

[xanweaner]

You should post your question to the medical expert, Dr. Gould. He'll give you his opinion - he's a psychiatrist on the mental health forum area.
Good luck!!

[DLA]

When you see the endocrinolotist make sure your TSH leves are between 0.3-3.0.  BUT you will probably feel hypo unless it is around 1.0.  Also make sure he checks your thyroid for nodules as this can cause all the symptoms with no changes in thyroid levels.  Have them also check your adrenal gland levels as they have much of the same symptoms as thyroid.  

Many thyroid patients are wrongly dx as bipolar or severe depression when all along it is their thyroid causing it.  Thyroid problems run from deep depression, paranoia, high anxiety levels, to even being hyperactive.

I have been there and done it all.  Very smart to have your thyroid checked.  Also lithium damages the thyroid.

Oh, and by the way, for your sake I hope it's bipolar.  IT'S the easier of the 2 to deal with.

[Osc]

I will talk to my endocrinologist today and i will consider the points you mentioned.
--How is a thyroid checked for nodules, is it a physical examination?

A very important thing i would like to ask is how is bipolar easier to deal with. I
am confused. Because i felt it was the opposite. I read that bipolar has no cure. I have been told by my psychistrist that i have to learn to live with it by reducing stress. I am in deep suffering and have found  much improvement.

On the other hand i have read that hypothyroid is easier as you just have to take thyroxine tablets and your levels come back to normal. Your symtoms go away.You can live a normal life. You can keep a constant check of your thyroid levels by blood tests (unlike bipolar in which there are no tests for if things are getting better or worse. Everything works on how i feel, and what i tell my psychiatrist and what he understands from it)

Please explain 'coz it would help. I really thought that hypothyroidism was better. That is why i am eager to meet my endocrinologist, so that if i am diagnosed as hypothyroidism I could get rid of my suffering entirely and live a normal life like everyone else.
Also is it possible that i can have both bipolar and hypothyroidism?. I will feel bad if my endo says that this is the case. ( I am not on Lithium. I am on Divalproex and Lamotrigine)

[Osc]

In most cases, symptoms of hypothyroidism start to improve within the first week after you start treatment. All symptoms usually disappear within a few months.

I read it at --------
http://www.webmd.com/a-to-z-guides/hypothyroidism-treatment-overview

[Venora Moonwind]

DL a is right the bi polar is alot easier to treat than hypothyroidismI too am thryoidless and bi polar and it takes forever to get the right synthroid dose. you have to keep tweaking and tweaking. I finally started to feel better after about 9 months of changing my synthroid dose I am now on 200 mcg and I feel pretty good. that is intereresting what you say about Doctors in India because most of docs are from India My endo and my surgeon are both from India and I love them. they have been great.
Let us know what you find out about the hypo dLAhas very good advice on what to ask your endo
Love Venora

[DLA]

Just like Venora I am thyroidless.  Hers was surgically removed b/c of cancer and mine was ablated by drinking a large dose of RadioActive Iodine (RAI).  It took me over 8 years from the onslaught of hyperthyroidism to have a regulated dose of levothyroxine that I can function with and feel normal.  I take 137mcg.

It took me about 6 months to feel better after being dx with bipolar, about 13 yrs ago, to be more stable and able to function much easier.   For almost anyone who has a thyroid problem you just don't take a pill and feel better.  And once your thyroid is damaged it is a downhill spiral with it from there unless you are one of the extreme few who actually go into remission for a time with it.

Get the thyroid checked, get a copy of your levels, and post them.  Venora and I can help you understand them better and if they are actually "normal" like the drs try to tell us.

[Osc]

I went to meet the endocrinologist today. Unfortunately he did not have time to talk with me as he already had many patients who already had appointments for today and a few who were fighting for an appointment for today. I have fixed up an appointment for Friday, March 14. So all I can do till friday is read, discuss this with you'll and do more research.

I recently read about Wilson's Temperature Syndrome and again(like hypothyroid) the symptoms seemed like I have or have had most of them.

Now, to start with, the question is---Am i Bipolar and/or Hypothyroid and/or have Wilson's syndrome???. Once I find this answers I could find the proper treatment.
(I am 23. I was 15 when the symptoms first appeared.I was a little less that 22 when i first told my sister about my sufferings and got diagnosed as bipolar)

I got my thyroid levels checked a week ago by doing a blood test at a clinic lab. Not with the endocronologist's clinic, i did it at a seperate clinic. I checked only for Ultra TSH, Free T4 and Free T3. The levels and normal ranges(as per the lab) are listed below,

Test                Value                 Normal Range                 Unit

Ultra TSH        2.11                    0.4 to 5.2                       mlU/L
Free T4           1.0                      0.65 to 2.3                     ng/dl
Free T3           1.9                      1.5 to 4.1                       pg/ml

Another thing, I checked my basal body temp (temp on wakin up) for 3 days during last week. They were,  97.0F, 96.4F, 96.8F.---I think this is low.

From tomorrow I will check my temperature, 4 times, starting 3 hours after waking up, 3 hours gap between each . I will try and maintain a chart. Hope that helps.

This is all for today. Please feel free to tell me anything you think that would help. I cannot explain how good it feels after talking with you'll. Thanks.

                        

[DLA]

Posted a question to my thyroid buddies about the "Ultra" in your TSH to see if it is different.  Will let you know as soon as I get some info back on that so I know better what I'm dealing with.

[DLA]

Okay, so I'm going to assume that it is just a normal thyroid test b/c we can't find out any differently.

A TSH of 2.11 is high enough to make you feel like cr@p!  The new standard for normal is 0.3-3.0, but most endocrinologists worth their salt won't let it go that high especially if you are symptomatic.  If my TSH goes over 1.0 I feel awful.  Your Free T's look fine going by your lab's reference ranges and I don't know much about them any more.  Will have to check on that.

The basal body temp . . .   I don't know anything about it, but I also don't think I trust it very well.  It would depend on a lot of variants from how cold the room was, if you were covered up or not, if you had been in REM sleep when waking.  So I don't know how accurate that would be.

Get the rest of the tests done and make sure you are seen and examined by an endo for nodules before ruling out the thyroid.

[Osc]

Which other thyroid tests should I do? is it total T3, total T4 also?
When i first told my psychiatrist that i want to rule out having hypothyroid, he said to get the Ultra TSH, Free T3 and Free T4 done and go to a endocrynologist. Thats why I asked only for these 3 tests from the lab. Does a Thyroid Function Test include more tests.?

I have read that in some labs normal Free T3 is 1.9 to 3.4 pg/ml. That makes my Free T3 low. I have read about T4 not being converted to T3 properly. This is called Wilson's Syndrome. The treatment to this is to take only T3 tablets. This is not approved by the US medical accociation. But i have to consider the case if my T4 is not being converted to T3.

What if I have a average general temp ( not basal but the temp i will take 4 time a day,starting 3 hours after taking up) less that 98.6F. Won't that and my symptoms be sufficient to prove anything (Hypothyroid or Wilson's)??

[DLA]

Everyone's temperature runs differently.  98.6 is the average, which means that when they tested a group of peopl--think it was 1,000--98.6 was the average out of all those people.  So a lot of people were like me and ran a really temp all the time and some run really high temps all the time.  Mine always runs around 96.0 and my husband's always runs around 99.  I use to be a CNA and I can tell you almost every one of my patients had a different temperature.  So unless you know what a normal temp is for you, you can't really use this a guide line.  To my way of thinking anyway.

You need to have the thyroid antibody tests run also.  Don't forget to have them feel for nodules on your thyroid.  As I said, they can give you all the symptoms even though levels in "normal" range.  I still think your's is a little high and more testing needs to be done.

Why don't you post over on the thyroid forum and get a lot of really good info.  Tell them Dac sent you over there and they'll treat you real special.  ;-)  There are a lot of members over there who are better with the numbers than I am.

[Osc]

Thanks DLA..............I will post a question on the thyroid forum

I am not feeling too good today. There are some other things that also bother me, like around 2 years ago I went into an high. Not very high, maybe hypomania. When i look back i find it very strange and wonder if that fits into the symptom of any illness (bipolar or hypothyroid) or was it just me going crazy. My psychiatrist has never really understood any of my past when i tell him. He just immediately says that i am bipolar and now i am in the mixed state.

Anyways, i will now move to the thyroid forum. Hope to receive a message from you soon.

[kris123]

I have both and it is very hard to maintain - if i become hyper it throws me way off and set me in a manic state