Evidence supporting the use of: Thyroid
For the health condition: Bipolar Mood Disorder

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Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Thyroid hormone, particularly in the form of levothyroxine (T4) or liothyronine (T3), has scientific support for adjunctive use in treating Bipolar Mood Disorder, especially in cases that are resistant to standard mood stabilizers. Several studies and case reports have shown that thyroid supplementation can enhance the effectiveness of mood stabilizers such as lithium, valproate, and carbamazepine, particularly for rapid-cycling bipolar disorder and treatment-resistant depression within bipolar disorder. The rationale stems from the observation that thyroid dysfunction, even subclinical hypothyroidism, is more prevalent in individuals with bipolar disorder and may worsen mood symptoms or interfere with treatment response.

Randomized controlled trials and open-label studies suggest that supraphysiologic doses of T4 or the use of T3 can have mood-stabilizing effects and may help reduce cycling frequency or improve depressive symptoms. However, the number of high-quality, large-scale studies is limited, and most evidence comes from smaller clinical trials and case series. Professional guidelines, such as those from the American Psychiatric Association, mention thyroid hormone augmentation as a consideration in treatment-resistant cases, particularly for rapid-cycling forms. Routine use in all bipolar disorder cases is not supported.

In summary, there is moderate scientific evidence supporting the adjunctive use of thyroid hormone in specific, treatment-resistant cases of bipolar mood disorder, but it is not a first-line therapy and should be considered on a case-by-case basis under specialist supervision.

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