Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Thyroid hormone, particularly in the form of liothyronine (T3) or levothyroxine (T4), has been investigated as an adjunctive treatment for Bipolar Mood Disorder, especially in cases that are refractory to standard mood stabilizers. The rationale stems from observations that thyroid dysfunction, notably hypothyroidism, is more prevalent among individuals with mood disorders, and that correction of thyroid abnormalities sometimes improves mood symptoms. Additionally, some patients with bipolar disorder benefit from supraphysiologic doses of thyroid hormone, even in the absence of overt thyroid disease, particularly for rapid cycling bipolar disorder.

Scientific studies, including small randomized controlled trials and open-label studies, suggest that adjunctive thyroid hormone therapy may reduce the frequency and severity of mood episodes in some patients. For example, several clinical trials have shown that high-dose levothyroxine can be effective in reducing cycling and stabilizing mood, particularly in rapid cycling bipolar disorder. However, the quality of evidence remains limited due to small sample sizes, heterogeneity in study design, and methodological weaknesses. There is not a robust body of large, high-quality randomized controlled trials to firmly establish efficacy, and the use of thyroid hormone carries risks, including cardiovascular side effects and bone loss.

In summary, while there is a scientific rationale and some preliminary evidence supporting the use of thyroid hormone in certain cases of bipolar disorder, especially rapid cycling, the overall strength of evidence is modest (rated 2/5). Use should be individualized and monitored closely by specialists.

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