HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

question-icon

Diagnosed With Bipolar 2. On Levothyroxine. Will Lowering Levothyroxine Make Me Hypo-manic Again?

default
Posted on Mon, 29 Apr 2013
Question: I'm 51 and diagnosed bipolar 2. went on 50mcg of levothyroxine about 4 years ago and it really leveled out my moods. I recently had my TSH level checked and it was .01. I went down to 25 mcg of levothyroxine and hypo mania started quickly so I resumed the 50 mcg. BUT, my heart rate has been 125-133 for the last three months, My BP two days ago was 116/68, heart rate was 125. My psych and my primary are arguing about the levothyroxine. I'm worried about my heart rate, but I also worry about lowering the levothyroxine and becoming hypo-manic again. Any suggestions?
doctor
Answered by Dr. Srikanth Reddy (18 minutes later)
Hello,
Thanks for choosing health care magic for posting your query.
Hypothyroidism does cause mood disturbances, but thyroxine is not a primary treatment for mood disorder. You should focus on your thyroid levels and physical problems with thyroxine and leave the mood problems to be taken care of with the help of other drugs. You physical problems are more important that you psych problems.
Secondly, I couldn't notice any front line mood stabilizer in your treatment protocol. You should ask your psychiatrist to consider adding valproate and quetiapine instead of focusing on thyroxine. If lamictal and keppra are not working they should be discontinued.
Also ask your treating psychiatrist to consider you for cognitive behavioural therapy.
Lastly regular exercise and good diet will go along way in helping you.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you can close the discussion and rate the answer accordingly.
In future if you wish to contact me directly, you can use the below mentioned link:
bit.ly/dr-srikanth-reddy

Wish you good health,
Dr. Srikanth Reddy M.D.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Srikanth Reddy (5 minutes later)
the lamictal is working well, a little too well at times. The keppra has just been added to try to help TD caused by geodon, discontinued in January, and sleep issues.
doctor
Answered by Dr. Srikanth Reddy (28 minutes later)
Thanks for the follow-up query,
You can still consider adding Valproate. Thyroid should be given with respect to your physical condition and TSH levels.
Mood fluctuations can be taken care of with other medications.
Sleep can be taken care of by Zolpidem.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you can close the discussion and rate the answer accordingly.
In future if you wish to contact me directly, you can use the below mentioned link:
bit.ly/dr-srikanth-reddy

Wish you good health,
Dr. Srikanth Reddy M.D.
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Srikanth Reddy

Psychiatrist

Practicing since :2007

Answered : 2770 Questions

premium_optimized

The User accepted the expert's answer

Share on

Get personalised answers from verified doctor in minutes across 80+ specialties

159 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
Diagnosed With Bipolar 2. On Levothyroxine. Will Lowering Levothyroxine Make Me Hypo-manic Again?

Hello,
Thanks for choosing health care magic for posting your query.
Hypothyroidism does cause mood disturbances, but thyroxine is not a primary treatment for mood disorder. You should focus on your thyroid levels and physical problems with thyroxine and leave the mood problems to be taken care of with the help of other drugs. You physical problems are more important that you psych problems.
Secondly, I couldn't notice any front line mood stabilizer in your treatment protocol. You should ask your psychiatrist to consider adding valproate and quetiapine instead of focusing on thyroxine. If lamictal and keppra are not working they should be discontinued.
Also ask your treating psychiatrist to consider you for cognitive behavioural therapy.
Lastly regular exercise and good diet will go along way in helping you.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you can close the discussion and rate the answer accordingly.
In future if you wish to contact me directly, you can use the below mentioned link:
bit.ly/dr-srikanth-reddy

Wish you good health,
Dr. Srikanth Reddy M.D.