>From: Nancy Dunham <[log in to unmask]>
>Well it has happened again (why am I not surprised). My lithium took my
>tsh
>from 2.5 (where I felt like I was hardly living after being .2 for so long)
Is there no alternative to lithium?
It does bad things to thyroid function, here's a good discussion -
http://psychiatrictimes.com/p020156.html
An increasing body of research supports the hypothesis that lithium alters
cellular responsiveness to thyroxine in addition to inducing significant
changes in the function of the thyroid gland.
Bolaris et al. (1995) documented altered binding of T3 in the CNS of rats,
implying that a state of cellular hypothyroidism developed.
In 1998, Lazarus listed impaired thyroidal uptake of iodine, impaired
iodination of tyrosine, altered thyroglobulin structure and impaired release
of thyroxine from the thyroid gland as the mechanisms by which lithium
induces hypothyroidism. Impaired release of thyroxine is considered the most
clinically significant, and this phenomenon has been used to enhance the
effectiveness of radioactive iodine when treating thyrotoxicosis (Bogazzi et
al., 1999).
Elevation of thyrotropin in response to lowered circulating thyroxine is
probably the main stimulant for goiter formation, which has been reported
with incidences of 3% to 60% in lithium-treated patients; much of this
variation is related to varying definitions of goiter and differences in the
methods used to measure thyroid size (Lazarus, 1998).
Thyroxine is secreted as T4 and then metabolized to its active form, T3, by
the enzyme 5'deiodinase. Lithium appears to impair the process of
deiodination of T4 peripherally (deiodinase I) and within some cells
(deiodinase III) (Terao et al., 1995). Eravci et al. (2000) found varying
effects of lithium on different isoenzymes of deiodinase and noted that it
appeared to enhance the activity of deiodinase II present in rat frontal
lobes. This effect may contribute to alterations in cellular responsiveness
to thyroxine.
************************
So, it elevates TSH (which frequently causes a goiter), causes trouble for
the thyroid in producing thyroid hormone, causes the cells not to be
responsive to thyroid hormone at all, both T4 and T3, and causes problems
for T3 in the cells also.
I would assume the doctor is taking T4 and T3 levels.
Obviously, an alternative would be better if one exists.
It's likely one cause of Bipolar is hypothyroidism.
With its effect on the thyroid, does the drug actually make your life
better?
Skipper
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