Q:  Relationship of CFS, Thyroid and Bipolar Disorder

I have been diagnosed with Chronic Fatigue Syndrome recently and hypothyroidism about 5 years ago but have recorded borderline TSH for several years. CFS is thought to have been present for c last 10 yrs. Blood analysis shows auto-immune dysfunction with damaged cells (bottle & lemon shaped not circular) with dysbiosis and high sugar. I'm following a nutritional programme with B vits, mag malate etc to alleviate joint pain etc. Suspected BP. What evidence is there of these interrelationships and where can I find current research to help improve - very little available in UK / NHS. No longer on anti-dep's just thyroxine. Excessive weight gain with lower swollen limbs & light/noise/sensory sensitivity currently. Is it truly all down to nutrition and do I need a comprehensive food ( and other ) allergy test ? Lactose intolerant now.

Many thanks

Angela   21/07/2001

Dear Angela -- 
As it happens, I was just yesterday trying to write up my experience with how thyroid stories and bipolar stories seem to link up.  As I surfed around for additional resources, I came upon some UK folk involved in some intense beliefs that thyroid problems are the basis for CFS.  Now, I'm sure not all people with bipolar disorder have thyroid problems; and I'm sure not all people with CFS symptoms have thyroid problems; but even before reading some of their stuff, I was pretty sure that a few people with CFS had something pretty close to the "bipolar" stuff  I've been trying to treat (e.g. that the profound fatigue bears great resemblance to the leaden, energy-less state people with bipolar disorder get in the classic depressed phase). 

But just lately some of this speculation has taken a finer point: I've been seeing some of my patients with "bipolar disorder" get better, sometimes a lot better, on a thyroid medication.  Not just thyroxine ("T4"), which I've tried as a bipolar treatment with very limited (practically no) success.  And not just Cytomel ("T3"), which you may have heard of -- another form of thyroid hormone, which I've also tried with limited (though somewhat more) success.   When I tried the two together, something completely different seemed to happen:  they act like a "mood stabilizer", like lithium and Depakote and the lot.   This combined approach is not my idea; there is some growing interest in it. 

I'll be posting a whole section on this subject on my website within a week or two, if you'll have a look there. Look under the "bipolar" heading, amongst the new updates, for "thyroid".  Give me another two weeks, but if it stays cloudy here, maybe even today! (That's how we live, in Oregon).   I think you're onto something, and I hope find a treatment approach coming out of it (be cautious, though; there are people out there, well-meaning too, who will take your symptoms and weave a tale and in the end want to sell you something: vitamins, a book, a treatment).  Good luck to you. 

Dr. Phelps

Published August, 2001