Surgery-Trigger for Autoimmune Change?
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Q:  Surgery a Trigger for an Autoimmune Change?

My child had her tonsils out 10/01, shortly there after her asthma meds., Ritalin and Buspar stopped working. By 2/02 she was diagnosed Bipolar. She is now on her 7th med for Bipolar w/o success. She continues to have "rare" side effetcs making med changes necessary. Could a surgery cause some strange auto immune disorder? We have a family history of thyroid problems but her blood work so far has always come back normal. Do we need to look in some direction not yet thought of? We just want her to be healthy and to have Bipolar meds work for her if that is what she needs. Thank you for your ideas.

Dear Mr. or Ms. G' 
I've not heard of surgery as a trigger of some particular process such as an autoimmune change.  However, it's well known that stress can trigger bipolar symptoms, and we could assume that this surgery was at least somewhat of a physiologic stress at least.  Beyond that I'm afraid I can't help you understand this onset. 

The family history you describe, however, does bring to mind the use of thyroid hormone as a mood stabilizer.  I have one patient with bipolar-like symptoms who has had her symptoms controlled for quite a while on thyroid alone; and several more who've improved as never before when thyroid was added.  If you haven't seen it already, read my website section on thyroid and bipolar disorder.  I just revised it today to include a caution, which I'd emphasize for your daughter given her history so far, but this is material you should know about at least.  Good luck to you and your daughter, trying to figure this out and find effective treatments. 

Dr. Phelps

Published October, 2002


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