Relationship of Thyroid Disorder, Heart Disease and Bipolar Disorder
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Q:  Relationship of Thyroid Disorder, Heart Disease and Bipolar Disorder

I have read that heart disease is associated with bi polar disorders. every male member of my family history on my fathers side have died from heart disease as far back as i could trace. and as i read more about heart disease and bipolar i also found the common link of thyroid disorders. 

my question is have you seen this relationship between thyroid disorder, heart  disease, and bipolar disorders, in real life? could it just be the thyroid screwing everything up or does heart function and blood  flow have more to do with bipolar  (i.e. the use of calcium blockers, and exercise being helpful for bipolar)?

Dear Brian --

Part 1.
True: people with bipolar disorder have higher rates of heart attacks and other cardiac problems than those who do not. However, there are many possible reasons for this association. I am no expert in this area, but I don't think we have quite reached the point where we can presume that bipolar disorder itself is the cause of those higher rates.

For example, rates of cigarette smoking are also higher in patients with bipolar disorder than in the general population. Obviously, that could account for part of the increased cardiac risk. Similarly, rates of overweight and metabolic syndrome and high blood pressure, all of which raise cardiac risk, are also higher in people with bipolar disorder.

Moreover, depression has been strongly linked with heart disease risk, and teasing out the difference between the risks from depression in bipolar disorder from bipolar disorder itself will probably take a long time. 

Part 2.
Now, to get to your question about "real life".  For a psychiatrist in private practice, it would be very difficult to assess the connection between mood disorders and cardiac risk unless somehow we saw our patients falling over with heart problems all the time, which I can assure you is not the case. The connection with thyroid is similarly indirect: I don't see patients with obvious thyroid problems that would make heart disease risk higher. Mind you, there is a very interesting connection, I have tried to describe on a webpage on this issue, between
thyroid and bipolar disorder. But to my knowledge there is no statistical link between this combination and heart disease rates.

Dr. Phelps

Published March, 2008


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