I was Misdiagnosed as having Bipolar Disorder When I really had Hashimoto’s Disease

by integrativethyroid

Parents, I urge you to please read this post. The connection between depression, bipolar disorder and thyroid cycling is  commonly confused.

After about fifty minutes of hearing my father and mother recount the sordid details of my early high school years alongside a few antidotes from my brother, the sought after psychiatrist it took months to get an appointment with said “I think she has mild bipolar disorder”. I wondered if bipolar disorder could even be mild? What teenager doesn’t have mild bipolar disorder? What shocked me more was not the diagnosis itself but the quickness to render a diagnosis despite my barely being allowed to speak. Not even five minutes of one on one time. I was seventeen years old.

I looked at my brother, his brows were furrowed. At the time he was a medical student at the prestigious College of Physicians and Surgeons at Columbia University Medical School. I hoped his ivy league conventional medicine training might better interpret the diagnosis. Little did I know that he nor this psychiatrist were ever taught anything about nutrition and mental health. They weren’t taught about nutrition and any health apart from that sugar leads to diabetes and don’t eat red meat if you have high cholesterol. But forget the schooling, he had an assessment tool more powerful than this so called expert psychiatrist. He knew me. We grew up together. And he knew I wasn’t bipolar.

Why were we sitting in the Psychiatrist’s Office?

So what prompted this so called expert to negligently blurt out an incorrect assessment after less than an hour? I say negligently because imagine what would have happened if my family had listened to her. Maybe I would have been put on Lithium!. Ok back to the story. Why were we in this psychiatrist’s office in the first place? I had been cutting school. A lot of school, like whole semesters of high school.

I was enrolled at the Bronx High School of Science in New York City. You had to take a placement test in eighth grade to get in. My brother went to that school. It graduates many students who go on to attend ivy league and other prestigious universities, become Nobel Prize winners, famous producers, astrophysicists, CEOs of major tech companies, you get the drift. I was an honors student in every grade in elementary and junior high school, usually in the top 3 of my magnet classes. If I got a 95 on an exam, my father wanted to know where the other 5 points were. I also ate a ton of junk food, sat religiously in front of the TV for hours everyday and was overweight.

My skipping school caused real upheaval in our education focused family. No one understood why. I came home one day to find my room ransacked. They were searching for drugs. All they found were cigarettes. My blood was drawn. No drugs in my system. I hadn’t even tried pot by that time. They needed an answer. I probably did too.

It’s Important to Notice Trends in Your Child’s Behavior

What made a straight A and intelligent kid give up all of a sudden? It would take me ten years to figure out that a lot of it had to do with my father’s authoritative parenting style and a perfectionist personality (mine). It would take me twenty years to figure out the other missing link was my not so well functioning thyroid.  I remember having on and off brain fog with very little ability to focus after the age of fifteen. I, without a doubt, also suffered from nutrient deficiencies.

bipolar disorder and hashimoto's disease

How Thyroid Cycling can Lead to a Misdiagnosis of Bipolar Disorder

I shot up a few inches the summer before 9th grade and traded my Steve Urkel glasses for contact lenses. About 15-20 lbs flew off the scale without doing much. I had no idea at the time but that was probably the start of my thyroid cycling. I started hanging out with kids who smoked cigarettes and then I became a kid who smoked cigarettes. That horrible habit followed me for twenty years and inevitably screwed my thyroid even more.

What is Thyroid Cycling

Thyroid cycling is when you cycle between a hyperthyroid state and a hypothyroid one. The hyperthyroid state is marked by weight loss, restlessness, sleeplessness, agitation, increased perspiration. The hypothyroid state is the opposite…. weight gain feeling cold, sluggishness, extreme fatigue. Do you see why this could be diagnosed as bipolar disorder? It’s almost like cycling through manic and depressive states.

Integrative Thyroid

I later found out that smoking, the countless rounds of antibiotics administered to me by the family pediatrician for nothing more than a common cold, the junk food I ate as a kid, probably a C-section birth too all set me up for the perfect autoimmune storm. It wasn’t until the emotional devastation from the loss of my mother to Stage 4 ovarian cancer in my early 20s did I realize I had actual autoimmune disease. An enormous perfectly circular bald patch appeared on the right side of my head. It is known as alopecia arreata, an autoimmune disease where your body attacks the hair follicles on your body.

My grades were all over the place at Bronx Science. Sometimes I would come home with an A. Other times, my Dad would find the mailbox filled with truancy notices from the dean. A lot of times I would sleep for hours and hours on the weekend, other times I would barely get five hours of sleep before heading to school. In hindsight, I could see why maybe that psychiatrist’s first instinct was bipolar disorder.  But even now I think there wasn’t enough to warrant it in my opinion. That is a separate topic for later.

Between my junior and senior year, I put on 70 lbs. I was about 5’9 and went from 140 lbs to 210 lbs in a matter of months. I started developing weird symptoms like social paranoia. My hair was also thinning. My Mom finally took me to an endocrinologist.

Enter The Endocrinologist

Ah, the endocrinologist… the so called expert of the endocrine system which houses the almighty thyroid. He ordered the standard blood tests – TSH and hormone levels but of course, not a full thyroid panel.  All came back normal. He then performed a thyroid ultrasound. A thyroid ultrasound revealed I had a small nodule on my thyroid. Next step: He performed an in office procedure called a needle biopsy. Tissue came back benign for cancer cells. Next diagnosis: Polycystic Ovarian Syndrome (PCOS) Next step: Let’s put her on birth control. I stayed on birth control for two months. I was not even 18 and I certainly wasn’t having sex with anyone. The pills did not sit well. My mother decided to take me off them.  We didn’t go back to another endocrinologist after that.

Unfortunately many women with heavy menstrual cycles due to PCOS get prescribed birth control pills. This does not in any way address the underlying root cause of PCOS or any hormone imbalance. In fact, birth control contains synthetic estrogen. More on that below.

A year later 60 of those pounds flew off without doing much. What was happening?

The Link Between Thyroid Cycling, Estrogen Dominance and Insulin Resistance

How does thyroid cycling start? Why? There are a couple of culprits that science has demonstrated a connection with. One is insulin resistance. Another is estrogen dominance. In my non medical opinion, it’s both. I do not react well to carbohydrates. I never did. It is very possible that the diabetes that runs on both sides of my parents’ immediate families has a lot to do with it. Whenever I ate rice or potatoes as a kid, I was sluggish, foggy and very moody. It still happens to me today. I’m 40 years old and my blood sugar is in the low 80 range, which is fine, but I keep a tight check on it with a mostly paleo/whole30 lifestyle.

Estrogen is very tricky. Excess estrogen has been found to increase inflammatory responses and potentially make you more susceptible to developing autoimmune diseases. Testing for estrogen alone does not give a full picture because it’s important to understand the ratio/relationship to progesterone. Your estrogen levels can be normal but progesterone low… which could still cause the same responses. On top of that, excess estrogen has a tendency to get stored in the tissue and a blood test may not reveal true levels in the body.

Estrogen Dominance, Hashimoto’s disease, Bipolar Disease and Thyroid Cycling

Excess estrogen blocks the thyroid from releasing thyroid hormone. So you start to experience hypothyroid symptoms because your body is not actually getting to use thyroid hormone. The hormone then literally builds up in the thyroid, producing goiters, nodules and even tumors. Once the thyroid has no more capacity to hold the built up hormone, it releases it quickly. This is what causes hyperthyroid symptoms… too much thyroid hormone in the system. This vicious up and down is what leads to thyroid cycling. And we now see how thyroid cycling can contribute to misdiagnoses of mental health disorders, including depression and bipolar disorder.

Prolonged exposure to excess estrogen can also increase TPO antibodies, leading to Hashimoto’s disease. This is probably why women have a 20x higher incidence of Hashimoto’s disease than men. The fluctuation of estrogen and progesterone, especially in puberty, post pregnancy and in pre menopause, is much more prevalent in females. You can read more about it here and here.

What Can You do to Lower Estrogen Dominance?

  • Get rid of Estrogen Mimickers and Endocrine Disruptors

    1. Switch from plastic to glass or steel.  Tupperware, water bottles even food packaging should be free from plastic. BPA is a serious hormone disruptor and has been linked to early puberty in girls and infertility
    2. Lotions, shampoos, cosmetics are safer for you when free from Parabens and phthalates! Your skin is the largest organ in your body, it absorbs everything. Women are much more susceptible to the endocrine disruptors of the unregulated beauty and cosmetics market because we simply use more of these products
 A Name I trust in clean beauty products is True Botanicals.

I am a member of their affiliate program

3. Teflon must go. Non stick cookware (pans, baking trays, etc) coated with teflon is dangerous to your thyroid. It contains fluoride which is a known endocrine disruptor. Toothpaste should be free from fluoride and I highly recommend getting a filter that removes fluoride from your water

4. Rethink birth control pills. The pill, in my non medical opinion, is one of the biggest disservices to a woman’s hormonal balance and overall health

  • Detox  Your Liver

    Your liver is responsible for detoxing your body from excess estrogen. You do not want to inhibit this process so liver health is highly critical. The liver is also responsible for converting thyroid hormone into its active form. I know this is a bummer but reconsider alcohol consumption, at least for a period of time. Read more about Alcohol and Your Thyroid. The other things you can do to optimize your liver are:

    1. Take milk thistle. Milk thistle is a natural herb that has been scientifically shown to improve liver function
    2. Dandelion root tea can also be helpful for improving liver function

bipolar disorder and thyroid cycling

  • Supplements

Apart from milk thistle and dandelion root for liver support, I take Vitamin E which helps to limit the inflammation estrogen causes as well as reduce the response your cells have to excess estrogen. I also recommend keeping on top of your Vitamin D levels. Vitamin D deficiency is linked to disease and cancer. Only supplement if you are deficient.

  • Keep a Healthy Weight

Excess fat on your body is anabolic, it produces its own hormones like estrogen and has the ability to convert testosterone into more estrogen. Weird and scary.

  • Destress

Stress lowers progesterone levels in your body. This can lead to estrogen dominance even if your estrogen levels are normal. Again, the balance between estrogen and progesterone is very important.

  • Eat hormone free meat and increase your veggie intake

The hormones found in conventional meat and dairy are guess what? Estrogen mimickers. Ensure that you are sourcing hormone free food. Cruciferous vegetables like broccoli, cauliflower, brussels sprouts and kale are known to block estrogen production, are filled with amazing nutrients and help gut health. Just make sure they are fully cooked as some believe raw cruciferous vegetables interfere with iodine transport. Some will say to completely avoid cruciferous vegetables if you have thyroid disease but I don’t advise that.


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