Q. I am seeking information about the connection between thyroid problems and BPD. In very brief terms, I have been on and off thyroid medication of varying strengths for a couple of years. The doctors do not seem to be able to regulate my thyroid problems. According to the doctors the levels are normal but stand on the opposite extremes of normal–one high the other low. I have read that people with BPD may have to take medication even though their thyroid levels are normal.
Question 1: Is this true?
A. Yes, it’s called “non primary hypothyroidism” – also “secondary” or “tertiary” hypothyroidism.
Q. Question 2: Could the above pattern of thyroid medication mimic the symptoms of BPD or might they be a product of BPD?
A. Sounds much more like the BPD than thyroid problems. It’s extremely common for borderlines (and others with complicated problems) to want easy answers. Thyroid alone is rarely that significant, although being over or undertreated complicates the BPD significantly.
Q. Question 3: Will medication for BPD affect thyroid medication (i.e., may the regulation of thyroid levels become more stable)?
A. Only tegretol will have any significant effect, either falsely lowering blood levels or causing a true low thyroid condition.
Q. Question 4: If medication for BPD can affect thyroid levels can you possibly give me some guidance regarding the kinds of treatment issues I should discuss with my Primary Care Physician? For example: should I tell him about the BPD of my psychologist and what medication should I discuss with him? Thank you for your time.
A. Regarding the tegretol, get a baseline level. Document in writing all your low thyroid symptoms. If taking tegretol and your symptoms recur, have them in writing for your physician so if the thyroid blood level drops the physician can adjust the dose. Dr. Cowdry at NIMH did a study on tegretol and the BPD approximately 10 years ago, showing some borderlines develop “melancholia” after taking tegretol for an extended time. In my experience most of that is due to hypothyroidism or some comorbidity that’s either undertreated or untreated.
Yes, your physician needs to know all your medical diagnoses – and the BPD is a medical problem. Show your physicians a few key pages from this website.
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