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Association between lithium use and thyrotoxicosis caused by silent thyroiditis.

K K Miller1, G H Daniels

  • 1Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.

Clinical Endocrinology
|October 27, 2001
PubMed
Summary

Lithium use is associated with a higher incidence of silent thyroiditis and thyrotoxicosis. This study found increased odds of lithium exposure in patients with silent thyroiditis, suggesting a potential link.

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Area of Science:

  • Endocrinology
  • Pharmacology
  • Thyroidology

Background:

  • Lithium is a common treatment for bipolar disorder.
  • Thyroid dysfunction is a known side effect of lithium therapy.
  • Silent thyroiditis and thyrotoxicosis are thyroid conditions that can occur with lithium use.

Purpose of the Study:

  • To determine the incidence of silent thyroiditis in lithium users.
  • To characterize lithium-associated thyrotoxicosis.

Main Methods:

  • Retrospective record review of 400 patients undergoing radioiodine scanning.
  • Comparison of lithium exposure odds between patients with silent thyroiditis and Graves' disease.

Main Results:

  • Patients with silent thyroiditis had a 4.7-fold increased odds of lithium exposure compared to Graves' disease patients.

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  • Lithium-associated silent thyroiditis incidence: ~1.3 cases/1000 person-years.
  • Lithium-associated thyrotoxicosis incidence: ~2.7 cases/1000 person-years, higher than general population rates.

    • Conclusions:

    • Thyrotoxicosis caused by silent thyroiditis may be associated with lithium use.
    • Lithium therapy may increase the risk of developing silent thyroiditis and subsequent thyrotoxicosis.