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Lithium, thyroid function and antithyroid antibodies.

M C Leroy1, A Villeneuve, C Lajeunesse

  • 1Dept. of Psychiatry, Faculty of Medicine, Laval University, Quebec, Canada.

Progress in Neuro-Psychopharmacology & Biological Psychiatry
|January 1, 1988
PubMed
Summary
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Lithium treatment can lead to hypothyroidism, potentially involving autoimmune mechanisms. This study monitored psychiatric patients on lithium, revealing thyroid dysfunction and antibody presence during treatment.

Area of Science:

  • Endocrinology
  • Psychiatry
  • Immunology

Background:

  • Lithium is a common psychiatric medication with known effects on thyroid function.
  • Thyroid dysfunction associated with lithium can range from subclinical to overt hypothyroidism.
  • An autoimmune mechanism may contribute to lithium-induced thyroid dysfunction.

Purpose of the Study:

  • To investigate the role of the autoimmune system in hypothyroidism and thyroiditis development during lithium therapy.
  • To monitor thyroid function and antibody status in psychiatric patients undergoing long-term lithium treatment.

Main Methods:

  • Sixty psychiatric patients on lithium for over 6 months were enrolled.
  • Thyroid function tests and antithyroid antibody assessments were conducted over a one-year period.

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  • Patients were monitored for clinical and biological signs of hypothyroidism and thyroiditis.

    • Main Results:

    • At baseline, 16 patients had biological hypothyroidism, with 4 showing mild symptoms.
    • Initially, 20% of patients had antithyroid antibodies (antimicrosomal and/or antithyroglobulin).
    • During the study, one additional patient developed antimicrosomal antibodies; all patients with antithyroglobulin antibodies also had antimicrosomal antibodies.

    Conclusions:

    • Lithium therapy is associated with thyroid dysfunction, including hypothyroidism.
    • The presence of antithyroid antibodies suggests an autoimmune component in lithium-induced thyroid issues.
    • Long-term monitoring is crucial for detecting thyroid complications in patients treated with lithium.