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Lithium therapy and thyroid function: a long-term study.

J H Lazarus, R John, E H Bennie

    Psychological Medicine
    |February 1, 1981
    PubMed
    Summary
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    Lithium carbonate treatment can cause thyroid issues, including goiter and abnormal thyroid function tests. Antibody-mediated damage appears to be the primary cause of lithium-induced thyroid failure.

    Area of Science:

    • Endocrinology
    • Pharmacology
    • Immunology

    Background:

    • Lithium carbonate is a common mood stabilizer.
    • Long-term lithium use is associated with various side effects.
    • Thyroid dysfunction is a known complication of lithium therapy.

    Purpose of the Study:

    • To evaluate the clinical and biochemical thyroid function in patients on long-term lithium carbonate therapy.
    • To investigate the prevalence of thyroid abnormalities in this patient group.
    • To determine the likely mechanism of lithium-induced thyroid dysfunction.

    Main Methods:

    • Clinical examination of 73 patients receiving lithium carbonate for ≥6 months.
    • Biochemical assessment of thyroid function.
    • Measurement of thyroid auto-antibodies.

    Related Experiment Videos

  • Thyrotropin-releasing hormone (TRH) testing.

    • Main Results:

    • Goitre observed in 37% of patients.
    • Exophthalmos detected in 23%.
    • Positive thyroid auto-antibodies found in 24%.
    • Abnormal TRH tests in 49% of patients.
    • Thyroid failure appears linked to antibody-mediated damage.

    Conclusions:

    • Long-term lithium carbonate treatment is associated with significant thyroid dysfunction.
    • Antibody-mediated damage is the probable mechanism for lithium-induced thyroid failure.
    • A direct effect of lithium on the hypothalamic-pituitary axis is unlikely.