Effect of Lithium on Thyroid in Man

Villeneuve, A; Gautier, J.-F.; A, Jus; Perron, Du

doi:10.1016/s0140-6736(73)92101-6

Cited by 23 publications

(6 citation statements)

References 5 publications

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“…Crowe et al [1973] suggested that lithium might induce two types of hypothyroidism, one with thyroiditis, one without. Our results may sup port this hypothesis; lithium acts directly on the thyroid gland, causing an impairment of hormone production and/or release in most patients, whereas a minority of patients, females as a rule [Villeneuve et al, 1974], develop antithyroid antibodies and thyroiditis. However, high levels of antithyroid antibodies can be seen without clinical evidence of hypothyroidism, and hypothyroidism occurs without antithyroid antibodies [Deniker et al, 1978], so the significance of antithyroid antibodies seems uncertain.…”

Section: Discussionsupporting

confidence: 55%

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Lithium Therapy and Thyroid Function Tests

et al. 1984

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Thyroid function tests including thyroxine (T₄), T₃ test, thyroid-stimulating hormone (TSH), free T4 index and antithyroid antibodies were studied in 51 patients before the start of long-term lithium therapy and after 4 and 12 months on lithium. After 4 months on lithium, changes occurred in all laboratory parameters – T4 and T3 test levels decreased and TSH increased. After 12 months T₄ and T₃ test increased to pretreatment levels and TSH remained higher than before the start of lithium. During 1 year of lithium treatment only 1 patient developed clinical signs of hypothyroidism and started levo-thyroxine substitution therapy.

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Section: Discussionsupporting

confidence: 55%

“…They found a significant increase in TSH but no significant change in T4 concentration 3, 6 and 12 months after starting lithium therapy. Villeneuve et al [1974] reported on the thyroid function in 149 patients, but they did not measure TSH. They found hypothyroid ism in 14.7% of the patients treated with lithium from 16 to 152 weeks.…”

Section: Introductionmentioning

confidence: 99%

Lithium Therapy and Thyroid Function Tests

et al. 1984

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“…A similar iendency towards over-representaiion of hypothyroidism in female patients was been noted during the initial phase of treatment (Fyrö et al 1973;Villeneuve et al 1973) and in two groups of case reports representing altogefher 26 female and 4 male cases of hypoihyroidism (Crowe et al 1973;Lindstedt et al 1973). These 56 females accounted for 19 cases of hypothy¬ roidism, while just one case occurred in the remaining 30 patienis (P < 0.001).…”

supporting

confidence: 61%

“…Lithium leads to an increased uptake of iodine within the thyroid (Schou et al 1968;Sedwall et al 1968;Cooper 8c Simpson 1969); it decreases the release of hormone from the gland (Spaulding et al 1972) and is also believed to decrease peripheral deiodination of thyroxine (Wolff 1974). During the first 1 to 3 months of treatment, thyroid function decreases, preferentially in females (Fyrö et al 1973;Emerson et al 1973;Villeneuve et al 1973). Most subjects, however, escape from this general action, while some remain hypothyroid as long as treatment is continued (Emerson et al 1973;Fyrö et al 1973).…”

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confidence: 99%

Endocrine Effects of Lithium

Transbøl

Christiansen

Baastrup

1978

Acta Endocrinologica

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The purpose of this study was to evaluate the prevalence of hypothyroidism in a sample of lithium-treated manic-depressive outpatients who had been under treatment for several years. The sample included 86 patients, 70 females and 16 males, who had been treated for an average of 80 months. One-hundred-and-five blood donors, 58 females and 47 males, aged from 21 to 70 years, served as a reference population for the determinations of serum triiodothyronine (T3), thyroxine (T4), triiodothyronine-resin uptake (T3RU), the free T3 and T4 indices (FT3I and FT4I) and thyroid-stimulating hormone (TSH).Raised TSH levels occurred in 20 patients (23 %), all females, and all but one being over the age of 40 years. This prevalence of 19 cases of hypothyroidism among 56 females over 40 years of age (34 %) contrasted sharply with one single case in the remaining 30 patients (P < 0.001). Highly significant reductions (P < 0.001) of FT3I3I and FT4I were observed in the 20 patients with raised TSH levels, in whom log TSH also correlated very closely with FT3I and FT4I (r=\m=-\0.73and \m=-\0.86,respectively, P <0. 001). The remaining patients had average normal values of T4, FT4I and TSH, but slightly depressed levels of T3 (P < 0.05) and FT3I (P <0.01), possibly reflecting decreased peripheral deiodination of thyroxine.Our data suggest, that cases of hypothyroidism continue to appear as treatment continues. Determination of TSH is recommended at 6 to 12 months intervals in manic-depressive patients undergoing long-term lithium therapy. 759

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“…For instance, lithiumtreated patients show increased prevalences of goitre (1)(2)(3)(4) and, to a lower extent, increased incidences of clinical hypothyroidism (5,6). Thyroid function tests are modified in lithium-treated patients and volunteers within a few months of treatment (7)(8)(9)(10).…”

mentioning

confidence: 99%

Thyroid abnormalities during lithium treatment

Bocchetta

Bernardi

Pedditzi

et al. 1991

Acta Psychiatr Scand

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Thyroid function was evaluated in 150 Sardinian outpatients at different stages of lithium treatment. A visible and/or palpable goitre was found in 51% of patients, and there was no apparent correlation with the duration of treatment. No cases of symptomatic hypothyroidism were observed, but subclinical hypothyroidism was present in 19% of patients. The prevalence of specific antithyroid antibodies was positively correlated with age and duration of lithium treatment, and was higher in women. Subclinical hypothyroidism was observed in 53% of antibody-positive lithium-treated patients. Carbamazepine in combination with lithium was associated with significantly lower levels of total T4 and T3 than with lithium alone, and the ratios between total and free hormones were also decreased.

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Effect of Lithium on Thyroid in Man

Cited by 23 publications

References 5 publications

Lithium Therapy and Thyroid Function Tests

Lithium Therapy and Thyroid Function Tests

Endocrine Effects of Lithium

Thyroid abnormalities during lithium treatment

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